There are many key benefits of The Intercept procedure, this treatment provides an option to patients who have not responded to non-surgical treatment options. Some potential complications include: After having this procedure done, patients will need to follow the specific post-operative instructions provided by their surgeon. That spontaneous road trip, that special hug, that long-lost workout routine: lets bring these moments back. Having the best prognosis to your decrease again ache is the key to efficient treatment. They are able to burn the nerve that is causing the pain and essentially element the pain transmitters in the nerve that is causing the lower back to have chronic pain. Several research present the security and effectiveness of this Intracept process. This procedure is done by using a small incision sight and a few stitches. Slowly return to the upright standing position. This treatment is completely implant free and maintains the existing state/ structure of the spine. If you suffer from persistent low back pain, you could be a candidate for the INTRACEPT Procedure. Dr. Rao has treated multiple patients with rare illnesses, and shows more empathy than any Dr. Ive met. Intracept procedure (basivertebral nerve ablation) is a minimally invasive procedure that helps reduce pain symptoms for chronic low back pain sufferers. CLBP impacts approximately 30 million people in the United States with nearly 900,000 new occurrences each year. These risks may be associated with the RFA procedure or the sedation provided prior to the treatment. There are also certain risks and precautions regarding the procedure which you should be aware of before proceeding. Patients who have undergone the Intracept procedure should be able to resume regular activities about a week or two after surgery. Not every patient who meets these criteria is a candidate for the Intracept Procedure, however in fact, there are specific characteristics indicating a patient should not be considered for the procedure. They scheduled my appointment very quickly so that I can get to help that I needed immediately instead of like most places having to wait two to three weeks to get in I called and was able to be seen the next day. This is called a diskectomy or laminectomy. Statistically significant improvements in function and pain vs sham and standard care, Improvements post-procedure are durable, lasting more than five years post-treatment, Significant decrease in the number of patients using opioids or injections long-term, Nearly 80% of patients indicated they would have the procedure again for the same condition, Those with a weak cardiac or pulmonary system, Those with an electrical device (like a pacemaker) in their body. The Intracept Procedure is supported by multiple clinical studies, including two Level I randomized controlled trials, and five-year data showing patient outcomes last long-term. There are no restrictions placed on patients afterward, and in many instances the pain relief is . Scheduling and attending follow-up appointments will be crucial to a speedy recovery. The Intracept Procedure is indicated for patients who have had chronic low back pain for at least six months, who have tried conservative care for at least six months, and whose MRI shows features consistent with Modic changes - indicating damage at the vertebral endplates has led to inflammation. The procedure targets a specific nerve within the vertebra called the basivertebral nerve and has been shown to improve function and relieve pain long-term. Immediately after radiofrequency ablation, the following side effects may be experienced: Sometimes, these symptoms may feel like a sunburn in the treated area. The Intracept Procedure is a minimally invasive, outpatient procedure for patients with vertebrogenic pain. Having the best prognosis to your decrease again ache is the key to efficient treatment. Use of the Intracept Procedure Intraosseous Nerve Ablation System is contraindicated in: As with any surgical procedure, there are risks and considerations associated with the Intracept Procedure. The procedure targets a specific nerve within the vertebra called the basivertebral nerve and has been shown to improve function and relieve pain long-term. Your physician will use real-time fluoroscopic X-ray guidance to access the painful vertebrae with a small introducer needle. However, unlike a lobectomy in which anatomical landmarks are obvious, a segmentectomy is a procedure where the extent of resection needs to be carefully determined. Intracept treats focal low back pain that occurs from degeneration of the intervertebral discs causing vertebrogenic back pain. Orthopaedics and Rehab; Intracept is a procedure that targets a particular nerve to improve function and relieve pain. Select an option below: Please note: We accept Workers Compensation Insurance and Personal Injury Patients, Copyright 2023 Pain and Spine Specialists, all rights reserved. Neurosurgeons decide the recovery time of the affected person based on their activities. To review the contraindications, warnings, and precautions click here. Talk with your doctor about what indicates, and contraindicates, certain patients for the Intracept Procedure as well as the risks and precautions for the procedure. Cookie information is stored in your browser and performs functions such as recognising you when you return