A new, sutureless technique allows the complete and rapid removal of varicose branch veins with few missed varicose veins, little bruising and an excellent cosmetic result, reports an article in The American Surgeon. The procedure, which is designed to remove branch varicose veins from the thighs, calves and ankles, combines two current varicose vein-removal methods — powered phlebectomy and stab phlebectomy — which excise veins through a small incision in the skin. The method also employs transilllumination, in which a light source is placed beneath the skin to help highlight the veins during the procedure.
"This new, sutureless technique allows complete and rapid varicose branch vein removal with few missed varicose veins, little bruising and an excellent cosmetic result," said Dr. Peter Lawrence, UCLA's chief of vascular surgery and developer of the technique.
During the light-assisted stab phlebectomy (LASP) procedure, in which the patient is sedated but remains conscious, Lawrence makes a tiny incision near the varicose veins and threads a slender tube with a light source at its tip underneath the vein cluster. A mixture of saline, lidocaine and epinephrine is infused into the area, providing a further anesthetic and "plumping up" the veins so that they are easily visible. The lights of the operating room are turned off so that Lawrence can 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," Lawrence said. "Usually the veins are mapped before the procedure, which is not as effective."
Lawrence said that LASP is often used to treat branch veins in the calf — in conjunction with either laser or radiofrequency procedures that are used to close the main saphenous vein that runs from the bottom of the foot to the thigh."We believe that LASP will provide surgeons with an additional tool to be used to treat varicose veins," he said. "With more options, we can better target individual treatment." According to Lawrence, LASP may also provide lower residual varicose vein occurrence due to the greater ease in identifying the veins in the operating room through transillumination.
Source: University of California - Los Angeles
