Percutaneous Radiofrequency Ablation

Percutaneous radiofrequency ablation is a minimally invasive procedure to treat cancer. Cancer cell is killed by heat generated by radio waves. It is performed by interventional radiologist in the CT scanning room. Under ultrasound and CT guidance, through a tiny skin incision, a probe (antenna usually less than 2-3mm diameter) is inserted into the tumour. The probe is connected to a generator that delivers radio waves into the probe’s tip. These radio waves create heat in the tissue around the tip of the probe. This heat kills the cells in a small area around the probe tip.

Depending on the tumor’s size, the probe may be guided and repositioned during the procedure to try to destroy the whole tumor. A small margin of normal tissue near the tumor is also destroyed to ensure complete ablation.

Are there risks from radiofrequency ablation?

• Most patients tolerate this procedure well. You may feel some pain at the site after the procedure. Pain medication is available if you need it.
• Bruising or internal bleeding may occur.
• The dead tumour may become infected.
• Damage to adjacent tissue/organ can occur. The risk is minimized by close monitoring using imaging.
• If the tumor being treated is in your liver or upper kidney, there is a small risk of lung collapse (pneumothorax) when the probe is inserted.

Preparation:

• You may be required to have some blood tests few day before the procedure.
• You must not eat any solid foods for 8 hours before the procedure. You may continue to drink clear fluid and take your usual medication with water.
• Wear a hospital gown, with the opening in the back.
• Please arrive in SAN Radiology 1 hour before your procedure is scheduled.
• The radiologist and a nurse from the special procedure section will sit down with you to explain the procedure, alternative treatments, and risks. They will also answer any of your questions.
• The radiologist will ask you to read and sign a consent form, which gives your permission for the procedure to be performed.

Procedure: 

• Your vital signs (heartbeat, blood pressure, breathing, and temperature) will be monitored before and during the procedure.
• The nurse will place an intravenous (I.V.) line in one of your arms. You will get fluid and medications through this line. You will be given medication (sedation) to keep you relaxed and slightly drowsy during the procedure.
• Numbing medicine (local anesthetic) will be injected into the skin where the probe will be inserted. You will feel a pinprick and stininging lasting around ten seconds when the local anesthetic is given.
• You will be asked to stay still during the procedure. From time to time, the radiologist may ask you to take a deep breath, hold your breath, or exhale as the probe is positioned.
• Whenever you feel discomfort, you may be given pain medication through your I.V. line.
• If you prefer, the radiologist and nurse will explain what they are doing throughout the procedure. You may ask questions at any time.
• When treatment is completed, the probe will be removed, and a small bandage will be placed over the insertion site.
• The dead tumor will not be removed; the body system will gradually remove dead tissue through its natural functions. Ideally, over the next few months, the treated tissue will shrink and be replaced by scar tissue.

After the Procedure:

• Most patients will be on strict bed rest for 2 to 3 hours after the procedure.
• The nurse will monitor your vital signs until you have recovered from the sedation..
• For patients who have no history of heart failure or kidney problems: Drink 8 to 10 cups of fluid per day for several days after radiofrequency ablation.
• For patients who have a history of heart failure or kidney problems: Ask your doctor how much fluid you should drink after radiofrequency ablation.
• You may resume your usual diet as soon as you feel up to it..

Special Instructions: 3

• Do not drive a car, do not make any important decisions, and do not sign legal documents for 24 hours after the procedure. The sedation you received may affect your judgment until it clears from your body.
• Do no excessive physical activity for 24 hours.

Post-procedure Information

Notify us, see your doctor or come to SAN Emergency Department immediately if any of the following occur:

• chills and fever of  38.5 ºC.
• lightheadednes, dizziness, or feeling faint.
• difficulty breathing, shortness of breath, pain with breathing, or chest pain.
• bleeding or swelling at the probe insertion site.
• no urine output for 4 hours after the procedure.
• redness, drainage, or tenderness at the probe insertion site.

For any procedural related problems or questions, please call SAN Radiology at 94879840 from 8 a.m. until 5 p.m. Monday through Friday. After 5 p.m. on weekdays, or on weekends or holidays, if you feel you need immediate assistance, go to SAN Emergency Department for assessment and they can contact us for advice.

For your ongoing cancer care, please make appointment to see your oncologist in about one week.