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Once you have been evaluated to see if you are a suitable candidate and we have explained to you all the risks associated with the device and the procedure, you may be scheduled for treatment. We will shave the skin over the target area. You will have a urinary catheter placed to drain your bladder during the procedure and will wear compression stockings during the procedure. An intravenous catheter will be placed into your arm to administer fluids and medications. You will be administered medications to dull your pain and make you comfortable. You will be positioned on the table so the correct part of your body is in direct contact with the transducer gel pad without any gaps and so that you are comfortable and supported. Your heart rate, blood pressure and blood oxygen levels will be monitored throughout the procedure.
During the procedure
Treatment set up for an ExAblate® procedure
You will be given a Stop Sonication Button to hold during the procedure. You will be moved inside the MR device (see Figure 3). If you get claustrophobic, tell someone so that you can receive medication to help you relax. The procedure will be performed from a computer in the room adjoining the MR suite. The doctor can see you through a window into the MR scanner room, and he and a circulating nurse will be close to check on you and to administer medication.
A series of MR images will be taken for the purpose of planning the treatment. The physician will mark the area to be treated and the ExAblate® device will plan the treatment to cover the area and avoid vulnerable areas with nerves or bowel. Your physician will review the plan and optimize it for your treatment.
Initially, very low strength sonications are delivered to ensure that the MR and the transducer are aligned properly. After that, the sonications will be at full strength and will move sequentially over the area marked for treatment. After each sonication, the doctor will talk to you to make sure you are okay. You must remain still throughout the treatment session.
After all the sonications have been performed, a contrast agent will be administered through the IV catheter and a final series of MR pictures will be obtained to see how well the treatment target was covered.
After the treatment
You will be moved to a recovery room for observation for 1-2 hours. Once your sedation has worn off, all the monitoring equipment and catheters will be removed. Your physician will come by to evaluate you, and to explain to you the post treatment care that you may need. Your physician will let you know when you can go home, which is almost always the same day, and when you will need to return for a follow-up visit.
When to call your doctor
If you experience severe pain that is not relieved by the medication your doctor has prescribed for you, or fever of 101°F or higher within 48 hours of treatment, call your physician. You will receive a follow-up phone call the next day, and you will be scheduled for a post-treatment follow-up visit.