MIS Cryotherapy for Kidney Tumors

Doctors at the University of Virginia Medical Center (UVA, Richmond, USA) treated a renal cell carcinoma in the left kidney of a 64-year-old man by using cryotherapy, eliminating the need for surgery and its complications.

The minimally invasive procedure took less than 55 minutes. Doctors froze the tumor with ultra-thin needles inserted directly through the skin, using cryotherapy technology. UVA radiologists used real-time ultrasound to guide the needles to their target, where a template aligned and held them in place through two freeze/thaw cycles, which completely ablated the tumor. In this procedure, doctors used the SeedNet Gold system and CryoNeedles from Galil Medical, Ltd. (Yokneam, Israel).

When a computed tomography scan showed the 2.5 cm mass on the man's left side two months ago, a partial nephrectomy seemed to be the only option. Doctors had removed the patient's left kidney over a year ago. Now, the risk of losing the remaining kidney led to the decision to use cryosurgery. Patients undergoing this procedure can leave the hospital the same day and expect recuperation in a few days, versus laparoscopic removal (one to two days in hospital and about two weeks at home) or open surgery (one week in hospital and six weeks at home), says Galil.

"Those small CryoNeedles make this type of surgery possible,” said Dr. Theodorescu, professor of urology in UVA's department of urology. "Large conventional probes would be difficult to insert percutaneously and to direct into the kidney as well as control during the freezing process.” Dr. Theodorescu also noted that patient selection is the key to success. Patients should have tumors less than 3 cm and these should be in an anatomical position that can be viewed clearly by ultrasound.


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