LAWRENCE ILLUMINATES THE WAY FOR PHLEBOLOGY’S FUTURE

Peter Lawrence, M.D., is fine-tuning what he believes is a significant discovery in the treatment of venous disease. Lawrence, who serves as chief of vascular surgery at the University of California at Los Angeles has learned through clinical studies how to treat varicose veins with a new procedure called Light-Assisted Stab Phlebectomy (LASP).

His study, which first appeared in the October 2007 issue-of the journal, The American Surgeon, relied on more than 250 patients who underwent the procedure to remove branch varicose veins from the thighs, calves and ankles. The technique combines powered phlebectomy and stab phlebotomy along with transilllumination. For the latter, a light source is placed beneath the skin to aid in highlighting the veins during the procedure.

The patient is sedated prior to treatment, but remains conscious during the LASP procedure, Dr. Lawrence said. A tiny incision is made near the varicose veins. A slender tube with a light source at its tip is then threaded underneath the vein cluster. To provide further anesthetic and to make the veins readily visible, a mixture of saline, lidocaine and epinephrine is infused into the area. With the operating room lights turned off, Dr. Lawrence can now see the veins illuminated under the skin.

“This is one of the first times that transillumination is used during the actual vein-removal procedure, which offers maximum visibility for the surgeon,” Dr. Lawrence said. “Usually the veins are mapped before the procedure, which is not as effective.”

Lawrence said the procedure may provide lower residual varicose vein occurrence due to the greater ease in identifying the veins in the operating room through transillumination. The next step is a larger study and longer follow-up with patients, he added.

Dr. Lawrence is the director of the Gonda (Goldschmied) Vascular Center at the David Geffen School of Medicine at UCLA.