I am a Vascular and General surgeon, specialising in disorders of veins, arteries and have a general surgical practice including laparoscopic cholecystectomy, hernia surgery (laparoscopic and open) and thyroid surgery. I have been practicing as a consultant in the North East for 13 years now- the bulk of my practice is now Vascular surgery and I have a special interest in the treatment of varicose veins. During my period as vascular lead for County Durham and Darlington Trust I established the trust centre for radiofrequency ablation of varicose veins (RFA also known as VNUS or Venefit) and usually practice this as the first line in the treatment of patients with varicose veins (NICE guidelines 2013).A typical first consultation includes a clinical exam and an ultrasound scan to establish the best form of treatment for that individual patient- usually it is an endovenous treatment such as RFA- but about 10% of people are best served initially with surgery or injection sclerotherapy depending on the type, symptoms and cause of their varicosities. Endovascular treatment is normally carried out under a local anaesthetic with the patient awake- this gives them the advantage of the patient not being fasted, walking in, having their treatment and, after a short observation period, walking out again.Some people feel uncomfortable about a local anaesthetic procedure and if so then a general anaesthetic is easily arranged. Most people resume their normal activities within 24 hours. Some patients will need further treatment on their veins, this would be decided at the initial consultation after the assessment and a discussion regarding the patients needs.