Radio frequency ablation of benign thyroid nodules/ goitre

Today we are going to discuss about an interesting and novel pinhole procedure to treat large benign harmless thyroid gland swellings (goitre) without open surgery or general anaesthesia.

Thyroid gland is a vital gland which secretes a hormone called thyroxine which is essential for daily body function and metabolism. Benign (harmless) swellings in the thyroid gland are very common and can grow slowly over time to cause big unsightly swellings in the front of the neck. Traditionally these are treated by a major open surgery in which whole or half of the thyroid gland is removed.

Many people are not keen for a major surgery or to lose their vital organ to treat these swellings which can also lead to a big scar in the neck. RFA treatment is a perfect solution for these people as we can treat the nodule through a tiny pin hole in the neck and without any harm to the normal thyroid gland.

During the procedure, local anaesthesia (pain killer) is injected into the skin at the access site to prevent discomfort. An injection of a mild sedative is also given to ensure that you are comfortable and relaxed during the procedure.

A special needle which generates heat at its tip (RFA probe) is placed in the goitre under Ultrasound guidance and the heat is used to burn and shrink the goitre. This is ideal for patients with large thyroid swellings which appear unsightly.

Advantages over open surgery:

  • Short hospital stay
  • Back to normal life/ activities in 3 days
  • Significantly lower risks compared to open surgery
  • No general anaesthesia
  • No big scar or open surgery wound
  • Thyroid function is preserved

Varicose Veins


Advanced minimally invasive treatments for Varicose veins

Varicose veins are a very common problem with patients suffering from leg swelling, vague pain/ discomfort, tiredness and heaviness of the legs, with enlarged tortuous veins on the leg. In milder versions, patients may have spider veins (bluish tiny veins) or reticular veins. The symptoms are made worse by prolonged standing and is common in people with occupations such as teachers, supervisors, security personnel. It also commonly occurs in women during pregnancy due to increased abdominal pressure and may persist after childbirth.

Previously the treatment used to be open surgery where the entire vein is stripped and removed (surgical stripping) which leads to multiple disfiguring scars /skin bleeding or bruising and long recovery time.

Nowadays the patients can be treated with a pin hole procedure through which the faulty vein is permanently closed off with heat (Laser or RadioFrequency ablation). The latest advancement is Venaseal therapy where the faulty vein is closed with glue (VenasealTM) which is completely pain free. The procedure is performed under local anaesthesia with mild sedation (no general anaesthesia) and patient can be discharged mostly on the same day. Patient can resume normal activities by the very next day and there are no visible scars.

Some patients may have small leaky veins called perforator veins which lead to varicose veins. These can be easily treated by carefully injecting them under ultrasound guidance with medicines((sclerosant) to shut those veins. This is called percutaneous sclerotherapy. This treatment can also be used to treat spider or reticular veins in patients who want get rid of them for cosmetic reasons.


Uterine fibroid embolization



Uterine fibroids are a very common problem and lot of women suffer from painful or heavy periods, tiredness (due to anaemia), bloated tummy, urinary urgency/ constipation due to the fibroids. Large fibroids can also cause difficulty in conceiving in some women.


Uterine artery embolization is a minimally invasive procedure is an effective treatment for uterine fibroids instead of hysterectomy (removal of uterus).

Under local anaesthesia and mild sedation, through a pin hole access in the groin or wrist blood vessel, tiny particles are carefully injected into the blood vessels supplying the uterus to cut off the blood supply to the fibroids. This results in shrinkage of the fibroids and treats the symptoms related to the fibroids.  Studies have proven that over 90 percent of women get relief of their fibroid related symptoms after this treatment. This treatment can be effective even in women with multiple or large fibroids, or infertility due the fibroids. Many women have gone on to have normal conception after fibroid embolization treatment.


Advantages over surgery:

  1. Can preserve the uterus.
  2. No need for general anaesthesia/ major operation
  3. No scars or stitches
  4. Less painful than surgery
  5. Fastest recovery time – very short hospital stay
  6. Back to normal work/activity in 5 days


Please click on this link to read about real life patient’s experience after this treatment.

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Lower limb angioplasty


Lower limb angioplasty is crucial to heal the non-healing diabetic leg wounds. 

Diabetic patients can develop non healing wounds or blackish discolouration of the toes or feet due to poor blood flow to the tissues as a result of narrowing or blockages in the blood vessels supplying the legs. This is due to gradual build-up of plaques inside the blood vessel over time. Patient may experience severe pain or develop infection in the unhealthy tissues.

Patients are often treated with medicines and trimming of the unhealthy tissues without improving the blood flow to the legs. Improving the blood flow is crucial for the wounds to heal along with medicines and wound management. Sometimes, the patients end up losing the leg as the wound or gangrene spreads. This can be devastating for the patient as their mobility is restricted or become dependent.

Angioplasty of the lower limb arteries can help restore the blood flow to the foot and help the healing process and prevent loss of the leg. In diabetic patients, the blockages are usually in the fine blood vessels in their calves which are challenging to treat. Angioplasty of these vessels needs to be done by an experienced endovascular specialist. Angioplasty with special drug coated balloons is proven to keep the treated arteries open much longer than normal balloons. Sometimes stents need to be placed to treat the tough blockages not responding to angioplasty alone.