"This is one of the first times that transillumination is used during the actual vein-removal procedure, which offers maximum visibility for the surgeon," Lawrence said. "Usually the veins are mapped before the procedure, which is not as effective."
Lawrence then makes a very small incision immediately adjacent to a varicose vein. Taking a size 7 crochet hook that has been filed down and modified for the procedure, he passes it through the incision, hooks a vein and pulls it through the opening. After turning on the operating room lights, Lawrence assesses the vein, sets the crochet hook aside and grasps the vein at its base with a tiny mosquito clamp. Using a gentle circular motion, he dislodges the vein from the skin. Further incisions are made to remove remaining veins.
The empty vein channels are flushed with solution to help collapse them and prevent bruising and hematomas from any residual blood remaining in the channels. No sutures are used; this allows for continued drainage if needed. A compression dressing is applied to the affected area, and within an hour, the patient goes home with instructions to elevate the leg for 48 hours. The resulting scars look like small freckles.
Between 2004 and 2006, 268 patients received LASP treatment at UCLA 49 of them underwent LASP alone, and 184 had it combined with another varicose vein-removal procedure. Researchers followed up with patients roughly a year after their procedures and found few early postoperative complications, such as infection, hematoma formation or severe pain requiring additional pain prescriptions.
According to Lawrence, LASP may provide lower residual varicose vein occurrence due to the greater ease in identifying the veins in the operating room through transillumination.
The next step is a larger study and longer follow-up with patients, Lawrence said.
|Contact: Rachel Champeau|
University of California - Los Angeles