83885 Nickel

Name of the Procedure:

Nickel Procedure (also known as Nickel-Titanium Memory Shape Stapling or Nickel-TiMSS)

Summary

The Nickel Procedure is a minimally invasive surgical technique involving the use of nickel-titanium (Ni-Ti) memory alloy staples to join or secure tissues within the body. This advanced technology utilizes the shape-memory properties of the alloy to ensure precise and secure closure of surgical sites.

Purpose

The Nickel Procedure is used to facilitate the healing of tissues and secure internal structures during various types of surgeries, including gastrointestinal, thoracic, and orthopedic procedures. The primary goals are to reduce recovery time, minimize scarring, and enhance overall surgical outcomes.

Indications

• Patients undergoing surgeries that require precise and durable tissue closure.
• Conditions such as gastrointestinal perforations, lung resections, or fractures needing stabilization.
• Criteria: Patients must be fit for surgery and have no nickel allergy or contraindications to metallic implants.

Preparation

• Pre-procedure fasting for at least 6-8 hours.
• Patients may need to adjust or discontinue certain medications (e.g., anticoagulants) as advised by their healthcare provider.
• Diagnostic tests such as blood work, imaging studies (e.g., X-ray, MRI), and pre-anesthesia evaluation may be required.

Procedure Description

1. The patient is positioned and prepped in a sterile environment.
2. Anesthesia (general or regional) is administered depending on the type of surgery.
3. Surgical incisions are made to access the targeted area.
4. Nickel-titanium staples, pre-shaped to the desired configuration, are applied to the tissues.
5. The staples react to body temperature, securing the tissues firmly as they return to their preset shape.
6. The surgical site is then closed using sutures or additional staples if necessary.
7. The patient is monitored during the initial recovery period.

Duration

The procedure duration can vary but typically ranges from 30 minutes to several hours, depending on the complexity of the surgery.

Setting

The procedure is performed in a hospital operating room or a specialized surgical center equipped for advanced procedures.

Personnel

• Surgeons specialized in the relevant field (e.g., gastrointestinal, thoracic, orthopedic).
• Nurses and surgical technicians.
• Anesthesiologist or nurse anesthetist for administering anesthesia.

Risks and Complications

• Common risks: Bleeding, infection, and minor reaction to anesthesia.
• Rare risks: Implant rejection or hypersensitivity to nickel, non-union or misalignment of tissues.
• Complications are generally managed with medications, additional surgical interventions, or close observation.

Benefits

• Enhanced tissue healing and reduced recovery time.
• Minimized scarring due to precise closure.
• Durable and secure tissue attachment.
• Benefits generally realized within weeks post-procedure.

Recovery

• Post-procedure care includes monitoring for any signs of infection or complications.
• Pain management through medications and comfort measures.
• Avoiding strenuous activities as advised by the healthcare provider.
• Typical recovery time ranges from a few days to several weeks, with follow-up appointments to assess healing.

Alternatives

• Traditional sutures or surgical staples.
• Non-surgical management depending on the condition.
• Pros: Generally more widely available and understood.
• Cons: May result in longer recovery times, increased scarring, and less precise tissue alignment.

Patient Experience

Patients may feel some discomfort during the initial recovery period, managed with pain medications. Many report mild soreness, which subsides as healing progresses. The use of Ni-Ti staples aims to enhance comfort and expedite the overall recovery process.