Scalpel
The scalpel is the traditional cancer surgery tool. Other
tools such as needles, forceps, or scissors are involved in
cancer diagnostic surgeries. However, these traditional cancer
surgery tools are being replaced by new and more effective
cancer surgical tools such as laser and radiation. These new
surgical tools often result in less operative time, cause
less pain to cancer patients, and reduce complications, such
as scarring that sometimes occur with surgeries performed
with traditional surgical tools.
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A recent innovative cancer surgery
tool, "Smart Scalpel," still in development, can even
detect cancer cells. "Smart Scalpel," a dime-sized biological
laser, can quickly identify a cell population that has
abnormal protein content (as cancer cells usually do).
This device should assist surgeons in cutting away malignant
tissue while minimizing the amount of healthy tissue
removed.
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Cryosurgery
Cryosurgery (also called cryotherapy) is the use of extreme
cold to destroy cancer cells. Traditionally, it has been used
to treat external tumors, such as those on the skin, but recently
some physicians have begun using it as a treatment for tumors
that occur inside the body. Cryosurgery for internal tumors
is increasing in popularity as a result of developments in
technology over the past several years.
For external tumors, liquid nitrogen (-196 degrees Celsius,
-320.8 degrees Fahrenheit) is applied directly to the cancer
cells or tissue with a cotton swab or spraying device. For
internal tumors, liquid nitrogen is circulated through an
instrument called a cryoprobe, which is placed in contact
with the tumor. To guide the cryoprobe and to monitor the
freezing of the cells, the physician uses ultrasound (computerized
moving pictures of the body generated by high-frequency sound
waves). By using ultrasound, physicians hope to spare nearby
healthy tissue.
Cryosurgery often involves a cycle of treatments in which
the tumor is frozen, allowed to thaw, and then refrozen.
Advantages of Cryosurgery:
1. Minimally invasive- no blood loss, no surgical incision,
and can be done as an outpatient.
2. Favorable success rates and less complications--less complications
than open surgery.
3. Short recuperation period.
4. Procedure can be repeated if the first cryosurgery has
failed.
5. Radiation therapy or radical surgery is still an option
if the cryosurgery fails.
6. Cost is less than traditional treatment.
Electrocauterization Surgery
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Cauterization is the process of destroying
tissue by using chemical corrosion, electricity, or
heat. Electrocautery is done using a small probe, which
has an electric current running through it, to cauterize
(burn or destroy) the tissue.
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Electrocautery is a safe procedure and is routinely used
in surgery to burn unwanted or harmful tissue. It is also
effectively used to reduce or stop hemorrhaging by "burning"
the bleeding blood vessels (seals them off). Various types,
shapes, and sizes of tips (probes) are available for specific
treatments.
A specific type of electrocautery is fulguration, sometimes
called electrodesiccation. Electrodesiccation is the destruction
of tissue with a diathermy instrument. Electrodesiccation
is particularly useful inside the bladder. Bladder electrodesiccation
is performed via the urethra and viewed through a cystoscope.
Laser Surgery
L-A-S-E-R stands for Light Amplification by Stimulated Emission
of Radiation. Through a complicated electronic process, a
beam of light is produced which has special properties. This
light is all one wavelength; that is, it is all one color
of the spectrum. The light is focused so that all of its rays
are traveling in the same direction. In a similar fashion,
you might use the lens of a magnifying glass to focus rays
of sunlight to a point.
Lasers are used for many reasons. In many instances, lasers
can improve the precision of the surgeon with finely focused
beams of light. Some lasers can reduce bleeding by coagulating
blood vessels as they cut tissue. Others can be aimed down
narrow passages or sent down fiber-optic channels in endoscopes
to reach areas that are otherwise inaccessible.
A new trend in laser surgery is to use the special properties
of different wavelengths of laser light to selectively treat
different problems. For instance, a yellow laser light absorbed
by the red blood cells of a birthmark called a "portwine stain"
can result in the selective destruction of the
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birthmark without affecting the skin
cells around it. The result is that scarring of the
remaining normal skin is lessened or avoided. In another
instance of selective laser treatment, drugs that are
retained by tumors are infused into the body and activated
by lasers to destroy only the tumor, preserving normal
structures.
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In many instances, the cost of medical care can be reduced
by lasers. Through their use, many procedures that previously
required hospital admission can be done on an outpatient basis.
Photodynamic Therapy (PDT)
PDT is a revolutionary medical technology that uses lasers
to activate light-sensitive pharmaceuticals to treat cancer
(and other diseases) in a minimally-invasive manner.
PDT is considered to be cancer-directed surgery, and there
are specific codes in the surgery data fields for PDT of various
primary sites.
PDT works as follows:
- The patient is injected intravenously with a light-sensitive
drug (most often, "photofrin").
- The drug is retained by malignant tissue, remaining inactive
until exposed to a specific wavelength of laser light.
- Laser energy is directed to the site through a flexible
fiberoptic device that allows the laser to be targeted precisely
at the site.
- When activated by the lasers' light energy, the drug creates
a toxic form of oxygen that destroys the cancerous cells
with minimal damage to surrounding healthy cells.
Gamma Knife
Developed in 1968 by Swedish professors Lars Leksell and
Borge Larsson, the gamma knife (sometimes called the "Leksell-Larsson
Gamma Knife") is a highly advanced instrument used to treat
arteriovenous malformations (AVM), facial pain, benign and
malignant brain tumors, and other functional brain disorders.
What makes the gamma knife so unique is that it successfully
treats these conditions with no incision. Instead, it uses
a concentrated radiation dose from Cobalt-60 sources. A total
of 201 beams of radiation intersect to form a powerful tool
focused on a targeted area of abnormal tissue within the brain.
Amazingly, the gamma knife is so precise that it damages and
destroys the unhealthy tissue while sparing adjacent normal,
healthy tissue.
En Bloc Resection
An en bloc resection is a surgical procedure in which a lesion
and surrounding tissues are removed in one piece.
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