A medical procedure involving ablation (removal) of a layer/layers of tissue is known as ablative surgery. Ablation can be performed in many ways including surgery, hormones, drugs, radiofrequency, heat, or other methods. The prime objective of this surgery is to remove all visible tumors and/or malignant or genetically defective hematopoietic cells along with a clear margin of healthy tissues surrounding the tumor. Ablative surgical procedures are the important choice of treatments in the neurological armamentarium.
Lesioning (in neurological surgeries), maze surgery (in cardiac cases)
The brain, heart, or liver
How Ablative Surgery performed?
Ablative surgery is performed through surgery, diathermy, cryotherapy, or minimally invasive techniques such as laparoscopy. Generally, ablative procedures involve minimally invasive procedures, which may be performed without open surgery. Tissues can be destroyed by freezing them with cold liquids (cryotherapy) or applying hot liquids to the affected area (diathermy). Commonly used methods for ablative surgery include:
- Microwave ablation where a thin probe is inserted that releases microwaves to destroy the tissue.
- High energy radiofrequency ablation where a similar procedure is performed through radiofrequency waves.
- Thermal balloon ablation where a balloon is inserted into the body cavity and filled with fluid heated to around 200 degrees Fahrenheit.
- Laser ablation where a laser is used for ablation of layers of skin tissues.
- Cryo-ablation where a probe is applied to the tissue and supercooled to about -4 degrees Fahrenheit with liquid nitrogen or argon.
Preparation for Ablative Surgery
The surgical procedure is performed on an empty stomach and the surgeon decides the length of fasting depending on the type of procedure followed.
- Patients are advised not to wear any jewelry for the procedure.
- Some blood tests and other diagnostic tests may be performed before the procedure.
- The procedure can be performed after hospitalization or as an outpatient facility.
- Sedation/anesthesia can be given before the commencement of the procedure either in the form of local or general anesthesia.
- An area of the skin can be shaved and disinfected if required.
- A needle puncture or incision is created for insertion of probe or catheter.
- In the case of catheter ablation, a balloon catheter is inserted and threaded through a blood vessel until it reaches the target area.
Ablative Surgery Follow up
Depending on the type of procedure many hours or overnight hospitalization can be needed. In the case of a local anesthetic procedure, the patient can be allowed to go home in a few hours.
The recovery period varies depending on the type of procedure performed during ablation and underlying condition too. In cases of neurological and cardiac ablative surgical procedures, the recovery time is usually more and the surgeon may suggest a longer hospital stay for observation and the patient may be watched for various post-surgical complications. Strenuous activities are strictly avoided to ensure a healthy recovery. If the patient experiences symptoms such as high fever, excessive bleeding, vomiting, pain, or any other unusual symptoms, then immediate medical care is required.
Risks of Ablative Surgery
The risks of ablation therapy vary depending on the type of procedure and severity of the underlying conditions. The surgeon may watch out for the following post-surgical complications:
- Bleeding or damage to the blood vessels where ablation tools were inserted.
- Excessive bleeding at the operated area.
- New or continuing arrhythmias
- Irritation or infection around the operated area.
- Stroke or heart attack.
- Brain lesions.
Recovery for Ablative Surgery
The recovery time for an ablative surgery depends on the type of procedure followed and the severity of the conditions underlying. A brain or cardiac ablative surgery involves a longer recovery period in comparison to the ablative surgery of other regions. For procedures such as urethral or venous ablations, the patient is likely to be sent home on the same day as it involves the least chances of risks and complications.
Certain signs during recovery can indicate that you need immediate medical assistance, which includes excess bleeding, shortness of breath, swelling, numbness at the site of operation, fever, inability to keep fluids down in terms of bladder ablation, or increased vaginal discharge in case of endometrial ablations. Taking care of post-surgical wounds is equally important for a good recovery. To sum up, Ablative surgical procedures are generally simple procedures with a brief hospital stay and a short recovery process. The key to progressive recovery is an apt rest for a few days before resuming back to normal activities.