This paper will prove that Ultrasonography is influencing neurosurgeries by providing an alternate method of surgery that is beneficial to the patient, doctor, and families. This paper will answer questions like how can we make difficult surgeries easier on the surgeons and patients? The answer to that question is HIFU. HIFU stands for high-intensity focused ultrasound. According to wikipedia, HIFU is “similar to using a magnifying glass to focus sunlight. Focused ultrasound uses an acoustic lens to concentrate multiple intersecting beams of ultrasound on a target.
Each individual beam passes through tissue with little effect but at the focal point where the beams converge, the energy can have useful thermal or mechanical effects. ” HIFU is typically performed with real-time imaging via ultrasound or MRI to enable treatment targeting and monitoring (including thermal tracking with MRI). A LITTLE HISTORY LESSON If this concept is too much, then look back to where sonography very first started. Pythagoras started by starting to study the pitch of sound waves in which is the base component of sonography.
The next advancement was made by Galelli, he determined that there was, in fact, a link in between Frequency and pitch. After these minor advancements, Jacques Curie determined that sound waves can create pictures, although the technology at the time was not advanced enough to implement this new idea. After numerous studies of Curie’s research on ultrasound took the medical field by storm. COMMON USES Today, the most common way that ultrasound is used in pregnancy.
Ultrasound is used in pregnancy to show expectant parents, their child, and to look for early abnormalities that the baby may posses. Ultrasound is also used in injuries of organs to detect whether the organ has ruptured, and to determine the patient’s next few steps in order to rehabilitate from the injury in a safe way. Ultrasound is also used to detect gallstones, cancer of the fatty liver, and cysts or otherwise known as abnormal growths that would otherwise be undetected. With this being said, this does not explain exactly how HIFU is a better solution for surgeries. HIFU HELPS
HIFU can help in difficult surgeries by filling the nervous void in the medical field, otherwise known as neurosurgery Before the discovery of HIFU, there were three main types of neurosurgeries. The first type is a biopsy, which a procedure that removes brain tumors with some incisions. The next type of surgery is a craniotomy, which is a surgical opening of the skull. There are many types of craniotomy, and the first that will be mentioned is extended bifrontal craniotomy. The extended bifrontal craniotomy is a skull base approach used to focus on difficult tumors towards the front of the brain.
It is based on the concept that it is safer to remove the extra bone than to unnecessarily harm the brain. The next surgery is an extended bifrontal craniotomy involves making an incision in the scalp behind the hairline and removing the bone that forms by the forehead. This bone is replaced at the end of surgery. Temporarily removing this bone allows surgeons to work in the space between and right behind the eyes without having to mess with the brain. The next type of surgery is the “Eyebrow” craniotomy. In this procedure, neurosurgeons make a small incision within the eyebrow to target tumors in the front of the brain.
This approach is used when a tumor is very large or close to the optic nerves or vital arteries. Next is the “Keyhole” craniotomy, which allows for the removal of skull base tumors through a small incision behind the ear, providing access to the cerebellum and brainstem. By the end of knowing all of this, patients only notice the pain that must be involved with these gruesome procedures. HIFU IN NEUROSURGERY How does this new technology work? The rate at which ultrasound passes through different tissue types varies — bone absorbs a lot of sound, whereas the jelly-like tissue of the brain takes in much less.
To make matters worse, our skulls are not a uniform thickness all the way around. So surgeons have to use CAT scans to measure the bone density at thousands of points around the scalp. Later, a cap full of ultrasound emitters, called transducers, will be placed on the patient’s head. Each transducer is tuned using information about the bone density underneath so that it emits just the right frequency, for just the right amount of time, to focus the waves at the desired point in the brain. How long does this procedure last? The whole procedure probably took less than 2 hours, and apart from a strange buzzing sensation, it was completely painless,” says a former patient to HIFU HIFU IS BETTER THAN PREVIOUS METHODS Well to start out, no scalpel is used so no extra marks could be made, no cuts are done so then no stitches or staples are needed, and the chance of bollix. Since cuts are no longer needed with HIFU, then the recovery time is so much faster. This is also a benefit to hospitals because “When you’re dealing with a lot of very sick people, that’s a huge advantage,” says Gail ter Haar, who studies ultrasound at the Institute of Cancer Research in London.
Usually it takes patients months to recover due to the impending threat of infections, and blood clots. Now, since HIFU is beyond minimally invasive, the patient will be in and out in about twenty four hours at the most. This saves on doctors’ bills, and the risk of exposure at the hospital. Another pro with HIFU is that no medicine is required at all. The patient is fully conscious during the operation, and feels absolutely nothing besides maybe a tingle. This saves on prescription drugs that could potentially harm you, and the around the clock care needed to ensure that the drugs are administered correctly.
The final point that will be mentioned that favors HIFU is the pain level. This operation from start to finish is nearly painless, which saves patients from the traditional pains that comes with surgery. With all of the pros of HIFU being listed, one may question may arise. THE FUTURE How much longer will it be until HIFU is more regularly used? Currently, HIFU is used in many countries such as Mexico, Poland, and India. The cost of a surgery like this in Mexico is $25,000 dollars, $8,026 in Poland, and $8,000 in India.
The cost for this specific surgery in the United States is still undetermined, but the cost will most likely be higher than the cost of having the surgery in Mexico. This type of technology not yet FDA approved because they do not know the long term effects. This will most likely be approved soon because According to the article Surgery’s new sound, “Trial results so far have been impressive: in a 2012 study of about 40 men receiving HIFU, 90 per cent could maintain an erection by the end of the study, and no man was left incontinent. One year later, 95 per cent showed no signs of the disease (Lancet Oncology, vol 13, p 622).
WHY THIS IS IMPORTANT An estimated 77,670 people will receive primary brain tumor diagnosed in 2016, with this being said, there are specific groups that would benefit from the implementation of the idea of HIFU. The lower class would benefit because less time is spent in the hospital’s care, and since a specialist is no longer needed, then the bill would be lower as well. The working class would also benefit because less time would be spent away from work. Insurance companies will also benefit because the mortality rate is lower, as well as any risks that the hospital may provide such a sickness.
The ethics behind this surgery are almost flawless. The mortality rates are nonexistent with this procedure, which gives families the chance to remain with loved ones even after terminal brain tumors and cancerous growths. This also saves on the treacherous medical bills, and the hard road of recovery for the patient and the loved ones of the patient. Currently there is approximately 3,500 neurosurgeons in the U. S. serve a population of more than 299 million, a ratio of 1 neurosurgeon to 85,542 people. This means that there really is not many options for operations, especially in more rural states that do not have larger cities.
This creates another cost that is transportation, which could be a problem for most. With the creation of more HIFU machines the gap could be filled, and at least three hospitals or more could have the proper equipment and staff needed to guide the painless lifesaving procedures. IN FINAL WORDS As earlier stated, HIFU doesn’t just help the patients, it helps anyone and everyone included in the harsh medical realities provided by our withered bodies. The predicted plan for HIFU advancements is still unknown currently, but the technology is underway to becoming the next solution to all of our medical problems.