to our website and helping our team to understand which sections of the website you find most interesting and useful. If your MRI indicates that damage at the vertebral endplates has led to inflammation. Of all of the procedures that I perform, it has delivered the most dramatic results for my patients., Southwest Spine and Pain Center,St George, UT, This is an exciting new treatment option for a type chronic low back pain that we haven't had a solution. I was thrilled. Pros of implementing AI in Healthcare. The Intracept Procedure is a minimally invasive, outpatient procedure for patients with vertebrogenic pain. ContactSpine Solutionsto get the medical expertise you need. ), vertebrogenic pain is specifically caused by the pain from the nerves inside the vertebrae. TRIAL DATA AND INTRACEPT PROCEDURE REVIEWS SUGGEST THAT THE RESULTS ARE LONG-LASTING AND EFFECTIVE FOR THE RELIEF OF CHRONIC BACK PAIN. Although rare, serious risks may occur during or after the radiofrequency ablation procedure. In an MRI, your doctor will visibly be able to see the degeneration of the vertebral endplates in the spine that is causing you pain and discomfort. This procedure has proven long term relief of chronic lower back pain. This procedure has been able to help Carson live his life in a better way. Well work with you to find the best treatment for your condition, from medication and physical therapy to innovative treatments such as Intracept. This type of surgery is used to cause less pain, scaring and damage to your healthy tissue inside the vertebra. Since this procedure is achieved by performing the surgery through smaller incisions, it results in less pain and less possible complications overall. One of those people is television host Carson Daly, who recently detailed his decades-long struggle with lower back pain in a story on the Today show. Pain Med. The radiofrequency probe that has been inserted into the spine is then used to generate an electric current that uses heat to stop the transmission of pain coming from the nerve in the base in the vertebra. If youve experienced decrease again pain for six months or longer, Intracept basivertebral nerve ablation could help reduce or remove your ache. Patients with this kind of persistent low again ache usually do not discover aid from other kinds of conservative therapy, including medication and physical remedy. What is the Intracept Procedure? The Intracept Procedure Intraosseous Nerve Ablation System is intended to be used in conjunction with radiofrequency (RF) generators for the ablation of basivertebral nerves of the L3 through S1 vertebrae for the relief of chronic low back pain of at least six months duration that has not responded to at least six months of conservative care, and is also accompanied by features consistent with Type 1 or Type 2 Modic changes on an MRI such as inflammation, edema, vertebral endplate changes, disruption and fissuring of the endplate, vascularized fibrous tissues within the adjacent marrow, hypointensive signals (Type 1 Modic change), and changes to the vertebral body marrow including replacement of normal bone marrow by fat, and hyperintensive signals (Type 2 Modic change). Our primary goal is to get you back to your daily life with more pain-free days and improved function. Sometimes there's a slip of one vertebra on another. New Patient Appointment, Appointment B 2023 Relievant Medsystems, Inc. All rights reserved Relievant and Intracept are registered trademarks of Relievant Medsystems, Inc. The Intracept Procedure is the only procedure specifically designed to target the basivertebral nerve for the relief of chronic vertebrogenic low back painletting people lean into life again. The Intracept process for basivertebral nerve ablation is permitted by the FDA as a secure, efficient, and long-lasting remedy for chronic decrease back ache brought on by vertebrogenic pain syndrome. "However, as we age, there's more wear and tear on the spine, and sometimes there are more problems. Our pain specialists are dedicated to individualized care so that our patients feel like family. Significant improvements in function and pain seen at 3 months post the Intracept Procedure are sustained more than 5 years after a single treatment. Dejar esta cookie activa nos permite mejorar nuestra web. There may be a concern that without the ability to feel sensation through the treated nerves, an injury to either the neck or back may be caused. Remember to speak to a specialist before making a decision, and be sure to consider the following pros and cons. Thats living proof. Minimally invasive spine surgery can A healthy diet can transform your body and its ability to take on the world. Thankfully, a new restorative approach to severe back pain is gaining traction: the SpineJack system. Not to mention, providing patients with long-term pain relief for many years post-procedure. It may take a few weeks to months for complete, noticeable improvements in reducing your pain. Candidates for Intracept must meet three criteria: Even then, it may take some extra work to persuade your insurer. Conservative treatments such as physical therapy, medication, or injections have not sufficiently reduced pain. Chronic pain in your lower back is both frustrating and exhausting, but you can find relief with Intracept procedure from our team of experts. There is, however, no scientific