Alexander Loh  MBBS MS FRCS Consultant General and Vascular Surgeon
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Special Interests

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Varicose veins and venous disease

Various treatments are available for the treatment of varicose veins. The most important advance in the last few years is the introduction of catheter based techniques (laser - ELVT, radiofrequency ablation - RFA) which has changed the treatment of venous disease to a minimally traumatic procedure. Venous disease can manifest in the form of varicose veins which can cause significant aching or skin problems including varicose eczema and ulceration. It can also present with chronic oedema without any signs of varicose veins. I favour RFA which has been shown to be less painful than laser. It can be performed under a general or local anaesthetic depending on the patient wishes. Another advantage is that medications including warfarin or other blood thinning drugs do not need to be stopped for the operation.

Further information can be obtained from : www.northlondonveincinic.com

Hernia

Although open mesh repair is a very successful and effective procedure, a laparoscopic repair does have the advantages of reduced pain, less wound and mesh infections and minimal neuralgia which can be present in up to 20% of patients in the former group. Every patient is different and each will need to be assessed as to which of the repairs is more appropriate to them. Similarly this applies to other abdominal hernias including umbilical and incisional hernias.

An important recent advance has been the use of TAP blocks for all patients undergoing open or laparoscopic inguinal hernia repair. This has significantly reduced the amount of post-operative pain the patient experiences allowing them to go home earlier and recover quicker.

Further information can be obtained from: www.northlondonherniaclinic.com


Portacath insertion

This is a small device implanted on the chest just under the skin which makes giving chemotherapy much easier as there is no need to find a vein in the arm. It can be inserted under a local anaesthetic or general anaesthetic according to the patients wishes. The device can be used to take blood for tests and also be used to give dye or contrast during CT or MRI scans. 

Further information can be obtained from : www.macmillan.org.uk

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