If you have varicose veins or unsightly dilated superficial veins of the legs, you should consult and seek treatment from a Vascular Surgeon before complications arise. Varicose veins are not just a cosmetic problem.

Dr. Lee see patients with varicose veins at various stages of the problem. In early stages, patients usually suffer pain, swelling, heaviness and, sometimes, unsightly veins. In late stages, there will be skin discolouration, venous ulcers or bleeding.

Traditional Vascular Surgery involves open surgery. With the advent of minimally invasive surgery, Endovascular Surgery is now the trend for the treatment of most arterial and venous diseases. Endovascular Surgery is a "super specialty" within the field of Vascular Surgery.

"Endo" simply means "inside", so Endovascular Surgery is about treating arteries and veins from within.

For example, with varicose veins, this treatment entails closing the veins from inside using a laser fibre passed in through a needle puncture. This is known as Endovenous Laser Treatment (EVLT).

Dr. Lee, who has undergone certified EVLT training in the Alabama Phlebology Training Institute in the USA, now uses the CoolTouch CTEV 1320nm laser for treating varicose veins.

He says, "Since the advent of EVLT, stripping of varicose veins should be a thing of the past. Traditionally, those with bad skin problems or ulcers associated with varicose veins and those with a history of bleeding would be recommended this treatment. But vein stripping meant more pain, scarring, bruising, longer recovery periods, risks involved with general anaesthesia and a higher recurrence rate.

“EVLT is superior for a variety of reasons. It is done under local anaesthesia as a day care surgery. There is minimal pain and bruising after the procedure. Patients can walk immediately after EVLT. Parallel veins, if present, can be treated at the same sitting. This will minimize the recurrence rate.

“My patients are all usually surprised at the change after treatment. Their legs feel so much better. There’s no more pain, heaviness and discomfort.”

Patients who have varicose veins may also have associated spider veins. Spider veins are like varicose veins but smaller. They also are closer to the surface of the skin than varicose veins. Often, they are red or blue. They can look like tree branches or spider webs with their short, jagged lines.

During the same operative session, treatment of the spider veins can be done. Sclerotherapy is the treatment for spider veins. A needle is used to inject a liquid chemical (known as a scleroscent) into the vein. The chemical causes the vein walls to stick together, seal shut and eventually the vein turns into scar tissue. Once the injection is done, the vein will fade within six months. Two or three treatments may be needed for best results.

Sweaty palms or hyperhidrosis is a medical condition whereby patients sweat excessively on the palms. Hyperhidrosis may also involve the armpits and the soles of the feet. It is reported that this occurs in about three percent of the population and commonly affects teenagers and young adults. Seventy percent of those with symptoms do not know where to seek treatment.

There is a variety of treatment for this problem, from aluminum-based lotions to electrophoresis (electric current therapy) and Botox injections. However, all these treatments are ineffective or may just provide short-term partial relief.

Definitive treatment of this condition is by way of Endoscopic Thoracic Sympathectomy (ETS). ETS is a keyhole technique that is safe and effective, with a short recovery time. This treatment entails cauterizing the part of the nerve that is responsible for the excessive stimulation sent to the sweat glands in the palms.

This method has proven very successful. Excessive sweating of the palms ceases immediately after successful ETS. The patient would immediately be able to perform functions that he or she was not able to do before, such as writing without wetting the paper and shaking hands with others without embarrassment.

- Avoid standing or sitting for long periods of time.
- Use graduated compression stockings when need to stand or sit for prolong   periods of time.
- Avoid leg crossing when sitting.
- Regular exercise.
- Maintain healthy Body Mass Index (BMI).

There are many specialisations in the field of Surgery. So, why did Dr. Lee choose this area of specialisation over others?

"I find Vascular Surgery to be a very challenging and dynamic field. For example, the scariest scenario for any general surgeon when performing a laparotomy for an emergency abdominal trauma case would be arterial injury or a leaking abdominal aortic (the largest artery in the abdomen) aneurysm. The desire to be able to handle every possible situation if I had to do an emergency laparotomy spurred me on to choose Vascular Surgery as my specialty.

"On top of that, Vascular Surgery has expanded its application to Endovascular Surgery. This is an exciting area of superspecialty with minimally invasive procedures for treatment of arterial and venous problems. Vascular or Endovascular surgery, or a combination of both, can be performed depending on the best option for the patient."