Customer Reviews

Ambulatory Phlebectomy, Second Edition (Basic and Clinical Dermatology)

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This book provides an excellent description of the anatomy, pathophysiology and in-office management of varicose veins. The authors explore the original seminal work by Dr. Robert Muller that has revolutionized the minimally invasive removal of varicose veins and apply their own renditions of those techniques.

The authors explain the anatomy of venous disease, and point out the most common patterns of varicose veins based on their voluminous experience. The use of non-invasive diagnostic techniques is explored, but only briefly. There is an excellent discussion of the use of local infiltrative anesthesia that allows for these procedures to be done in the office setting. Both standard infiltration and tumescent anesthesia techniques are detailed. Recommendations for allowable dosages of topical agents are made and validated with their large clinical experiences.

Only after a thorough discussion of the anatomical basis of the disease and the means of diagnosing the problem do the authors actually begin delving into their techniques of ambulatory phlebectomy in Chapter 9. As opposed to the use of large incisions, previously the standard of most vein specialists, they show how the removal of significant varicose veins can easily be routinely accomplished through incisions as small as 1 mm with minimal, if any, discomfort to the patient. Finally, the postoperative care, emphasizing the importance of a properly placed dressing, is well described. A thorough discussion of potential complications and management is also helpful. An informative CD-ROM disc accompanies the text.

My only criticism of this book has to do with the illustrations and photographs. I found the illustrations to be somewhat confusing, thus inadequate. There is also a significant loss of depth perception in the black and white photographs of the limbs with varicose veins and the procedures being performed. The color-flow duplex images in black and white were difficult to analyze, making some of them almost useless as well.

In summary, "Ambulatory Phlebectomy" is an excellent book for the phlebologist or surgeon wishing to establish or refine the technique of varicose vein removal in the office setting. I highly recommend it.

Michael A. Zatina, M.D.
Maryland Vein Treatment Center