Surgical Treatments

Surgical Vein Removal

Ambulatory Phlebectomy - This procedure may be used to remove varicose veins that are too large for sclerotherapy but too small for the TriVex system. It involves vein removal through tiny incisions. It is often used in conjunction with sclerotherapy to reduce the pressure in the smaller spider veins for a more pleasing cosmetic outcome.

Transilluminated Powered Phlebectomy (Trivex) is a reliable minimally invasive approach to vein removal. This procedure is performed in the operating room, under tumescent anaesthesia. The TriVex system requires few small incisions, and is a more complete approach to vein cluster removal. The surgeon passes a light source through a small incision allowing visualization of the veins. A scoping device is passed through a second small incision, which actually removes the abnormal vein. Patients are discharged the same day with a brief recovery period.

Vein Ligation and Stripping (Babcock procedure). This procedure is performed in the operating room. It involves tying off the affected vein through small incisions, and then stripping the vein from the leg. This technique is typically used for removal of the saphenous vein from the leg. Patients are discharged the same day with a brief recovery period.

Minimally Invasive Treatments

Endoluminal Laser Ablation (ELVeS) - this procedure uses laser technology to internally close off large veins that have valve abnormalities, this larger vein may be supplying blood flow to other varicose veins in the leg. EVLT does not remove large vein cluster or treat spider veins. Additional procedures like that provided by the Trivex system may be needed to remove remaining vein clusters.

Radiofrequency ablation (VNUS) is a relatively new thermal ablation technique that uses a specially developed proprietary RF catheter placed inside the vein. A cutdown, stab incision with vein exteriorization, or a Seldinger over-the-wire technique is used to place an introducer sheath into the truncal varix to be ablated. A special RF ablation cathteter is passed through he sheath and along the vein until the active tip is at the saphenofemoral junction just distal to the subterminal valve. Position of the tip is confirmed by ultrasonography. Tumescent volumes of local anesthetic are injected in quantities sufficient to separate the vessel from the overlying skin and other delicate tissues along its entire length. Metal fingers at the tip of the RF catheter are deployed until they make contact with the vessel endothelium. RF energy is delivered through the metal catheter fingers and passes through the surrounding tissues; tissue heating occurs both in and around the vessel to be treated. Thermal sensors record the temperature within the vessel. Energy is delivered until the tissue temperature is just sufficient to ensure endothelial ablation. The RF catheter is withdrawn a short distance, and the process is repeated all along the length of the vein to be treated.

Subfascial Endoscopic Perforator Surgery (SEPS). Minimally invasive endoscopic approach for ligation ("clipping") of abnormal perforator veins underneath the muscle fascia in the legs. This is done by making small incisions in the calf region for placement of the scope. Sutures are placed under the skin so scarring is minimal. Recovery time is minimal as well.

For your information:
This page has been provided for your information and to answer common questions. This web-site has been prepared to answer questions about a variety of circulatory problems, ranging from cosmetic blemishes through to more serious underlying circulatory problems.

The site is intended to be a simple guide, answering commonly asked questions. It does not replace a formal consultation with a vascular or vein specialist, who will be in a better position to