TIPSS Procedure
The "Pressure Relief Valve" for the Liver. TIPSS (Transjugular Intrahepatic Portosystemic Shunt) is a life-saving, non-surgical procedure used to treat severe complications of Portal Hypertension. By creating a bypass channel inside the liver, we can stop internal bleeding and reduce massive fluid buildup (ascites) without opening the abdomen.
How It Works: The Bypass Concept
In liver cirrhosis, the liver becomes hard like a stone. Blood from the intestines cannot flow through it easily, causing high pressure (Portal Hypertension). This pressure forces liquid to leak into the belly (Ascites) or veins to burst (Variceal Bleeding).
Who Needs It?
- Refractory Ascites: Fluid requiring tapping every week.
- Variceal Bleeding: Vomiting blood that doesn't stop with endoscopy bands.
- Hydrothorax: Fluid accumulation in the chest/lungs.
Who Cannot Have It?
- Severe Heart Failure.
- Uncontrolled Infection (Sepsis).
- Multiple Liver Cysts or Cancer blocking the path.
- Severe Hepatic Encephalopathy (Confusion).
The Procedure: Step-by-Step
TIPSS is performed in the Cath Lab (Angiography Suite), not the Operating Theater. You will be under deep sedation or general anesthesia.
- Access: We make a tiny pinhole in the neck vein (Internal Jugular Vein). No cut on the stomach.
- Navigation: A catheter is guided down into the liver veins using X-ray guidance.
- Creating the Tunnel: A needle is used to create a path between the Portal Vein and Hepatic Vein inside the liver.
- Stenting: A specialized metal mesh tube (Stent) is placed to keep this tunnel open permanently.
- Result: Blood rushes through this new tunnel, instantly lowering the pressure in the abdomen.
Recovery & Results
Usually 24-48 hours for monitoring.
Fluid reduction seen within 2-4 weeks.
Immediate cessation of variceal bleeding.
Important Note: TIPSS is often a "Bridge to Transplant." While it fixes the symptoms (bleeding/fluid), it does not cure the underlying cirrhosis. It buys valuable time until a liver becomes available.