The TriVex® System (Smith & Nephew, Andover, MA) also known as Transilluminated Powered Phlebectomy is a minimally invasive technique to directly remove varicose veins. This outpatient procedure has become a widely accepted method used as an alternative to the traditional microphlebectomy approaches. The TriVex System uses two small cannulas inserted through a minimal number of 1-2mm puncture sites to localize and directly visualize varicosities and assist in their complete removal.  Tri-Vex is a useful technique for patients who are not candidates for endovenous catheter therapies because of venous anatomy or varicose veins recurrence.