Transilluminated powered phlebectomy is a varicose vein removal procedure and is an alternative to stab phlebectomy, also knows as ambulatory phlebectomy. Your vein specialists inserts a light under your skin to see your varicose veins clearly, and then removes them using a slim tube that cuts and suctions away the varicose veins.
Although less invasive methods of treating varicose veins are more common today, some vein conditions are better treated with transilluminated powered phlebectomy. This includes people who have large varicose veins or complications of varicose veins, such as bleeding or ulcers.
What is transilluminated powered phlebectomy?
Phlebectomy is the surgical removal of all or part of a varicose vein through small cuts (incisions) in the skin. With ambulatory phlebectomy, several incisions are needed.
Transilluminated powered phlebectomy uses a device that has a long, narrow tube with a rotating blade at the tip. The blade cuts the varicose vein into small pieces, which are then sucked into the tube and destroyed.
A light source is also placed beneath the skin to light up the veins through the tissue (transilluminated). This helps your doctor see the varicose veins more clearly.
How is transilluminated powered phlebectomy performed?
Before the procedure, your doctor will map and mark the veins that are of concern to you. This may include using an IR imaging device to help find those veins.
TIPP can be performed as an outpatient procedure under local or general anesthesia. You may also be given a sedative to help you stay calm throughout the procedure.
The anesthesia is injected into the tissue along the length of the vein to be treated (tumescent anesthesia). This numbs and firms up the area, which reduces pain and makes it easier for your doctor to remove the vein.
A light source is then placed into the tissue beneath the skin through a cut in the skin. This will help your doctor see the veins more clearly.
The tube with the blade is inserted through a second cut in the skin until the device is near the vein that will be treated. When the device is turned on, the blade cuts the vein into small pieces which are sucked into the tube.
How does TIPP compare to other phlebectomy treatments for varicose veins?
One advantage of transilluminated powered phlebectomy is that it requires fewer cuts in the skin than other types of phlebectomy. This includes ambulatory phlebectomy, in which the vein is removed through several cuts with a special hook.
The light source used in TIPP also helps your doctor see the veins before removing them. This may reduce the risk of missing a varicose vein or damaging healthy veins. The powered cutting tool also makes removal of a large number of veins easier than with a phlebectomy hook.
Compared to conventional surgery, TIPP takes less time and requires fewer incisions, especially for more complicated varicose vein problems. However, the cosmetic results are similar between the two procedures.
In addition, some people have more pain and bruising after TIPP, compared to ambulatory phlebectomy. This means a longer recovery time.
Cost is another issue. The equipment and supplies needed for TIPP are expensive. These costs can add up for people who also need to have other vein procedures at the same time.
What is the recovery after TIPP like?
After the procedure, incisions are closed with Steri-strips. Multiple layers of absorbent bandages are applied along the length of the vein removal site, and the leg is wrapped from toe to groin with stretch and elastic bandages.
You will need to keep the bandages on until the follow-up visit with your doctor in six to 10 days. After your doctor removes the bandages, you will need to wear compression stockings until fully healed.
At this time you will be able to shower and resume most of your regular activities. You should be able to return to work within several days, although you might need longer if your job involves standing for long periods or heavy lifting.
While recovering, you should avoid sitting or standing for long periods. You should also walk 10 minutes every two to three hours. In addition, you should raise your legs above your heart for at least 15 minutes two times a day.
Potential complications after TIPP include bleeding, infection, discoloration of the skin, and numbness. These should go away after a few days. However, you may have swelling in the legs for up to three months.
Transilluminated powered phlebectomy cost and insurance coverage
While insurance frequently covers the cost of transilluminated powered phlebectomy when deemed “medically necessary,” you should check with your insurance company before scheduling your procedure. Also, more than one type of treatment may be needed depending on the extent and severity of your varicose veins.