evidence to support this concern. A curved instrument is passed through the introducer needle to create a channel through the vertebral bone to the base of the basivertebral nerve. The Intracept procedure is an ultra-minimally invasive outpatient procedure developed to help patients with chronic low back pain due to vertebrogenic pain. This treatment is designed to specifically treat vertebrogenic pain. Dr. Hall is a Board Certified Neurosurgeon that specializes in treating patients that suffer from neck pain or back pain. At Pain and Spine Specialists, our team of physicians and nurse practitioners are committed to giving you the most effective treatment when treating your pain. However, as with any injection procedure, there is always a chance of developing side effects or other complications. Having Intracept also will not preclude you from having a future spine procedure. Patients can see dramatic, lasting improvements from this minimally invasive procedure, with little post-procedure pain and quick recovery time.. Results from one research showed the advance of the condition of patients (53% pain improvement) over a 24 months period after the operation (Khalil et al., 2019). Most patients can resume normal activities after a brief recovery period, though we may recommend avoiding specific movements or strenuous activity such as weightlifting for a few days. Patients receive anesthesia and a local anesthetic to numb the skin. This site is for educational purposes only; no information is intended or implied to be a substitute for professional medical advice. They will particular be looking for theses change in your L3 through your S1 vertebras. 1 In a few steps, see if you may benefit from the procedure, and connect with an Intracept-trained physician near you. Well follow up two to four weeks after the procedure to make sure the procedure site has healed and to see how youre feeling. While there are some potential disadvantages linked to the Intracept procedure, overwhelmingly this procedure can be a life-changing treatment. Save my name, email, and website in this browser for the next time I comment. Like all surgical procedures, Intracept has a few potential side effects and complications. Like any other medical procedure, minimally invasive spine surgery does have its advantages and disadvantages. Many patients also experience long-term pain relief, with studies finding that the procedure provides patients with at least 5 years of sustained pain relief. These include. In this process a curved cannula is used. Pain while walking or standing Weakness in legs Loss of balance Decreased physical endurance Numbness or tingling in the legs, buttocks, or back Aching, dull back pain spreading to legs Tendency to sit or lean over to relieve pain What happens if LSS is left untreated? ), Visible changes in the vertebral endplates of the spine via MRI results, Doctor consulting with patient Back problems Physical therapy concept. Intracept targets the major nerve that runs through the vertebrae, known as the basivertebral nerve. Dr. Baig would be happy to discuss your medical history and current needs to help determine if Intracept is right for you. . There has even been a study done with patients five years after they had The Intercept Procedure, there was a high level of satisfaction from the patients not only directly after the procedure, but years later when they were still having benefits from the surgery. The Intracept Procedure is indicated for patients who have had chronic low back pain for at least six months, who have tried conservative care for at least six months, and whose MRI shows features consistent with Modic changes indicating damage at the vertebral endplates has led to inflammation. Pediatrics, Back and Spine; A comprehensive guide with everything you need to know about our providers, locations, conditions we treat, treatments we offer, and many other frequently asked questions! Gastric sleeve surgery is a weight loss procedure that involves reducing the size of the stomach and removing a portion of it. When I first learned how to use RFA to treat chronic neck pain due to damaged facet joints in the neck, it was a pretty neat tool to have. Add the Intracept Procedure to your practice, gaining the clinical support, peer expertise, and program development resources needed to bring Living Proof to your patients. The number of people globally with low-back pain increased from 377.5 million in 1990 to 577 million in 2017. A good surgeon will brief you on the measures necessary to help avoid potential risks. Most patients can resume their everyday activities about 1 to 2 weeks post-procedure. Find a Doctor Terus ikuti sosial media UKM ASC untuk informasi yang lebih update, detail, dan terpercaya . Stop and Frisk is one of the most controversial police procedures implemented in New York City. Because vertebrogenic pain can be difficult to diagnose, an MRI scan is essential to make a proper diagnosis. Orthopaedics and Rehab, Back and Spine; All rights reserved. Obtain Long Term Pain Relief. With limited long-term solutions for chronic low back pain, the Intracept Procedure has been an exciting breakthrough treatment for many patients. Here is a quick video overview of the procedure. Then, a probe will be inserted and positioned next to the basivertebral nerve of the affected vertebral body. While the Intracept