General Considerations

The original Racz procedure technique is well documented.6,8,15,20,24 As expected, modifications of this original procedure have emerged over the years.10,20,25 Changes in procedural technique, medications, and equipment may provide improved outcomes, safety, and cost effec-

tiveness.9,12,23,26

We suggest that practitioners proposing to add this therapy to their practice initially adopt a standard method well reported in the literature without modification. This establishes a dependable method during acquisition of basic knowledge and expertise in the therapy. Modifications can be considered with greater confidence when the entire scope of the therapy is better understood. We should always draw on previous experience (both our own and that of others) in modifying and improving an original idea. The desire to modify procedures carries with it the responsibility to study the effects any change might have on patient outcome. Only in this way can it be determined whether a given change is warranted.

The technical considerations proposed in this chapter have subtle variations from the original procedure that are identified with appropriate rationales. These variations have been discussed with Racz and others who have considerable expertise in the field and are acceptable although not adopted universally.

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