Name of the Procedure:

Ablation, irreversible electroporation (IRE); 1 or more tumors per organ, including imaging guidance, when performed, percutaneous.

Summary

Irreversible electroporation (IRE) ablation is a minimally invasive procedure that uses electrical pulses to destroy cancerous tumors. It is guided by imaging techniques and performed through the skin (percutaneous).

Purpose

The procedure is designed to treat malignant tumors. The goal is to destroy tumor cells while preserving surrounding healthy tissue, providing an option for patients with tumors that are difficult to remove surgically.

Indications

• Solid tumors in the liver, pancreas, kidney, or other organs.
• Patients who are not candidates for traditional surgical removal of tumors.
• Tumors that are close to critical structures and would be risky to remove surgically.

Preparation

• Patients may need to fast for several hours before the procedure.
• Certain medications, particularly blood thinners, may need to be adjusted.
• Pre-procedure imaging tests like MRI or CT scans are usually required to locate tumors precisely.

Procedure Description

1. The patient is positioned on the procedure table and connected to monitoring equipment.
2. Local anesthesia or general anesthesia may be administered for comfort.
3. Using imaging guidance (such as ultrasound, CT, or MRI), the healthcare provider inserts fine needles or probes through the skin and into the tumor.
4. Electrical pulses are delivered through the probes to the tumor, causing cell death without generating significant heat.
5. The probes are then removed, and a small bandage is applied to the insertion site.

Duration

The procedure typically takes 1 to 2 hours.

Setting

Performed in a hospital's radiology or surgical department, or an outpatient clinic equipped with appropriate imaging technology.

Personnel

• Radiologist or oncologist specializing in interventional procedures.
• Radiology technician.
• Nursing staff.
• Anesthesiologist, if general anesthesia is used.

Risks and Complications

• Pain or discomfort at the insertion site.
• Infection.
• Bleeding.
• Damage to nearby structures.
• Rarely, cardiac arrhythmias due to electrical pulses.

Benefits

• Minimally invasive compared to traditional surgery.
• Can target tumors in challenging locations.
• Preservation of adjacent healthy tissues.
• Shorter recovery time compared to surgical interventions.

Recovery

• Patients may need to stay for observation for a few hours or overnight.
• Mild pain or discomfort can be managed with medications.
• Most patients can return to normal activities within a few days.
• Follow-up imaging tests are scheduled to monitor treatment efficacy.

Alternatives

• Surgical removal of tumors.
• Traditional thermal ablation (e.g., radiofrequency or microwave ablation).
• Chemotherapy or radiation therapy.
• Each alternative has its own risks, benefits, and suitability depending on the specific patient's condition.

Patient Experience

• Patients might feel pressure or minor discomfort during needle insertion.
• Post-procedure, mild soreness at the insertion site is common.
• Pain management options will be provided.
• Patients typically feel well enough to resume normal activities shortly after the procedure.