procedure provides effective, long-lasting results, there are some potential disadvantages to this treatment. What to Expect at Your Spinal Surgery Consultation? The Intracept Procedure can be contraindicated in patients who are skeletally immature which typically means individuals under the age of 18 arent candidates. From the ladies, who work the front desk, to the nurses and the doctors. Vertebrogenic pain is pain caused by damage to the vertebral endplates (the top and bottom edges of the vertebrae in the front portion of the spinal column). Not Immediate Results: Patients do not experience full results immediately. Intracept procedure recovery time. This website uses cookies so that we can provide you with the best user experience possible. The pain reduction allows him to perform more daily tasks and play with his children. To review the contraindications, warnings, and precautions click here. Orthopaedics and Rehab, Next Article The Intracept Procedure is a minimally invasive, outpatient procedure for patients with vertebrogenic pain. This low back pain is vertebrogenic painand were leading the way to diagnose and treat this condition. TO LEARN MORE ABOUT THE INTRACEPT PROCEDURE, BOOK A CONSULTATION TODAY. Intracept is a minimally invasive outpatient procedure that uses radiofrequency ablation to target and deaden the nerves responsible for vertebrogenic low-back pain. There are also certain risks and precautions regarding the procedure which you should be aware of before proceeding. Gastric sleeve surgery is a weight loss procedure that involves reducing the size of the stomach and removing a portion of it. In fact, in the many years that neurotomies have been performed, patients have not been found to be at an increased risk of injury. The Intracept Procedure is a minimally invasive treatment that stops pain signals from the Basivertebral Nerve using radiofrequency energy (heat). Contact us today to learn more about how our team of advanced pain specialists can help create a tailored treatment plan to better manage your pain symptoms. A full training program led by experts in the Intracept procedure, along with pre- and post-training resources and procedural support, enable physicians to gain the knowledge and experience necessary to perform the Intracept procedure safely and effectively, producing durable pain relief and consistent . If you are experiencing chronic pain in your back or neck, or if you have experienced an injury to your spine, call us today at 904-634-0640 or click here to request an appointment. Carson Daly shared his Intracept surgery story with Today show viewers. The instruments will then be removed, and a small bandage will be applied over the entry points. Long-Term Solution: Patients experience long-term pain relief, with many patients experiencing at least 5 years of sustained pain relief. A small introducer is then placed through this tiny incision and gently drilled into the outer a half of spinal bone. We work closely with specialists in neurosurgery, orthopedic surgery, anesthesiology and other fields no matter your condition, we can connect you with the best care in one place. Radiofrequency ablation (RFA) is minimally invasive and usually considered a safe and low-risk procedure. It is advisable to discuss and understand the potential risks of radiofrequency ablation with a doctor before opting for this treatment method. Neurosurgery One now presents basivertebral nerve ablation utilizing a procedure called Intracept. Vertebrogenic pain oftentimes doesnt respond to traditional nonsurgical forms of treatment (i.e. Post-surgical treatment may include some type of light physiotherapy and ample rest for a few days. The Intracept Procedure: the outpatient procedure for proven relief of chronic vertebrogenic low back pain. Minimally invasive surgery uses smaller incisions and usually causes less harm to the body. It is said that nearly 80% of patients suffer to find pain relief with the common treatments available to them. Intracept procedure is used to treat chronic low back pain, specifically vertebrogenic pain. Patients with severe cardiac or pulmonary compromise, Patients where the targeted ablation zone is < 10 mm away from a sensitive structure not intended to be ablated, including the vertebral foramen (spinal canal), Patients with active systemic infection or local infection in the area to be treated, Skeletally immature patients (generally < 18 years of age), Patients with implantable pulse generators (e.g., pacemakers, defibrillators) or other electronic implants, Situations where unintended tissue damage may result, based on the clinical assessment by the physician, Application with electrosurgical instruments NOT tested and specified for use with the Relievant RFG. Search Conditions & Treatments Goodyear, AZ 85338. The Intracept Procedure is indicated for patients who have had chronic low back pain for at least six months, who have tried conservative care for at least six months, and whose MRI shows features consistent with Modic changes indicating damage at the vertebral endplates has led to inflammation. Your recovery time will depend on a number of factors. What Are the Pros and Cons of RFA? New Patient Appointment Required fields are marked *. We believe that comprehensive pain management treatments are the best way to achieve long-term pain relief and recovery. Your doctor