The TRLOP Technique (Transluminal Occlusion of Perforators) is a minimally invasive treatment for faulty perforator veins in the leg. These small veins normally connect the deep and superficial veins, but when they fail, blood can flow backwards, causing varicose veins, swelling, skin changes or ulcers. Using ultrasound guidance, a fine laser fibre is inserted directly into the vein and sealed from within. The procedure is done under local anaesthetic, involves only a tiny puncture, and allows patients to recover quickly with minimal pain.
The best candidates are patients whose duplex ultrasound scan shows refluxing perforator veins. Perforator veins are a normal part of the leg’s venous system and are only treated when they are not functioning properly.
The TRLOP procedure treats faulty perforator veins using a fine laser fibre under ultrasound guidance. It is performed under local anaesthetic with a single small puncture, avoiding surgical incisions. Energy is delivered in controlled pulses to seal the vein safely, resulting in minimal pain, quick recovery, and effective closure of the problematic vein.
Anaesthetic Details
The TRLOP procedure is performed under local anaesthetic, which numbs the treatment area while keeping the patient awake. No general anaesthetic or large incisions are required, ensuring minimal discomfort and a quick recovery.
Number of treatment Sessions
Typically, one session per leg is needed for the TRLOP procedure. In some cases, both legs can be treated in a single session if only a few perforator veins require treatment, often performed alongside the treatment of the main truncal veins.
Pain Level
Patients may feel a brief sting from the local anaesthetic injections and some pressure from the tumescent anaesthesia. The TRLOP procedure itself, using the laser, is generally not painful. Overall, discomfort is minimal and well tolerated.
Price Range
The TRLOP procedure typically costs between £1,460 and £2,200 per leg.
Financial Aids
Low-interest finance options are available to help spread the cost of TRLOP, making the treatment more accessible.
Patients can resume normal activities immediately after the TRLOP procedure, with walking encouraged, but intense exercise should be avoided for the first three days. Compression stockings should be worn day and night for three days, the bandage removed after 24 hours, and Steristrips removed after three days. Swimming and bathing should be avoided until the small puncture sites have healed, usually within 3 days to 1 week. Most bruising and tenderness will resolve within 1–2 weeks, though complete healing and any areas of heightened sensitivity or numbness may take up to six weeks.
The TRLOP procedure is generally safe, but patients may experience pain, bruising, or small scars at the treatment site. There is a 3% chance of wound infection, a 0.1% risk of deep vein thrombosis, and a 0.01% risk of pulmonary embolism. Temporary numbness or nerve pain may occur in 20% of patients, while permanent numbness or nerve pain is less common (1%). Some patients may experience sensitivity in the inner thigh for several weeks. Other possible effects include brown stains (0.2%) or thread veins (0.2%). The risk of recurrence is approximately 3% per year, and no vein treatment can prevent new abnormal veins developing in the future. The risk of procedure failure is less than 1% per year.
A five-year follow-up study reported that the TRLOP technique achieved an 81% success rate in closing incompetent perforator veins.
A five-year follow-up study found that approximately 19% of treated perforator veins either remained open or reopened, indicating the recurrence rate after TRLOP.
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