Definition & Overview
Ablation therapy is a medical procedure that destroys (ablates) certain tissues in the body that exhibit abnormal behaviour or cause certain health conditions. For example, small tissues in heart muscles can cause abnormal rapid heart rhythms. The ablation of such tumours can provide symptoms relief and correct the condition.
Ablation therapy is minimally invasive and usually requires only local anaesthesia. However, general anaesthesia can be used for children as well as anxious adults. General anaesthesia is also recommended for patients with complex cardiac anatomy, congenital heart disease, or if the procedure is expected to last longer than usual.
Surgeons perform ablation therapy with the use of probes. These probes are inserted into the skin through a small puncture in the marked area. Flexible tubes are also used and inserted into the blood vessels in the area where abnormal tissues are found.
The identified abnormal tissues are destroyed with the use of radiofrequency or heat. Others are treated with cryoablation where abnormal cells are subjected to extreme cold temperature. Some surgeons use chemicals or lasers.
Who Should Undergo and Expected Results?
Ablation therapy can be recommended for patients with benign or less invasive pulmonary tumours. The procedure comes with minimal risks and complications when compared to open surgical procedures.
Since the procedure is less invasive, patients experience faster recovery. The procedure spares nearby healthy tissues thereby increasing the patient’s chance to recover more quickly.
Patients are advised to talk to their surgeons to see if ablation therapy is the right therapy for them and weigh its benefits and risks.
How is the Procedure Performed?
The procedure is rather simple. For patients with pulmonary tumours, surgeons use a catheter guided by an electrode, which is inserted into the pierced skin near the target location. An electrode is a type of an electrical conductor that helps in the delivery of electrical current (in the case of radiofrequency or transcatheter ablation) to the cancer site. The heat is usually painless although some patients reported having some tingling sensation in the treated area. The anomalous tissues receiving such current will die, and the growth or biological activity in that area will stop. The process is similar to cauterising skin tags or warts only that the procedure is done in tissues located inside the body.
Surgeons require that the patient be motionless throughout the entire procedure. Immobility ensures that ablation catheters stay in place, and that the mapping of target tissues is as accurate as possible.
Depending on the area to be treated, the entire procedure can last between two and six hours. If there are more than one site to be treated, it may last longer. The procedure is performed in a hospital’s electrophysiology or cardiac catheterisation lab.
The punctured site where the catheter and electrode are inserted is applied with pressure in order to stop bleeding as soon as the procedure has been completed. Doctors and nurses will look for signs of bleeding or swelling and the patient’s vital signs are monitored carefully to make sure they are stable before the patient is allowed to be taken out of the surgery room.
To prevent blood clot formation in the ablated area, surgeons usually prescribe aspirin to be taken 2-4 weeks after the procedure.
Possible Risks and Complications
In terms of pain, cryoablation is observed to be less painful than radiofrequency ablation. The procedure may induce pericardial irritation or pain surrounding the surface of the heart, but it can be relieved by taking non-steroidal anti-inflammatory drugs (NSAIDs) or over-the-counter drugs such as acetaminophen (paracetamol).
Because catheters are inserted into the blood vessels, these soft tissues can rupture and cause mild bleeding or in some cases, an infection.
In the case of radiofrequency ablation, the success rate is 90% with virtually no chance of complications. The patient can go back to work or resume normal daily activities a few days after the procedure. Some mild irritation in the treated area may be experienced while the treated tissue heals.
Elizabeth MC Ashley; BSc MB ChB FRCA FFICM; “Anaesthesia for Electrophysiology Procedures in the Cardiac Catheter Laboratory”; http://www.medscape.com/viewarticle/771059_6
American Heart Association; “Ablation for Arrhythmias”; http://www.heart.org/HEARTORG/Conditions/Arrhythmia/PreventionTreatmentofArrhythmia/Ablation-for-ArrhythmiasUCM301991_Article.jsp#.V-Sej5N94qI