Pinhole Surgery can make Open Surgeries

Interventional radiology is a new speciality, which treats patients using minimally invasive techniques, usually as an alternative to traditional surgery. This important subspecialty of radiology, contributed to some of the most significant medical developments. Most patients will have heard of “keyhole surgery” but interventional radiologists go one step further and perform “pinhole surgery”.

Who is an Interventional Radiologist?

Interventional radiologists are doctors trained in radiology and experts in reading X-rays, ultrasounds, CAT scans and other medical images. This expertise with imaging techniques enables them to guide small catheters and guide-wires through blood vessels to treat many diseases. These small catheters (tubes) are usually only a few millimetres in diameter. In fact, interventional radiology is termed “pinhole surgery” because of the small holes that are made in the skin to perform these procedures.

Pinhole procedures can be performed for many surgeries:

These include blood vessel blocks. Blocks can occur in blood vessels anywhere in the body: in the neck, leading to a stroke; in the leg leading to gangrene; in the kidney leading to renal failure and so on. Previously reestablishing blood flow in these cases involved surgery. Now thanks to pinhole surgery they can be carried out with local anesthesia.

Opening Procedures

We insert a catheter through the groin vessel (chosen because it’s the widest vessel) and using imaging guidance navigate beyond the obstruction and insert a stent to restore the blood flow.

Closing Procedures

Pinhole surgery is also used to control abnormal bleeding anywhere in the body. This is called embolisation – performed for acute life threatening diseases like coughing up blood, uncontrolled bleeding in the intestines, during childbirth etc. The conventional treatment for these was blood transfusions. Now, with pinhole surgery, we identify the site of the blood, use the catheter to access the blood vessel and block it with chemical agents.

Using the same technique we can block the blood supply to tumours thereby ‘starving’ them. Similarly, liver tumours can be “cooked” using radio frequency waves or chemo – therapy can be administered directly to them.

Advantages of Interventional

Radiology Only a short hospital stay is required for most procedures. General anaesthesia is usually not required. Risk, pain and recovery time are reduced compared to conventional surgery.

Know your options

Pinhole surgery is available for many diseases, but few patients know to ask about them, or to seek a second opinion from an interventional radiologist. Usually patients do not have direct contact with interventional radiologists. General practitioners still refer their patients to surgeons and rely on the surgeon to provide advice on available treatment options.

Surgeons may or may not know the minimally invasive treatments that another specialty offers. Eventually this situation will change and patients will be sent to the least invasive practitioner for consult first, but in the meantime, it is important for you to know that you may have a “pinhole option”.