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Saturday, February 9, 2002



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COURTESY OF KAPIOLANI MEDICAL CENTER AT PALI MOMI
The results of Transilluminated Powered Phlebectomy are shown on this patient, whose varicose veins before the operation, left, were less visible post-surgery, six months later.



Method speeds
recovery from
varicose-vein care

The new surgical procedure
uses light to make veins visible


By Helen Altonn
haltonn@starbulletin.com

People suffering from varicose veins have an alternative now to long operations involving many incisions and weeks of recovery time.

Kapiolani Medical Center at Pali Momi is using a quick, noninvasive technique allowing patients to resume usual activities within one or two days.

It is the first use of technology known as Transilluminated Powered Phlebectomy (TIPP) in Hawaii, the hospital reported.

The procedure involves passing light through the area beneath the skin so the varicose vein is clearly visible and the surgeon can quickly and accurately remove it.

Vein clusters were removed from one patient's legs in less than an hour on an outpatient basis, the hospital reported.

"We are definitely excited about this new procedure, which provides significant and immediate benefits to our patients," said Dara Fairchild, clinical manager of the hospital's surgery department.

About 25 percent of women in America and 15 percent of men suffer from some form of varicose veins, usually because of problems with valves that do not open and close properly.

When that happens, the veins channel blood back into the leg instead of to the heart. As blood collects in the veins, they become enlarged. Hence the name varicose, a medical term for "enlarged."

Smaller enlarged veins appear in a blue spiderlike web. Larger ones are bulging and are not only unsightly, but can cause leg pain, fatigue, aching, throbbing and other symptoms.

A compression stocking may be used initially to relieve the symptoms and prevent the condition from worsening, but this does not eliminate the cause, the hospital said.

The best treatment, it said, is to surgically destroy the varicose vein to stop the blood from flowing back into the legs.

Among traditional procedures for extensive varicose veins is stripping, which involves threading a wire into the vein from the groin to the ankle and securing it to an acorn-shape head attached to the wire, the hospital said.

Traction on the wire at the groin is used to pull out the vein, with remnants of the vein removed through incisions.

In another procedure, called stab avulsion phlebectomy, several tiny incisions are made with a scalpel, and a hook probe is used to separate the vein from body tissue. The vein is grasped by a clamp and pulled out from the soft tissue of the leg.

With the transilluminated technology, patients can walk after a brief recuperation and return home after a few hours at the hospital. The usual one to two weeks of recovery time for conventional surgeries is cut to one or two days.

This technique not only is quicker and more accurate, it reduces the risk of postoperative infection and the need for more surgeries, according to the hospital.

"The quicker procedure time, reduction in use of anesthetics and number of incisions, and exactness of the vein removal process where a surgeon can now actually 'see' the veins being removed, helps patients heal quicker and benefit from very favorable cosmetic results," Fairchild said.

Patients in early clinical studies were free of pain within two weeks after the procedure, she said, "and that's remarkable."



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