What Is an Ablation?

Ablation is a term used in medicine to describe the removal of tissue either by surgery or less invasive techniques. It is used to treat a variety of medical conditions ranging from serious to cosmetic. It differs from a resection which involves the partial or complete removal of an organ. An ablation, by contrast, is meant to remove a layer (or layers) of tissue with the aim of restoring normal function.

Some of the more common types of ablation include:

Surface Ablation

Surface ablation of the skin involves the removal of a layer of tissue to treat discoloration, improve skin texture, or remove superficial lesions, warts, or tumors. When used for cosmetic purposes to induce skin regeneration, it is referred to as dermabrasion. There are several techniques used for skin ablation:

• Laser ablation used primarily for superficial lesions or discoloration
• Chemoablation in which topical acids are used to peel skin or remove warts
• Cryoablation which freezes the skin using cold gases like liquid nitrogen or argon
• Fulgeration using high-frequency electrical currents remove small lesions or warts

Eye laser treatments used to treat astigmatism are another form of surface ablation. The technique, also known as Lasik surgery, removes the surface cells of the cornea which then regrow to correct the vision disorder.

Surface ablation can also be applied to otolaryngologic procedures involving the ear, nose, or throat. One such procedure strips way excess soft palate tissue to treat snoring or sleep apnea.

Cardiac Ablation

Cardiac ablation is a technique primarily used to correct heart rhythm problems (arrhythmias). Rather the removing tissue to enable regeneration, cardiac ablation aims to destroy tissue in the heart associated with irregular heartbeats. By blocking specific nerve pathways, the electrical signals that trigger the arrhythmias are effectively stopped.

Cardiac ablation is typically performed by inserting a thin, flexible tube (called a catheter) through a vein or artery in the groin and threading it to the heart. When in place, a form of energy is used to either freeze or burn the area of tissue. The technique, commonly referred to a catheter ablation, can be used to treat arrhythmias of either the upper chambers (atria) or lower chambers (ventricles) of the heart.

They include:

• Atrial flutter ablation (involving the atria)
• Pulmonary vein isolation (involving the atria)
• Supraventricular tachycardia ablation (involving the atria)
• Ventricular tachycardia ablation (involving the ventricles)

A similar technique can be applied to arterial blockages that don't respond to standard balloon angioplasty. Known as rotoatherectomy, the procedure involves the use of a tiny, diamond-tipped drill that removes fatty deposits and restores blood flow.

Endometrial Ablation

Endometrial ablation is a minimally invasive procedure that destroys the lining of the uterus (known as the endometrium). The aim of the procedure is to reduce or stop the abnormal bleeding of the uterus.

The ablation itself can be carried out in several ways:

• High-energy radiofrequency which elevates the temperature of the uterus to destroy endometrial tissue
• Thermal balloon ablation in which a balloon is inserted into the uterus and filled with 190^oF fluid
• Microwave endometrial ablation (MEA) which increases the temperature of the endometrium using microwaves
• Cryoablation in which a probe is inserted into the uterus and superchilled to -4^oF to create an ice ball which destroys endometrial tissue

Other Types of Ablation

Bone marrow ablation is commonly used to remove bone marrow in advance of a bone marrow transplant. It is not performed mechanically but rather with a combination of chemotherapy and radiation.

Ablative brain surgery is used to treat certain neurological disorders such as Parkinson's disease and cluster headaches.

Venous ablation is the removing of the saphenous vein to eliminate venous reflux and varicose veins.