01. Local Anesthesia & Access

Tumescent local anesthesia is given around the vein. A small puncture is made and a thin catheter is inserted into the vein under ultrasound guidance.

Tumescent local anesthesia is given around the vein. A small puncture is made and a thin catheter is inserted into the vein under ultrasound guidance.

The laser fiber is advanced through the catheter to the required position below the saphenofemoral/saphenopopliteal junction.

Tumescent solution is injected around the vein. This compresses the vein, provides anesthesia and protects surrounding tissues.

Laser energy is delivered while the fiber is gradually withdrawn. The vein wall collapses and the vein is sealed shut.

The fiber and catheter are removed and pressure is applied to the puncture site.
Percutaneous transhepatic biliary drainage (PTBD) followed by biliary stenting was performed to relieve obstructive jaundice caused by Klatskin tumor. The intervention restored biliary drainage, improved liver function, reduced bilirubin levels, and provided symptomatic relief from pruritus and cholangitis. Internal-external drainage and metallic stenting helped improve quality of life and facilitated further oncological management.