Transilluminated Powered Phlebectomy

What is transilluminated powered phlebectomy?

Transilluminated powered phlebectomy is an alternative to ambulatory phlebectomy for the removal of larger varicose veins. The procedure uses fewer incisions than traditional phlebectomy procedures, minimizing the amount of discomfort and downtime for the patient. Transilluminated powered phlebectomy, or TIPP is a relatively new procedure that can be used on even the largest varicose veins that are too large for sclerotherapy or laser ablation.

Transilluminated powered phlebectomy uses a combination of light and a special suction device to remove varicose veins from the leg. The light is inserted through one incision and illuminates the vein to be removed. A second incision is made to insert the special tool that breaks the diseased vein loose and then suctions it out of the leg, much like a traditional liposuction procedure. The procedure is less invasive than other phlebectomy procedures and often leaves a better cosmetic result.

When is it done?

Transilluminated powered phlebectomy is often recommended as treatment for varicose veins that are bulging or twisting above the surface of the skin. These veins are often accompanied by uncomfortable symptoms, including achiness and heaviness in the lower legs, swelling of the lower legs and feet and leg cramping at night. Patients may also experience burning or itching around the location of the diseased vein, and the formation of skin sores known as venous ulcers.

Transilluminated powered phlebectomy will address the symptoms as well as the cosmetic concerns associated with varicose veins. Most patients will experience relief from symptoms as soon as treatment is completed. Cosmetic results also occur right away and improve in the days after the procedure as the treatment area heals fully.

How does the procedure work?

Transilluminated powered phlebectomy is performed as an outpatient procedure in a physician’s office or surgical suite. It may be done with local anesthetic and sedation or general anesthesia. The first incision is made above the vein to be treated. A special light, called an endoscopic illuminator, is inserted into this incision and threaded to the location of the vein.

A second incision is made below the treatment area. This incision is used to insert the phlebectomy device, which removes the vein through a gentle suction device. The entire procedure typically takes less than one hour to complete, depending on the number of veins to be removed. Treatment time for transilluminated powered phlebectomy is typically significantly less than for traditional phlebectomy procedures.

What is the recovery like?

After the procedure, a compression dressing is applied to both incisions, which may remain for a day or two. Patients are encouraged to walk within a couple of hours after the procedure, and usually go home the same day. Compression stockings will probably be worn for up to three weeks after the procedure, to encourage faster healing and healthy blood flow to the area.

Patients may experience minor bruising, swelling and discomfort after the procedure, which typically diminish on their own within a few days. Pain is usually effectively managed with over-the-counter medication. Intense exercise and physical activity is usually restricted for four to six weeks after the procedure.

When will the results appear?

Results of transilluminated powered phlebectomy can be seen right away, since the diseased vein is removed completely from the leg. Symptoms that accompanied the varicose vein will also be relieved right away. Results will gradually improve over the weeks following the surgery as the incision sites heal and the compression stockings are no longer required.

How many treatment sessions are needed?

Transilluminated powered phlebectomy removes varicose veins in a single treatment session. If additional veins need to be removed, another surgical procedure may be recommended a few weeks later. Other types of vein treatments, such as sclerotherapy, may also be used in combination with TIPP to achieve the best possible results.

Will veins reappear after treatment?

Because veins are removed from the leg during transilluminated powered phlebectomy, they will not return. However, the condition that caused damage to the valves inside the removed vein could impact additional veins in the future. If this occurs and more varicose veins appear, additional procedures may be recommended to maintain positive results.

What is the cost of transilluminated powered phlebectomy?

The cost of transilluminated powered phlebectomy may be slightly higher than that of traditional phlebectomy, which ranges from $500 to $2,500 per leg. Costs vary based on the location of the physician and the number of veins to be removed. Type of anesthesia and where the procedure is performed (outpatient clinic, physician’s office, etc.) will also determine the full cost of the procedure.

If varicose veins are symptomatic, insurance will often cover at least a portion of the procedure. If transilluminated powered phlebectomy is performed for strictly cosmetic purposes, insurance coverage may not be available. However, physicians that perform this procedure may offer special financing programs to make the procedure more affordable to patients.