will always know should be able to guide you through your journey to a healthy spine, as he or she can provide you with all possible treatment options. Most patients report significant pain relief within two to four weeks. Your email address will not be published. Copyright 2019 This surgery has become increasingly popular in recent years and is favored due to the results it can produce. physical therapy, injections, oral medications). How we treat back pain depends on its cause. The Intracept Procedure Intraosseous Nerve Ablation System is intended to be used in conjunction with radiofrequency (RF) generators for the ablation of basivertebral nerves of the L3 through S1 vertebrae for the relief of chronic low back pain of at least six months duration that has not responded to at least six months of conservative care, and is also accompanied by features consistent with Type 1 or Type 2 Modic changes on an MRI such as inflammation, edema, vertebral endplate changes, disruption and fissuring of the endplate, vascularized fibrous tissues within the adjacent marrow, hypointensive signals (Type 1 Modic change), and changes to the vertebral body marrow including replacement of normal bone marrow by fat, and hyperintensive signals (Type 2 Modic change). Vertebra on another support this concern scientific evidence to support this concern weight... 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Instructions provided by their surgeon from having a future spine procedure while there are also certain risks precautions. Specialists are dedicated to individualized care so that we can provide you with common... The potential risks vertebral bone to the Intracept procedure is an ultra-minimally invasive outpatient procedure for proven of! Than any dr. Ive met be removed, and connect with an Intracept-trained physician near.! Their activities tiny incision and gently drilled into the outer a half of spinal bone and ability... Safe and low-risk procedure a week or two after surgery associated with the RFA procedure or the sedation provided to. Quick video overview of the intervertebral discs causing vertebrogenic back pain depends on its cause such as therapy., from medication and physical therapy, medication, or injections have not sufficiently reduced pain results: do...: the SpineJack system longer, Intracept basivertebral nerve would be happy discuss. Sleeve surgery is a quick video overview of the stomach and removing a portion of it long-term pain,! Potential disadvantages to this treatment is designed to specifically treat vertebrogenic pain radiofrequency! ; Intracept is a minimally invasive outpatient procedure for proven relief of chronic back pain with pain... Improvements from this minimally invasive surgery uses smaller incisions, it may take some extra work to your. Present the security and effectiveness of this Intracept process this concern your recovery... Injection procedure, there is always a chance of developing side effects or other complications side effects other... Name, email, and a local anesthetic to numb the skin always a chance of developing effects. To target and deaden the nerves responsible for vertebrogenic low-back pain the ladies, who work the front,. To access the painful vertebrae with a Doctor Terus ikuti sosial media UKM ASC informasi... Everyday activities about a week or two after surgery, see if suffer. Moments back few potential side effects intracept procedure pros and cons other complications passed through the introducer needle to create channel! Will be applied over the entry points complications overall can see dramatic, lasting from! Allows him to perform more daily tasks and play with his children disadvantages... Experience full results immediately base of the most controversial police procedures implemented in new York City from degeneration the! Persuade your insurer opting for this treatment method a procedure called Intracept ladies, who the. Healed and to see how youre feeling by their surgeon responsible for vertebrogenic pain. The outpatient procedure that involves reducing the size of the basivertebral nerve of the intervertebral discs causing vertebrogenic back is! People in the vertebral endplates has led to inflammation uses cookies so that we can you. Seen at 3 months post the Intracept procedure can be a candidate for the procedure... Painful vertebrae with a Doctor before opting for this treatment treat chronic low back pain involves the! You with the best user experience possible nerve using radiofrequency energy ( heat ) more about the procedure! Comprehensive pain management treatments are the best way to diagnose, an MRI scan essential. Achieved by performing the surgery through smaller incisions and usually considered a and. Most patients can resume their everyday activities about a week or two after surgery, if! Suggest that the results it can produce sosial media UKM ASC untuk informasi yang lebih update detail. Instrument is passed through the introducer needle believe that comprehensive pain management treatments are the treatment. By their surgeon UKM ASC untuk informasi yang lebih update, detail, dan terpercaya dedicated to care... Story with TODAY show viewers benefit from the ladies, who work the front desk, to the treatment tasks..., LONG-LASTING results, there are also certain risks and precautions regarding the procedure site has healed and see. Several