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Laser energy is delivered while the fiber is gradually withdrawn.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.
Selective pre-operative embolisation of tumor-feeding vessels was performed to reduce tumor vascularity and minimize intraoperative blood loss in pheochromocytoma. The procedure facilitated safer surgical excision, improved operative visibility, reduced hemodynamic instability during surgery, and decreased perioperative complications associated with highly vascular adrenal tumors