Ablation uses heat to destroy cancer cells. There are three types of ablation that produce heat in different ways. These are:•Microwave•Radiofrequency•Laser ablation.Each type destroys cancer cells by heating them to a high temperature. They may beused if you have previously had surgery or if you’re not fit enough to have surgery.You will be given a sedative drug to make you feel drowsy and a local anaesthetic to numb the skin of your abdomen. Sometimes ablation is performed using a general anaesthetic. The doctor puts a fine needle through the skin over your liverand into the centre of each tumour. They use an ultrasound or CTscan to guide them. The microwave, radio-frequency or laser then produces heat which passes through the needle and into the tumour. This treatment takes about 30–60 minutesand can be used to treat tumours up to 5cm (2in) in size. You can usually go home a few hours after you’ve had your treatment.The side effects of ablation are usually mild and may last up to a week. They include pain in the liver area, which you cancontrol by taking regular painkillers. Other side effects are a fever (high temperature) and feeling tired and generally unwell. These side effects are due to the body getting rid of the cells that have been destroyed. Try to drink plenty of fluids and getenough rest. Your doctor or nurse may ask you to contact the hospital if your temperature doesn’t settle within a few days orif it goes higher than 38˚C (100.4°F). This is to make sure you don’t have an infection. Your specialist can give you moreinformation about the possible benefits and risks of these procedures.
I’ve been trolling the internet to find a suitable presentation of this procedure, but sadly there appears to be nothing available from a British perspective as tohow this procedure is carried out over here. I have therefore used an Americanvideo as I suspect that the procedure to be pretty much the same. This videomaybe a little heavy for some people, But this procedure does look to be a littletricky. The best way of describing what TIPSS is, is to explain what the letters stand for:
Tis for TRANSJUGULAR. This means that the radiologist will put a fine, hollowneedle into the jugular vein in your neck while you are asleep. Through this needle he, or she, will pass a fine, thin wire in astraight line until it reaches the veins from your liver. This is much easier than you would imagine. Over this wire the radiologist will pass a fine plastic tube called a catheter, about the size of a very long piece of spaghetti.I is for INTRAHEPATIC. The catheter that the radiologist has inserted will be passed down one of your liver veins into the liveritself. The radiologist will then take the wire out and insert a long curved needle.PS is for PORTO-SYSTEMIC. The long needle will be pushed from your liver vein, (or SYSTEMIC vein) into your PORTAL vein, which lies close to it. It is this portal vein which has become partially blocked up by your liver disease. Because of the blockage, there is high blood pressure in this part of your circulation, and this procedure is designed to relieve this.S is for SHUNT. Once the needle has been passed between your liver vein and the portal vein, a wire will be passed through the needle and the needle withdrawn. Over the wire the radiologist will pass a metal spring called a stent. This stent will expand to create a channel between the two veins. Blood will then flow from the high-pressure portal vein into the low-pressure liver (or systemic) vein. The high pressure in the portal vein which is causing your problem, will consequently be reduced, back towards normal.