The tips procedure, which involves the creation of a new blood flow channel between the portal vein and the hepatic vein. The procedure is performed by an interventional hepatologist under the supervision of a contrast angiogram, unlike other surgical procedures, which are performed under general anesthesia. The procedure is usually painless and involves the insertion of a catheter from the skin of the neck through the jugular vein to the hepatic vein. The catheter has a balloon and a metal stent at the end of the catheter, which needs to be dilated once the balloon has reached the target vessel. If the patient is under general anesthesia, the patient will usually feel nothing. The purpose of the procedure is to create a channel between the portal vein and the hepatic vein. This allows the patient to have better blood flow back to the heart, reduces varices caused by cirrhosis, reduces bleeding, and reduces the production of ascites.