Radiology increasingly replaces surgery

Robert Bazell Chief science and health correspondent • Profile • E-mail

NEW YORK — Bruce Tempone is undergoing treatment for varicose veins in his legs. In the past this would have required surgery, including a day in the hospital and weeks of recovery.

But with the help of ultrasound, Dr. Robert Min guides a laser repair device into the veins. The entire procedure is over within an hour and Tempone recovers immediately.

This vein repair is one of dozens of procedures that fall into the expanding field of medicine called "interventional radiology" — often replacing more costly and difficult surgery. Doctors can now repair all sorts of organs by running tubes through various blood vessels. They're guided by live images such as X-rays, ultrasound or magnetic resonance imaging.

"They require less anesthesia," says Dr. Min. "Certainly interventional radiologists who do these minimally invasive procedures help minimize those costs."

Interventional radiology can be an alternative to dozens of surgeries — even repairs inside the brain.

"This is very gentle, the patient is awake, cooperative," says Dr. John Pile-Spellman as he performs a procedure at New York-Presbyterian Hospital.

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But often patients are not informed about the less-invasive alternatives. Many say this is a huge problem with a treatment for fibroids that allows women to avoid a hysterectomy.

One reason that patients don't know about the option is that interventional radiology is relatively new.

"Everyone knows what a surgeon does, [but] very few people know what an interventional radiologist does," says Min.

But another factor can be surgeons fighting to keep lucrative business. Sometimes, the main consideration is how much the doctor makes for doing the procedure.

"Yes, that is the driving force," says Min. "That is the reality of medicine like any other field or business."

Increasingly, patients like Bruce Tempone are learning from friends or on the Internet that sometimes there can be an alternative to surgery.

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