RadioFrequency Ablation

What is Radiofrequency ablation:
Radiofrequency ablation works by passing electrical current in the range of radiofrequency waves between the needle electrode and the grounding pads placed on the patients skin. The current creates heat around the electrode inside the tumor, and this heat spreads out to destroy the entire tumor but little of the surrounding normal liver tissue. Basically the tumor is destroyed by "cooking" it. As a CT scan will show, the tumor is killed immediately. Because healthy liver tissue withstands more heat than a tumor, radiofrequency ablation is able to destroy a tumor and a small rim of normal tissue about its edges without affecting most of the normal liver. The dead tumor cells are gradually replaced by scar tissue that shrinks over time.

Patient preparation:
You will receive instructions from staff at least a day before the procedure. You may have blood drawn for pre-procedure testing at either the hospital or clinic. Staff will advise you if changes in your regular medication schedule are necessary. Make sure you let the staff know if you have any allergies to medication . You will be asked to not eat or drink anything after midnight on the night before your procedure. If you are on any blood thinning medication such as Coumadin, you should check with the staff about it and when you should stop the medication. If you are taking asprin , you may be instructed to stop ten days beforehand. Make sure someone will be available to drive you home afterwards.

There are three main components of the equipment needed for radiofrequency ablation: needle electrodes, an electrical generator, and grounding pads. When the needle is positioned inside the tumor a plunger on the hub of the needle is advanced so that the electrodes extend from the tip of the needle. When fully extended, these electrodes resemble an umbrella. The radiofrequency generator is connected by insulated wires to the needle electrodes that are in the tumor and to grounding pads that are placed on the patient's back or thigh. The generator produces alternating electrical current in the range of radiofrequency waves.

During the procedure: 
Radiofrequency ablation is generally done in a room devoted to CT. An IV will be started and labs will be drawn. You will have a foley catheter inserted into your bladder. After you lie down on the exam table the tumor will be located by CT scan. You will receive general anesthesia. Each radio frequency ablation treatment takes about 15-30 minutes and the total procedure will be completed in two to four hours, depending on how many tumor sites have to be treated. After radiofrequency ablation you may receive further medication to prevent pain and nausea as the sedation wears off. After the procedure you will be admitted to the hospital for observation. 

Infection and cardiac arrest, stroke, liver failure, paralysis, embolism or injury to vessels, Lowering of blood pressure requiring CPR and/or intubation (tube to help you breath). The ultimate risk is death.

Post procedure information:

  1. You will be admitted to the hospital at least overnight
  2. You will have an IV in place for fluids
  3. You will have a PCA pump which will allow you to have IV narcotics for pain control
  4. If you have nausea make sure to alert the nursing staff so that medications can be given to help control any nausea
  5. You will have a catheter in your bladder after the procedure which is usually removed the following day
  6. Labs will be drawn as needed
  7. A CT scan will be done post-op the following day of the area that had radiofrequency ablation done