| BUSINESSWEEK ONLINE : OCTOBER 25, 1999 ISSUE | ||||||||
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| BUSINESSWEEK LIFESTYLE
The Kindest Cut? Thermal surgery may treat many ailments After innumerable sleepless nights lying beside her blissfully snoring husband, Susan Douglass was at wit's end. So the wife of Delphi Ventures partner David Douglass issued a challenge. ''You're Mr. Medical Device venture capitalist,'' she said one day in 1995. ''Why don't you invent a device to do something about your snoring?'' Her timing couldn't have been better. David Douglass was working with two startups that were using radio-frequency-generated heat to shrink enlarged prostates and burn away liver tumors. Could the same technology be used to quiet his nocturnal din? Doctors were intrigued. Within a year, Douglass became one of the first patients to take advantage of a radio-frequency probe developed by Somnus Medical Technologies (800 250-6031), a venture that resulted from his wife's challenge. In a procedure done in a doctor's office, the probe was used to shrink tissues at the back of his palate and around nasal passages. ''I got treated with my Hermes tie on, and there wasn't a platelet of blood,'' he recalls. Douglass is one of a small, but growing number of patients benefiting from relatively inexpensive medical treatments harnessing the power of heat. Instead of cutting and stitching, surgeons using thermal tools and endoscopes can apply a probe to ligaments, tendons, and other tissue, burning it away or reshaping it into a tighter package if it has been slackened by age and overuse. The probe itself usually isn't heated, but emits radio waves that can warm tissues up to 180F. Because the procedures are less invasive than traditional surgery, they are relatively painless, usually require only local anesthesia, and recovery is quicker. MORE TOOLS. Insurers generally pick up the cost of thermal surgery if it treats an ailment that's already covered. Still, some doctors are hesitating, concerned that heat-sculpted tissue may not wear as well over the years as tissue left in its natural state. ''The long-term success is not totally proven,'' warns Dr. Jon J.P. Warner, chief of the Harvard Shoulder Service at Massachusetts General Hospital. In addition, debate persists over which patients would benefit. ''We have a hammer now, and we want to continue figuring out which nail to hit,'' Warner says. Indeed, most of the procedures are so new that patient studies go back only a few years. Despite these concerns, thermal surgery is being used to help patients suffering from conditions such as varicose veins, chronic back pain, worn-out shoulder ligaments, and even incontinence (table). Researchers are experimenting with thermal treatments for such life-threatening ailments as congestive heart failure, asthma, and emphysema. The approach uses a principle known to leather tanners for centuries: Connective tissue shrinks when heated. This results from heat's impact on collagen, a fibrous protein that makes up 90% of the organic material in most of our tissues. A collagen molecule resembles a stretched-out spring. When heated, the bonds keeping the spring taut are released, and it snaps into a jumbled coil, shriveling the tissue. In some cases--such as in varicose vein surgery using a probe from VNUS Medical Technologies (888 797-8346)--that's all surgeons aim to do. Instead of removing the collapsed vein, surgeons rely on the body to absorb it and reroute its blood flow elsewhere. In shoulder surgeries, a probe from Oratec Interventions (800 784-6060) emits radio waves that tighten tissue surrounding the shoulder joint. As the patient heals, the body weaves stronger collagen around the framework. Costs tend to be sharply lower than that for traditional procedures because most thermal surgeries require only tiny incisions and are done on an out-patient basis. Back patients who undergo a $7,000 thermal surgery that shrinks bulging discs usually can return to work within a week or two. By comparison, patients who undergo the traditional alternative--a $50,000 procedure called spinal fusion--remain hospitalized for up to five days and often must take months off work. For these reasons alone, thermal surgery likely will remain a hot topic for years to come. By JANET RAE-DUPREE _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ BACK TO TOP |
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