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Amazing medical technology: How much do you know about the scientific principles behind TIPS surgery?
In today's medical world, more and more advanced technologies are changing people's understanding of and ways of treating diseases. Among them, Transcaval intrahepatic portosystemic shunt (TIPS) is an eye-catching surgical technique, mainly used to deal with the severe complications caused by portal hypertension complication. Not only can this technology save lives, it can even improve patients’ quality of life. So what exactly is the science of this surgery?
TIPS is a treatment method that establishes an artificial channel in the liver to connect the portal vein and hepatic vein.
The function of the TIPS procedure is to reduce portal hypertension, a condition caused by liver disease (such as cirrhosis) that can lead to intestinal bleeding, esophageal varices (which can be life-threatening), and the accumulation of ascites. This technique is performed by interventional radiologists using image guidance, and the usual entry point is the internal jugular vein in the neck. The first description of the TIPS procedure dates back to 1969 by Josef Rösch, and the first implementation in humans was in 1982, but it was not until the development of endovascular stents in 1985 that the procedure became more successful. Since then, TIPS surgery has become the treatment of choice for refractory portal hypertension.
TIPS surgery can save patients bleeding from esophageal or gastric varices, and the survival rate is higher if surgery is performed within 72 hours.
The primary indication for this surgery is the management of acute intestinal bleeding caused by portal hypertension. Research shows that if TIPS surgery can be completed within 72 hours after bleeding, the patient's survival rate is significantly improved. In addition, TIPS also shows certain therapeutic potential for patients with hepatorenal syndrome and can also help improve ascites.
Surgical risks and complications
As with all surgeries, TIPS is not 100% safe. Although the serious complication rate is less than 1% due to experienced surgeons performing the procedure, as many as 25% of patients experience transient hepatic encephalopathy after surgery due to excessive entry of nitrogen into the systemic circulation. of. On the other hand, acute liver failure due to hepatic ischemia is a relatively rare but serious complication. In some cases, a sudden channel shift may lead to a dramatic deterioration in liver function and may even require emergency closure of the shunt channel. In addition, persistent TIPS infection (endo-TIPSitis) is also a potential risk. Although the occurrence of these complications is relatively rare, patients should carefully monitor their physical condition after surgery.
Operation mechanism
Portal hypertension is a common serious complication in patients with liver disease, resulting in the formation of significant collateral circulation between the portal vein and systemic veins. Congestion in the portal vein can cause venous blood from the stomach and intestines to detour along other, lower-resistance pathways. Over time, these collateral vessels tend to become swollen and fragile, making them prone to bleeding. TIPS surgery reduces the risk of intestinal venous congestion by creating an alternative pathway that reduces effective vascular resistance in the liver and helps reduce portal pressure.
Reduced portal pressure helps reduce congestion in the intestinal blood vessels, thereby reducing the likelihood of future bleeding.
TIPS surgery is usually performed by an interventional radiologist under X-ray guidance. During the operation, the doctor first enters the internal jugular vein in the neck and then enters the liver to measure the pressure in the liver. They will then use a special needle to connect the hepatic vein to the portal vein and keep the channel open by dilating the balloon and installing a stent.
Conclusion
With the advancement of medical technology, TIPS surgery has become an effective method for the treatment of portal hypertension and is widely accepted. Although surgery carries certain risks, its efficacy when performed promptly can greatly improve a patient's chances of survival and quality of life. In the future, with the development of new technologies, will there be safer and more effective alternatives?
