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What is the difference between ambulatory phlebectomy and transilluminated powered phlebectomy? What would each be used for?
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.
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
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.
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.
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.
Ambulatory phlebectomy consists of making small (2 to 3 mm) holes to remove the varicose veins. It is done under local and tumescent anesthesia. Transilluminated powered phlebectomy consists of using a powered device to disconnect and essentially suction out the varicose veins. In my experience, microphlebectomies (ambulatory phlebectomy) is the better of the procedures, with less discomfort and downtime than the powered phlebectomy.
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.