a. Overview

Cryoablation is a well-established technology for the treatment of many benign and malignant tumors and lesions. Kidney cancer cryoablation destroys the cancerous tissue by freezing the cancer cells. Very precise targeting and control of the extremely cold energy allow for efficient destruction of tumor cells while leaving healthy kidney tissue intact and functional.

b. Cryoablation Procedure

To freeze the cancer, special ultra-thin probes called cryoablation needles are inserted into the site targeted for ablation. Argon gas is delivered under pressure into a small chamber inside the tip of the needle where it expands and cools, reaching a temperature well below -100º Celsius. This produces an iceball of predictable size and shape around the needle. This iceball engulfs the tumor, killing the cancerous cells as well as a small margin of surrounding tissue while sparing healthy kidney structures.

Ultra-thin thermal sensors may also be placed at the margin of the tumor to monitor tissue temperature and help ensure that the entire tumor is destroyed.

c. Cryoablation Approaches

A couple of approaches can be used to perform renal cancer cryoablation, so the physician can customize the treatment to accommodate the patient’s general health as well as the size and location of the tumor. A minimally invasive approach, rather than an open surgical approach, is usually preferred.

Percutaneous Approach
The minimally invasive approach most frequently chosen is percutaneous ablation. With percutaneous access, no incisions are made. The patient is positioned in a CT (computerized tomography) or MRI (magnetic resonance imaging) scanner. The cryoablation needles and thermal sensors are inserted through the skin and positioned in the tumor under the image guidance of CT, MRI or ultrasound and the entire procedure is monitored using CT or MRI. Image-guided percutaneous cryoablation may be performed under conscious sedation, local anesthesia, or general anesthesia.

Laparoscopic Approach
Laparoscopic-guided kidney cryoablation, also a minimally invasive approach, is conducted using 3-4 small incisions through which instruments are inserted. A laparoscopic ultrasound probe is inserted through one of these incisions to send images to a screen so the physician can visualize the kidney, appropriately position the cryoablation needles, observe the iceball formation and ensure tumor destruction. Laparoscopic cryoablation is almost always performed under general anesthesia.

Open Surgery
Renal cryoablation can also be performed during traditional open surgery, although this approach is rarely used today.How quickly were you able to resume your normal activities after primary prostate cryotherapy?