Answers

Replied on 10/15/2009

By: Laser Lipo and Vein Center  |  Thomas Wright M.D. F.A.C.P.
St. Peters, MO

Ambulatory phlebectomy is less invasive than a transilluminated phlebectomy. The latter uses a light source to visualize the location of the veins. The former is usually done as an adjunct to an ablation.

Replied on 10/9/2009

By: Novi Vein  |  Jeffrey H. Miller, M.D.
Novi, MI

There is no advantage of transilluminated powered phlebectomy compared to ambulatory phlebectomy. Ambulatory phlebectomy is usually done in an office setting with excellent results, while the transilluminated powered phlebectomy in an OR.

Replied on 10/8/2009

By: General Vascular Surgery Group  |  Michael D. Ingegno, M.D.
San Leandro, CA

I have no experience with transilluminated powered phlebectomy, and
have been able to do all of my procedures with ambulatory (or Micro)
phlebectomy. These procedures are used for removal of the more
prominent varicose veins usually seen on the surface lower in the leg.

Replied on 10/8/2009

By: The Vein Treatment Center of NJ  |  Dean H. Wasserman, MD, FACS, RVT, FACPh
Paramus, NJ

Dear Patient,
Both of the vein removal procedures you question remove varicose
veins.
The differences can be described in two fashions, the technique
and the applications.
The technique of Ambulatory Phlebectomy (essentially
microphlebectomy ) is making small 1-2mm (millimeter) incisions along
the course of the varicosed vein, and teasing out segments between
incisions. Transilluminated Powered Phlebectomy involves an incision to
introduce a light source to highlight veins, and a cutting revolving
powered instrument to sever and pull together the varicose veins for
extraction. The second method evolved from a similar orthopedic
instrument used to cut up and removed torn knee cartilages.
The application for Ambulatory Phlebectomy is ideal for well
defined varicose veins and varicose branches under local anesthesia
emphasizing gentle tissue manipulation. Powered Phlebectomy may be
applied to clusters of varicosities and is generally more traumatic
requiring further anesthesia .

Replied on 10/8/2009

By: The Jacksonville Vein Center  |  Geoffrey L. Risley, M.D., F.A.C.S.
Alfred D. Harding, Jr., M.D., F.A.C.S.
Jacksonville, FL

Powered phlebectomy uses fewer incisions, but requires general anesthetic in an outpatient OR setting and a more painful recovery, but can be performed in a shorter period of time.
Ambulatory phlebectomy is done under local anesthesia in the office through multiple very small incisions. There is less post-operative discomfort, but more incisions. However, the incisions will be almost invisible when fully healed.

Replied on 10/8/2009

By: Vein and Laser Specialist  |  Edward G. Mackay, M.D.
St. Petersburg, FL

The powered phlebectomy using a sort of rotor rooter machine hence the
word power. Ambulatory phlebectomy just uses some surgical tools
through very small incisions nothing powered. I personally am not a big
fan of the powered one, though my experience is limited.

Replied on 10/8/2009

By: VeinSolutions - Minneapolis  |  Christopher F. Roland, M.D., F.A.C.S.
William R. Omlie, M.D., F.A.C.S.
Timothy Jon Gavin, M.D., F.A.C.S.
C. Phifer Nicholson, M.D., F.A.C.S.
Howard L. Saylor III, M.D., F.A.C.S.
Edina, MN

Ultimately, both of these procedures are very similar and achieve the
same goal (removal of varicose veins). We do ambulatory phlebectomy in
our clinic. The main difference between the two is that transilluminated
phlebectomy utilizes a special light to better visualize the varicose
vein beneath the skin. This theoretically reduces the number of
incisions that need to be made. Keep in mind that with ambulatory
phlebectomy, the incisions are small enough that they do not require
stitches anyways.

Replied on 10/8/2009

By: Makris MD Interventional Radiology Center  |  Angelo N. Makris, M.D.
Oak Brook, IL

Ambulatory phlebectomy is less invasive than a transilluminated
phlebectomy. The latter uses a light source to visualize the location
of the veins. The former is usually done as an adjunct to an ablation.

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