Medical Techniques & Procedures
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Some early-stage cancers and polyps that would have previously required surgical removal can now be treated endoscopically, notes V. Raman Muthusamy, M.D., associate clinical professor of medicine at the David Geffen School of Medicine at UCLA and director of interventional endoscopy. In some advanced cancers, stents can relieve obstructions for patients with tumors blocking the gastrointestinal tract. Interventional endoscopists are accessing the bile duct and pancreas to remove gallstones or overcome obstructions that might otherwise require surgical exploration. For patients with Barrett’s esophagus with dysplasia -- early changes in cells that can signal cancer -- the first-line therapy now involves use of endoscopic techniques to burn away the affected cells and prevent the development of cancer and the need for surgery.
Endoscopy is also being used to treat other gastrointestinal disorders. With endoscopic ultrasound -- a procedure that combines endoscopy with ultrasound imaging to create more detailed pictures -- a patient suspected of having a pancreatic tumor, for example, can be diagnosed and biopsied, the tumor can be staged, and the nerves can be injected through the endoscope to relieve pain.
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To understand what an endovascular procedure is, it is helpful to look at what the word means: “endo” means within, and “vascular” refers to the blood vessels. So, an endovascular procedure is any therapy performed inside the blood vessels. These procedures are often used to treat heart disease or peripheral artery disease (PAD), in part because they are less traumatic for patient than open surgery because major incisions are not necessary. One endovascular procedure is angioplasty, which is used to treat atherosclerosis - hardening of the heart arteries caused by the build-up of fatty deposits called plaque inside the arteries. Angioplasty opens arteries narrowed by plaque so that blood can flow as it should through the blood vessel.
Endovascular procedures are performed by specially trained doctors, including interventional cardiologists, vascular surgeons, interventional radiologists and vascular medicine specialists. There are also interventional neurologists and neurosurgeons, who specifically treat arteries going to and in the brain. The procedure, whether in the arteries of the heart or the legs, goes like this:
• The doctor makes a tiny incision in the upper leg or the arm and inserts a thin, flexible tube called a catheter into a blood vessel. The catheter is threaded through the vessel to the area of the blockage or narrowing. The catheter provides a channel for the doctor to introduce tools to clean blockages and widen the vessel.
• A tiny, uninflated balloon is then advanced through the catheter until it reaches the blockage. The balloon is inflated (often several times), and the force of the expanded balloon compresses the plaque to the walls of the blood vessel, which also widens the path for blood flow.
• Then the doctor may deliver through the catheter an expandable, metal mesh tube called a stent. The stent will prop open the newly cleaned vessel.
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Any medical procedure involves risks, but seizure—the main risk associated with transcranial magnetic stimulation (TMS)—is rare. It's up to you to determine whether this risk justifies the benefits you'll receive. That said, in a recent trial involving 325 patients, no seizures occurred.
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In transcranial magnetic stimulation(TMS), magnetic fields are sent through the scalp and skull to a particular area of the brain. When the magnetic field enters the brain it creates a small electrical current. This electrical current stimulates the brain cells (neurons) in a targeted brain area and causes them to fire (or send an electrical impulse). For example, if TMS is focused on the part of the brain that is associated with movement of the right thumb, the activated neurons cause the right thumb to twitch.
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A person receiving TMS is awake and no anesthesia is required. The patient sits comfortably in a chair for approximately 30 minutes, during which time a magnetic coil is placed on the head in a specifically targeted region – the prefrontal cortex. The patient will feel a tapping on the head and will hear a clicking noise. The treatment is noninvasive.
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Infusion therapy is the administration of medications or nutrients through a needle or catheter. Some of the most common reasons for infusion therapy include:
- chronic pain
- dehydration
- gastrointestinal problems
- heart failure
- immunodeficiency disorders
- serious infections
The team responsible for infusion therapy, which may include pharmacists, pharmacy technicians, an intake nurse, a total parenteral nutrition (TPN) pharmacist and an infectious disease pharmacist, help ease a person’s transition from the hospital by matching a home nursing agency with the their geographical location and delivering IV medications and supplies directly to their home.
Trinity Health is a Catholic health care organization that acts in accordance with the Catholic tradition and does not condone or support all practices covered in this site. In case of emergency call 911. This site is educational and not a substitute for professional medical advice, always seek the advice of a qualified healthcare provider.
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Modern technology allows doctors to use minimally invasive techniques important for harvesting the tissues used in reconstruction surgery. Learn more from Dr. Mark Sisco on behalf of NorthShore University HealthSystem about reconstruction techniques.
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A CRT device electrically paces both lower chambers, organizing the heart’s electrical activation. A CRT can increase the heart’s pumping function and decrease HF symptoms—and has been shown to improve quality of life and increase exercise capacity. CRT also can reduce your chance of being hospitalized for heart failure and has been proven to enhance survival.
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Outpatients go home the same day they have their procedure and do not require an overnight hospital stay. The vast majority of U.S. patients are treated as outpatients.
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Going home after ambulatory (or outpatient) surgery will depend on the policy of the surgery center, the surgery type and the anesthesia used. Most patients are ready to go home between one and four hours later. Ask your anesthesiologist for a more specific time estimate. Occasionally, it is necessary to stay overnight. All ambulatory surgical facilities can make arrangements with a hospital.
