6 January 2010

NICE

Consultation Documents (14th December 2009 - 29th December 2009)
NICE are now consulting on the following:

Review of the guide to the technology appraisal appeal process - closing date for comments is 22nd March 2010

Rheumatoid arthritis - tocilizumab: appraisal consultation document 2 - closing date for comments is 20th January 2010

Lung cancer (non-small-cell) - pemetrexed (maintenance): appraisal consultation document - closing date for comments is 21st January 2010

Soft tissue sarcoma - trabectedin: final appraisal determination - closing date for comments is 18th January 2010

Transanal haemorrhoidal dearterialisation - closing date for comments is 27th January 2010

Laparoscopic radical hysterectomy for early stage cervical cancer - closing date for comments is 27th January 2010

Macular translocation with 360o retinotomy for wet age related macular degenertion - closing date for comments is 27th January 2010

Macular translocation for wet age-related macular degeneration - closing date for comments is 27th January 2010

Interventional Procedures Guidance IPG322. Negative pressure wound therapy for the abdomen (16th December 2009)
Emergency surgery for trauma or severe infection may lead to a wound being left open on the trunk. Such wounds may take many months to heal. Negative pressure wound therapy uses a dressing inserted against the bowel, tubing and suction a small vacuum unit to apply suction to the wound, with the aims of reducing healing time and simplifying wound management. The dressing may be left in place for days or weeks.
Guidance


Interventional Procedures Guidance IPG323. Balloon catheter insertion for Bartholin's cyst or abscess (16th December 2009)
The Bartholin’s glands are at the entrance of the vagina. A cyst or abscess can form in the Bartholin’s duct (which drains the glands) if it becomes blocked or infected. Cysts are usually treated either by ‘incision and drainage’ or ‘marsupialisation’, which involves cutting into the cyst and placing stitches to make a permanent opening so that the gland can drain freely. Insertion of a balloon catheter is a non-surgical alternative to incision and drainage or marsupialisation.
Guidance


Interventional Procedures Guidance IPG324. Electrocautery cutting balloon treatment for pelviureteric junction obstruction (16th December 2009)
Pelviureteric junction obstruction is a condition caused by a narrowing of the funnel-shaped part of the kidney (known as the renal pelvis) where urine collects before being carried to the bladder by tubes called ureters. The obstruction may cause episodes of loin pain and/or nausea and vomiting, urinary infections and kidney stones. In some patients the condition could also affect the normal function of the kidney.

This procedure (electrocautery cutting balloon treatment) aims to widen the renal pelvis by inserting a catheter with a balloon and wire into the urinary tract. The wire is used to cut away the tissue that is causing the obstruction.
Guidance


Interventional Procedures Guidance IPG325. Endopyelotomy for pelviureteric junction obstruction (16th December 2009)
Pelviureteric junction obstruction is a condition caused by a narrowing of the funnel-shaped part of the kidney (known as the renal pelvis) where urine collects before being carried to the bladder by tubes called ureters. The obstruction may cause episodes of loin pain and/or nausea and vomiting, urinary infections and kidney stones. In some patients the condition could also affect the normal function of the kidney.

This procedure (endopyelotomy) aims to widen the renal pelvis by inserting small instruments either up through the urinary tract or down through the skin and into the kidney. The instruments are used to remove the tissue that is causing the obstruction by cutting or burning it away or by applying laser.
Guidance


Interventional Procedures Guidance IPG326. Laparoscopic augentation cystoplasty (including clam cystoplasty) (16th December 2009)
An ‘overactive bladder’ or detrusor hyper-reflexia causes symptoms of urgent need to urinate, urge incontinence, frequent urination and waking at night to urinate. One of the causes is bladder muscle (detrusor) overactivity, in which the detrusor contracts unexpectedly during bladder filling. Laparoscopic augmentation cystoplasty (including clam cystoplasty) is reconstructive surgery to increase the size of the bladder and is done via small incisions. The procedure involves sewing or stapling a tissue graft from a section of the small intestine (ileum), colon or other substitutes to the urinary bladder.
Guidance


Interventional Procedures Guidance IPG327. Radiofrequency ablation for the treatment of colorectal liver metastases (16th December 2009)
Colorectal cancer is a type of cancer that develops in the bowel (including the colon and rectum). In some patients, cancer cells could spread from the bowel to other parts of the body to form one or more ‘secondary tumours’, also known as ‘metastases’. For bowel cancer, most commonly secondary tumours occur in the liver.

Radiofrequency ablation uses heat to destroy cancer cells in the liver. It involves placing one or more electrodes into the tumour. The electrodes are used to heat the tumour with the aim of destroying it. Radiofrequency ablation can be applied through the skin or during surgery.
Guidance


Interventional Procedure Guidance IPG328. Suction diathermy adenoidectomy (16th December 2009)
Adenoids are small lumps of lymphoid tissue at the back of the nose, which are part of the immune system. They are largest in young children and usually disappear by adulthood. An adenoidectomy is an operation to remove the adenoids if they become enlarged and are thought to be causing health problems such as ‘glue ear’. Suction diathermy adenoidectomy is a type of surgery to remove the adenoids using heat and suction.
Guidance


Interventional Procedures Guidance IPG329. Total prosthetic replacement of the temporomandibular joint (16th December 2009)
The temporomandibular joint (TMJ) is formed by the temporal bone of the cranium (skull) and the lower jaw or mandible. Symptoms of degenerative disease in this joint include dysfunction or pain in the head, face, jaws, neck and shoulders. TMJ replacement involves substituting a prosthesis, usually metal-on-metal or metal-on-acrylic, for the TMJ. The procedure takes 2–3 hours and the patient is usually in hospital for a few days afterwards.
Guidance


Interventional Procedures Guidance IPG330. Vagus nerve stimulation for treatment - resistant depression (16th December 2009)
Depression is associated with feelings of sadness, despair, helplessness, hopelessness and lack of interest in life. People with severe depression may be unable to eat or sleep or to take part in social activities, and they may become completely withdrawn. Vagus nerve stimulation aims to improve mood regulation and reduce depression by stimulating the nerve in the neck that carries signals to the brain areas involved. A generator implanted under the skin in the chest area is used to provide electrical stimulation to the nerve.
Guidance

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