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 You are here : Physicians > HIFU - Ablatherm > About Ablatherm> Treatment Procedure
Preparation
The prostate cancer patient is hospitalized the evening before the treatment. The patient is given an enema for colorectal preparation approximately two hours before treatment.
Procedure
Ablatherm Device dot The Ablatherm HIFU device is made up of 2 modules: the treatment module on which the patient is positioned and the control module which enables the surgeon to plan and check the treatment via a computerized system which guides the robotic endorectal probe.
Probe dot The probe is installed on a mobile support. The ultrasound generator and the integrated ultrasound scanning equipment (or transducers) are located on the end of the probe.
robotic movements dot The probe's mobile support is an instrument with robotic movements which enables the device to move the probe automatically and extremely precisely during the treatment to treat the whole prostate.
Patient dot After a local or general anaesthetic is administered, the patient lies down on his right hand side and stays in this position throughout the treatment.
Probe dot The probe is covered with a condom filled with a degassed liquid, then it is lubricated and inserted into the rectum via the anus. This non-invasive position enables the probe to be positioned near the prostate, which is then accessible for ultrasound treatment.
ULtrasound scan dot The first phase of the treatment involves an ultrasound scan of the prostate. Thanks to the 7.5 MHz of the imaging transducer, the Ablatherm device is able to produce a very high definition image.
prostate in 3D dot The computerized system will then recreate the prostate in 3 dimensions to enable the surgeon to plan the treatment on the screen and to program the robot to define the area to be treated.
Shooting phase dot Once the treatment has been planned the shooting phase can begin.
Robotic probe dot The robotic probe will then carry out the surgeon's instructions automatically and extremely precisely (orders are accurate to a few millimetres).
Target zone dot Every 10 seconds the probe generates a high intensity focused ultrasound beam which is used to destroy a very small part of the prostate with intense, very fast, highly localised heat. The targeted zone destroyed by each shot is oval-shaped and measures up to 24 mm in height by less than 2 mm in diameter.
Prostate destroyed dot This phenomenon generates almost no pain for the patient after treatment. This elementary lesion will be followed by a number of adjacent lesions, several hundred in fact, which gradually, one after the other, enable the entire prostate to be treated.
Patient dot The treatment then continues, lasting between one and a half and two and a half hours depending on the volume of the prostate.
HIFU treatment is followed by an immediate increase of the prostate volume due to edema and inflammation. Swelling of the prostate appears then immediately after the treatment and compresses the urethra. A temporary urine catheter is inserted. This allows the elimination of urine until the edema recedes (which takes generally from 3 to 8 days depending on the case). To reduce the need for post treatment catheterization, a "mini" transurethral resection can be done before the treatment with HIFU (during the same anesthesia): this is mainly performed on patients' prostate cancer presenting signs of hyperplasia (prostate greater than 35cc) and prostatic obstruction (weak urinary stream, frequent nocturnal urination, and residual urine volume in the bladder). Moreover, this TURP eliminating part of the central hyperplasic prostatic tissue, has been demonstrated to decrease significantly the duration of the treatment and allow to treat patients with prostates larger than the maximum volume admitted for HIFU treatment.
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