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Cinderella Comes of Age

Venous disease has long been the poor relation in the family of general surgery. Consisting principally of operations for varicose veins, it has been regarded as dull and uninteresting, and it has often been delegated to reluctant and disinterested junior staff. There has been a quiet revolution in the past decade, brought about largely by increasing specialisation in surgery. Almost all elective arterial surgery in the United Kingdom and Ireland is now done by specialist vascular surgeons. The drive towards provision of comprehensive cover for emergency arterial diseases is likely to fuel the separation of vascular surgery away from general surgery. An increasing number of surgeons now practise exclusively in vascular surgery, and many have turned their attention towards managing venous disease. Elective varicose vein surgery consists of largevolume, relatively low-difficulty procedures, and has the added attraction of a significant presence in the commercial sector. The time has come for vascular surgeons to bid strongly to be specialist venous, as well as arterial surgeons, but the argument has to be won on quality issues, not perceived greed.