Trivex Transilluminated Powered Phlebectomy:
Transiluminated Powered Phlebectomy (TIPP) is a minimally invasive technique of permanently removing varicose veins of the legs. It can be used anytime a traditional stab (ambulatory) phlebectomy is appropriate.
During TIPP your doctor will use a small light that’s inserted under the skin to determine the exact location of the unwanted veins. Once located, these veins are carefully removed using specialized surgical instruments. Only local anesthesia is necessary, and most TIPP procedures are performed on an outpatient basis.
This vein removal method is particularly useful for patients with very large varicose veins. It’s also the preferred technique for treating more complicated cases such as veins located near bleedings ulcers or active infections.
How is a transilluminated powered phlebectomy (TIPP) different than a “regular” ambulatory phlebectomy?
The term “phlebectomy” refers to the minimally invasive surgical removal of a varicose vein. There are currently two variations of the procedure in wide use today. These are:
- The ambulatory phlebectomy. This procedure is also sometimes referred to as a microphlebectomy. Before the procedure a local anesthetic, usually lidocaine, is used to prepare the area. Once the area is thoroughly numb the surgeon makes several tiny access incisions along the length of the vein. These are typically less than 5 mm across, making stitches unnecessary. The surgeon then removes the vein in small segments using specialized instruments.
- The Transilluminated Powered Phlebectomy (TIPP). To start, the area around the vein is prepared with lidocaine exactly as with an ambulatory phlebectomy. A very small light source is then inserted beneath the skin to reveal the exact position of vein. A single access incision is made and a long, flexible catheter with a bladed tip is inserted into the vein. As this instrument is slowly withdrawn the vein is sliced into small pieces which are then suctioned out of the body.
Both procedures accomplish the same end—the complete physical removal of the varicose vein. The only practical difference is that some surgeons prefer TIPP when removing veins located near ulcers or areas of infection.
Performing a Transilluminated Powered Phlebectomy (TIPP):
First, the light source is used to reveal the underlying vein. The technical term for this is “transillumination.” Your doctor will then mark the length of the now clearly visible vein using a surgical marker.
TIPP procedures are usually performed in-office, using only local anesthetics. Many surgeons prefer lidocaine yet drugs such as bupivacaine are equally effective. Regardless of which agent is being used this numbing medication is injected into the area surrounding the vein. This provides complete pain control for the duration of the procedure.
When the area is sufficiently numb a surgical catheter is inserted into the vein via a single access incision. A small bladed instrument at the tip of the catheter is then used to cut the vein into small segments. Once this is accomplished these pieces are vacuumed up the length of the catheter and out of the body.
How does a Transilluminated Powered Phlebectomy or TIPP compare a more traditional phlebectomy?
The main advantage of the TIPP procedure is that it lets the entire length of the vein to be seen clearly. This allows the surgeon to exercise extreme precision, ensuring that nearby healthy veins are not damaged. Another advantage is that TIIP requires fewer incisions than a “normal” ambulatory phlebectomy. It also takes marginally less time.
The only significant disadvantage of TIPP is the overall cost. The equipment and supplies involved are fairly expensive which significantly raises the price of the procedure. This makes the ambulatory phlebectomy the obvious choice for many patients paying out-of-pocket.