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Ambulatory Phlebectomy

Ambulatory Phlebectomy (also called microphlebectomy or mini-phlebectomy) is a minimally-invasive surgical technique that directly removes visible varicose veins via hook excision. Phlebectomy treats surface veins and is commonly done in conjunction with an anti-reflux procedure like endovenous laser, RF ablation, or vein stripping.

In ambulatory phlebectomy, a very small skin incision (generally less than 1 mm) is made adjacent to the visible vein and a phlebectomy hook is used to extract the vein through the incision. Microphlebectomy is commonly done under local anesthesia and stitches are generally not required. Given the small incisions, scarring from ambulatory phlebectomy is usually non-existent or minimal.

Compression stockings are generally worn after phlebectomy (to reduce swelling and discomfort) and patients may ambulate soon after the procedure and return to normal activities (minus strenuous exercise) the next day.

TRIVEX™ Procedure1

The TRIVEX procedure involves a novel technique called transilluminated powered phlebectomy. While most varicose vein surgery is done without directly visualizing the varicose veins, the TRIVEX system transilluminates the veins requiring removal via advanced fiberoptic technology (much like a flashlight can shine through your skin). Once the surgeon has visually confirmed the location of the diseased varicose vein(s), a local anesthetic is delivered under pressure into the area. A powered vein resector is then guided next to the vein and suction is used to draw up and remove the vein (much like ‘liposuction’). This varicose vein treatment allows accurate removal of large clusters of varicose veins with a minimal number of incisions.

The TRIVEX powered phlebectomy procedure is much more accurate and faster than blind varicose vein phlebectomy and patients usually recover quickly and with excellent cosmetic results. The procedure can be done under a light general anesthesia in an outpatient center or in the office under tumescent local anesthesia. Since the TRIVEX procedure directly removes the varicose veins, they are unable to come back (although new varicose veins can develop in close proximity).

Similar to ambulatory phlebectomy, patients undergoing the TRIVEX procedure commonly wear compression stockings during recovery.

1 Section content reviewed by Dr. Gregory Spitz, MD, FACS, inventor of the TRIVEX procedure.

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