home –› varicose vein surgery
Pre-surgical Evaluation
It is important to recognize that bulging surface varicose
veins are often due to underlying problem veins. In order to get better
results, these underlying veins should be treated, in addition to treatment
of the surface veins. In the case of bulging surface veins, most physicians
use duplex ultrasound to evaluate the underlying veins of the leg prior
to developing a treatment plan.
Ambulatory Phlebectomy
Ambulatory phlebectomy is a method of removing varicose veins on the surface
of the legs. It is done in the office under local anesthesia. This
procedure involves making tiny punctures or incisions through which
the varicose veins are removed. The incisions are so small no stitches
are required. Veins are very collapsible such that even large veins
may be removed through the tiny incisions used in this technique.
The patient is able to walk following the procedure.
After treatment, a compression bandage and/or
compression stocking are worn. Your physician will advice you
how long to wear any bandages or hose. Many physicians recommend
that you walk or bike after treatment. This reduces pressure
in the veins, increases the flow in the veins and reduces the
risk of forming a blood clot.
Transilluminated Powered Phlebectomy (TIPP)
Transilluminated
Powered Phlebectomy (TIPP) is a minimally invasive procedure
for removing varicose veins that is performed using the TriVex®
System.
Transillumination is a unique feature - much like a flashlight
placed under the skin - that allows a surgeon to see, accurately
target and remove varicose veins, then visually confirm the extraction.
Traditional varicose vein surgery is considered a "blind
procedure," meaning that surgeon cannot see the vein or
confirm removal.
The procedure in performed in an operating room under a light
anesthetic. The surgeon works through two small incisions in
a darkened room.
The
tumescent canula illuminator is placed under the varicose
vein. The cool xenon fiberoptic light allows the surgeon
to see the varicose veins easily through the skin. Tumescent
fluid, similar to that used in liposuction, is infused
under the skin, loosening the vein from the surrounding
tissue and providing local anesthesia.
A second instrument, the vein remover, is then guided to the
veins using the TCI light. The vein is suctioned into a small
hole at the tip of the vein remover and a protected blade cuts
the vein into small pieces that can be suctioned out of the body.
The procedure can be performed in about 30 minutes. The small
incisions do not require stitches. With the large volume of local
anesthetic used, most patients wake up without any pain and go
home in about one hour. Normal activity is encouraged immediately
and most patients return to work in 2–3 days.
Vein Ligation
Ligation historically has been used in an attempt
to treat both bulging varicose veins and underlying veins. During
this type of vein surgery, incisions are made over the problem
vein and the vein is tied off. This is done in order to cut off
the flow of blood to the varicose vein, which in turn causes
it to become less visible.
Many physicians do not recommend this technique
for most veins because the recurrence rate of varicose veins
is very high. It is important to remember that bulging surface
varicose veins are often due to underlying problem veins. These
underlying veins should be treated, in addition to treatment
of the surface veins, in order to get the best results.
Vein Stripping
Vein stripping involves tying off of the upper
end of a problem vein and then removing the vein. Vein stripping
is performed in an operating room. The patient is usually under
general anesthesia. Approximately 150,000 such surgeries are
performed each year in the U.S.
Modern alternatives to vein stripping include endovenous
laser treatment, radiofrequency
occlusion and ultrasound-guided
sclerotherapy. These techniques are done in-office under
local anesthesia.
