Before the procedure, you will be asked to have nothing to eat or drink starting at midnight the evening before treatment. Your list of medications will be reviewed with our staff at the time of your consultation and you will be told which medications you may take in the morning of the procedure.
If you are taking Coumadin, Plavix, or another blood thinner, you may need to stop taking that medication several days before the procedure.
The procedure itself is performed in a room containing a CT scanner or ultrasound machine, depending on which of these machines will be used for guidance during the procedure. You will be sedated through an IV line in your arm. Some patients may require the use of general anesthesia depending on their medical condition and anticipated discomfort during the procedure.
Before the procedure begins, patients are hydrated and given antibiotics to prevent procedure-related infections. Local anesthesia is injected into the skin surface and medicine for sedation is given to the patient through an IV.
Routine cardiovascular and respiratory monitoring helps ensure patient safety during the procedure. Grounding pads are placed on the thighs prior to beginning the procedure.
The procedure begins with a very small incision made in the skin. This allows a needle to be passed through the skin and into the organ containing the tumor. Ultimately, this needle is placed directly into the tumor being targeted for treatment. This is all done under the guidance of an imaging method such as ultrasound, CT, or MRI.
Once the needle is in place, a probe is passed through the needle into the tumor. This probe has many electrodes at its tip and these electrodes are projected into the tumor.
The probe is then attached to an RF generator and a current is passed through the probe in order to heat the tumor tissue. This heat spreads out around the electrodes and destroys the entire tumor, which takes approximately 15-20 minutes. For larger tumors, it is often necessary to perform overlapping ablations to be certain that the entire tumor is treated.
During the procedure, temperature is monitored so that the appropriate wattage and current may be applied to the tissue. When tumor cells are heated up in this manner, they die along with a small rim of normal tissue that surrounds them. More normal tissue is not destroyed because healthy liver is able to tolerate the heat better than the tumor can.
The dead tumor cells are gradually replaced by scar tissue that shrinks over time. If it happens at all, recurrent tumor tends to be found along the edge of the treated area of the liver, in which case retreatment is possible. That is why close follow-up with CT scans is very important.
