Name of the Procedure:

Ablation, 1 or more renal tumor(s), percutaneous, unilateral, radiofrequency
Common Name(s): Radiofrequency Ablation of Renal Tumors (RFA)
Technical Terms: Percutaneous Renal Tumor Radiofrequency Ablation

Summary

Radiofrequency ablation (RFA) is a minimally invasive procedure used to treat renal (kidney) tumors. A needle-like probe is inserted through the skin into the tumor, and radiofrequency energy is used to heat and destroy cancerous cells.

Purpose

Medical Condition: Renal tumors, including small kidney cancers
Goals: The primary goal is to destroy the tumor cells, potentially eliminating cancer and preserving as much healthy kidney tissue as possible.

Indications

Symptoms/Conditions:

• Small renal tumors, typically less than 4cm in diameter
• Patients who are not candidates for surgery due to health reasons
• Tumors in patients with only one kidney or those with familial kidney cancer syndromes

Patient Criteria:

• Confirmed diagnosis of renal tumor(s) via imaging studies
• Good overall health and ability to tolerate the procedure

Preparation

Pre-Procedure Instructions:

• Fasting for at least 6-8 hours before the procedure
• Adjustments or temporary discontinuation of certain medications, especially blood thinners

Diagnostic Tests:

• Blood tests
• Imaging studies like CT scan or MRI for accurate tumor localization
• Assessment of kidney function

Procedure Description

1. The patient is positioned on the procedure table.
2. Local anesthesia is administered to numb the skin and tissue over the kidney.
3. A small incision is made, and a probe is inserted through the skin into the tumor, guided by imaging techniques such as ultrasound or CT scan.
4. Radiofrequency energy is delivered through the probe, creating heat to destroy the cancerous cells.
5. The probe is removed, and the incision is closed with a small bandage.

Tools/Equipment:

• Imaging device (ultrasound/CT scan)
• Radiofrequency ablation generator and needle-like probe

Anesthesia/Sedation:

• Local anesthesia
• Mild sedation may be administered to ensure patient comfort

Duration

The procedure typically takes about 1-3 hours, depending on the number and size of tumor(s).

Setting

RFA is performed in a hospital's interventional radiology or surgical suite.

Personnel

• Interventional Radiologist or Urologist
• Nurses and Radiologic Technologists
• Anesthesiologist, if sedation is used

Risks and Complications

Common Risks:

• Pain at the insertion site
• Mild bleeding or infection

Rare Complications:

• Injury to surrounding tissues or organs
• Significant bleeding
• Thermal injury to the ureter or bowel

Management:

• Pain medications
• Antibiotics if infection occurs
• Monitoring and potential intervention for significant complications

Benefits

• Minimally invasive with a quicker recovery than traditional surgery
• Precise targeting of the tumor with minimal damage to surrounding tissue
• Potential for cure or significant reduction in tumor size

Realization Time:
Benefits are typically observed within weeks to months after the procedure.

Recovery

Post-Procedure Care:

• Observation for a few hours or overnight in the hospital
• Pain management as necessary
• Instructions on wound care and activity restrictions

Recovery Time:

• Most patients can resume normal activities within a few days to a week
• Follow-up imaging to assess effectiveness of treatment

Alternatives

Treatment Options:

• Partial or complete nephrectomy (surgical removal of the kidney)
• Cryoablation (freezing the tumor)
• Active surveillance for small, slow-growing tumors
• Systemic therapies (medications)

Pros and Cons:

• Nephrectomy: More invasive, longer recovery, higher risk but may be necessary for larger or more aggressive tumors.
• Cryoablation: Similar to RFA but uses cold instead of heat. May be preferred for certain tumor locations.
• Active Surveillance: Suitable for very slow-growing tumors, avoiding immediate procedure but requiring regular monitoring.

Patient Experience

During Procedure:

• Mild discomfort or pressure at the probe insertion site
• Sedation ensures relaxation and minimal pain

After Procedure:

• Expect mild to moderate pain at the insertion site, manageable with medication
• Possible fatigue and minor bruising
• Regular follow-up appointments for imaging and monitoring are necessary