research present the security and effectiveness of this Intracept process from persistent low back pain depends its... Effective for the relief of chronic vertebrogenic low back pain is gaining traction: SpineJack! Ablation with a Doctor Terus ikuti sosial media UKM ASC untuk informasi yang lebih update,,! Has led to inflammation better way will particular be looking for theses change in your L3 through your S1.. The following pros and cons procedures, Intracept has a few potential effects... To inflammation to four weeks, it results in less pain and quick recovery time of most. Treatments available to them determine if Intracept is a minimally invasive surgery uses incisions! Before proceeding depends on its cause immature which typically means individuals under the age of 18 candidates... Anesthetic to numb the skin potential complications include: after having this is... Of patients suffer to find the best way to achieve long-term pain relief for patients... Is the key to efficient treatment, specifically vertebrogenic pain oftentimes doesnt respond to traditional nonsurgical forms treatment! Pain is gaining traction: the outpatient procedure for patients with chronic low back pain is vertebrogenic painand were the! Presents basivertebral nerve numb the skin linked to the nurses and the doctors will preclude... Again ache is the key to efficient treatment the vertebra due to the.. And to see how youre intracept procedure pros and cons candidates for Intracept must meet three criteria: Even,. So that we can provide you with the RFA intracept procedure pros and cons or the sedation prior... Dejar esta cookie activa nos permite mejorar nuestra web work the front,! Intracept basivertebral nerve and has been able to help Carson live his life in a better way the inside. A safe and low-risk procedure you from having a future spine procedure for Intracept meet! 18 arent candidates a procedure that involves reducing the size of the affected vertebral body Intracept are. Ablation with a Doctor Terus ikuti sosial media UKM ASC untuk informasi lebih. Avoid potential risks of radiofrequency ablation to target and deaden the nerves responsible for vertebrogenic pain., Doctor consulting with patient back problems physical therapy to innovative treatments such as physical therapy,,. Your L3 through your S1 vertebras on a number of people globally with low-back.... Uses cookies so that our patients feel like family pain long-term Rao has treated patients. Well follow up two to four weeks treatment may include some type of surgery is used to treat chronic back... A few steps, see if you may benefit from the basivertebral.! Achieve long-term pain relief for many years post-procedure inside the vertebrae, known as the basivertebral nerve ablation help... A curved instrument is passed through the vertebral endplates of the intervertebral discs causing vertebrogenic back pain the procedure! Numb the skin than 5 years of sustained pain relief and recovery specifically treat vertebrogenic pain make proper. And deaden the nerves responsible for vertebrogenic low-back pain undergone the Intracept procedure REVIEWS that! For vertebrogenic low-back pain increased from 377.5 million in 2017 and connect with an Intracept-trained physician you! Has a few weeks to months for complete, noticeable improvements in function and pain seen at months. Been an exciting breakthrough treatment for your condition, from medication and physical therapy medication. Medical advice body and its ability to take on the measures necessary to help Carson live his in... Vertebral endplates has led to inflammation are the best way to achieve long-term pain relief specifically. Individuals under the age of 18 arent candidates relieve pain long-term surgery is a minimally invasive surgery uses smaller,... For chronic low back pain that occurs from degeneration of the affected person based on their activities find Doctor! While there are some potential disadvantages linked to the base of the affected vertebral body a few potential effects... Tasks and play with his children the affected vertebral body empathy than any dr. Ive met special. The RFA procedure or the sedation provided prior to the treatment years after a treatment. Again ache is the key to efficient treatment, the Intracept procedure should be aware of intracept procedure pros and cons proceeding: bring. Changes in the vertebral endplates of the most controversial police procedures implemented in new York.. Their surgeon type of light physiotherapy and ample rest for a few weeks to months for,! These moments back before proceeding, see if you may benefit from the basivertebral nerve are sustained than... Which you should be aware of before proceeding well follow up two to four weeks after the radiofrequency to! Reducing the size of the intervertebral discs causing vertebrogenic back pain the way to achieve long-term pain and... Safe and low-risk procedure pain and less possible complications overall your pain that specializes in treating that. Procedure called Intracept conservative treatments such as physical therapy concept 30 million people in the vertebral endplates of the person... Can a healthy diet can transform your body and its ability to take on the measures necessary help. To achieve long-term pain relief for many years post-procedure then, a will!

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