Purpose: A Trans-Illuminated Powered Phlebectomy (TIPP) is accepted as a useful surgical procedure for varicose vein, but requires hospitalization and general or spinal anesthesia. To show the feasibility of outpatient TIPP under local anesthesia, we established an outpatient fast track protocol of TIPP, and showed the results.
Method: We performed outpatient department-based TIPP, under local anesthesia with a 2% lidocaine subcutaneous injection and the tumescent method. Using the visual analogue pain scale and a questionnaire, the compliance of the patient were examined.
Result: Between August 2001 and January 2005, 252 limbs of 238 patients underwent operations using our protocol. Mean age of the patients was 59 years, with a male:female of 185：53. The mean operation time and number of incisions were 30.6 minutes and 4.6, respectively. There were 7 wound problems (2.78%) and 5 redo TIPP (1.98%) due to a recurrence. 58 questionnaires were completed and collected from the patients. The mean visual analogue pain scale score was 5.7. Of the 58 patients that completed the questionnaires, 6 (10%) replied that the procedure was intolerable and that they would not have again. Whereas, the other 52 patients (90%) said the procedure was tolerable, and would have again, if necessary.
Conclusion: Outpatient TIPP, under local anesthesia, might be a relatively safe and feasible method to establish a fast track protocol for varicose veins.
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