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The Nervous System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Another surgical technique known as cryoneurosurgery involves the application of extreme cold (cry- or cryo- denotes cold) with a cryoprobe in order to destroy the nerve or an associated tumor or other tissue.
Alternative Modes of Tissue Coagulation and Removal
Published in Sujoy K. Guba, Bioengineering in Reproductive Medicine, 2020
Cryosurgery for cervical erosion is an outpatient procedure requiring no anesthesia. In fact the pain is less than with electrocautery. Intravenous diazepam or a para cervical block may be given in apprehensive patients. In use the cryoprobe is applied to the cervix with the cone fitting the cervical os and the refrigerant is passed through the probe for cooling.Within 15 seconds the surface film of moisture freezes, fixating the probe to the os. Without applying traction the cooling is continued for several minutes, the duration depending upon the depth of effect desired. Thereafter the cooling system is turned off. Some equipment have a rewarming facility which is then turned on and the adhesion between the probe can be removed. In the absence of this provision of rewarming one has to wait for natural thawing which may take about a minute and during this period no pull is exerted on the os.
Treatment of Cancer
Published in Prakash Srinivasan Timiri Shanmugam, Understanding Cancer Therapies, 2018
Cryosurgery uses a liquid nitrogen or argon gas to produce extreme cold to destroy abnormal cells. A cryoprobe is used to circulate the liquid nitrogen or argon gas, which is placed in contact with the tumor. The ice crystal balls are produced around the probe and freeze the nearby tissues. Ultrasound or a computed tomography scan is used to monitor the freezing of the cells, limiting damage to nearby tissue. It is used to treat numerous cancers, including breast, skin, cervix, AIDS-related Kaposi sarcoma, prostate, and bone cancers (National Cancer Institute 2015).
Advantages and drawbacks associated with the use of endosonography in sarcoidosis
Published in Expert Review of Respiratory Medicine, 2023
Kuruswamy Thurai Prasad, Sahajal Dhooria, Valliappan Muthu, Inderpaul Singh Sehgal, Ashutosh Nath Aggarwal, Ritesh Agarwal
EBMC is a novel technique that utilizes a cryoprobe (1.1 mm or 1.7 mm) to biopsy the lymph node transbronchially under real-time ultrasound guidance [60,100,101]. The cryoprobe is inserted into the lymph node from the entry point created by a wide-bore TBNA needle (19 G) or an electrocautery knife. Alternatively, the puncture site of a standard 22 G needle can be used after enlargement of the tract by advancing the sheath over the needle. After inserting the cryoprobe into the lymph node, the cryoprobe is frozen for 4–5 seconds using liquid CO2 as the cryogen. The probe with the adhered lymph node tissue and the EBUS scope are then retracted en bloc. The frozen biopsy tissue is then retrieved by thawing in saline. In a recent multicentric study, the combined approach (EBUS-TBNA and EBMC) significantly improved the diagnostic yield than EBUS-TBNA alone in undiagnosed mediastinal lymphadenopathy (93% vs. 81%) [60]. Remarkably, the EBMC provided tissue samples with a mean diameter of 4 mm and area of 12 mm2. Another study that randomized the sequence of sampling technique (EBMC first or EBUS-TBNA first) found a better yield with EBMC than EBUS-TBNA in undiagnosed mediastinal lymphadenopathy (92% vs. 80%) [100]. Notably, in both studies, the diagnostic yield was higher with TBMC for benign pathologies, with a 100% yield for sarcoidosis [60,100]. The complications of EBMC include moderate to severe airway bleeding, pneumothorax, pneumomediastinum, cough, and dyspnea. As with EBUS-IFB, more evidence is needed for EBMC in the diagnosis of sarcoidosis.
Hysteroscopic treatment of submucosal fibroids in perimenopausal women: when, why, and how?
Published in Climacteric, 2020
S. G. Vitale, G. Riemma, M. Ciebiera, S. Cianci
According to the FIGO classification, the complete excision of fibroids using the slicing technique provided with a resectoscope or, in the case of smaller fibroids, in-office mini-resectoscope is the most commonly used approach for types 0 and 126,36. The slicing technique consists of a repeated and progressive passage of the cutting loop, and allows the operator to split the submucosal fibroid into smaller fragments, which can flow outside the uterine cavity. The procedure is considered finished by the operator when the fasciculate fibers of the myometrium are visualized. In the case of larger type 1 fibroids (at least 3 cm in diameter), the operator should proceed more carefully since there is an increased risk for intraoperative complications (fluid intravasation syndrome, postoperative pain, major bleeding). Besides, the use of electrosurgery may bring more damage to the surrounding myometrium10,12,26,41. Some authors are using a new technique with a cryoprobe to remove parts of the resected tissues, so the risk of complications may be reduced and visualization improved42.
Comparison of procedure-related complications between percutaneous cryoablation and radiofrequency ablation for treating periductal hepatocellular carcinoma
Published in International Journal of Hyperthermia, 2020
Seong Eun Ko, Min Woo Lee, Hyunchul Rhim, Tae Wook Kang, Kyoung Doo Song, Dong Ik Cha, Hyo Keun Lim
CA procedures were performed by one of the five interventional radiologists. After local anesthesia with or without conscious sedation, cryoprobes (IceSphere1.5® needle, straight type; Galil Medical, Yokneam, Israel) were percutaneously placed to the index tumor under US or fusion imaging guidance. One to three cryoprobes were used depending on the tumor size and morphology. According to the manufacturers’ recommendation, two CA cycles, including freezing (10 min), thawing (7 min), refreezing (10 min), and rethawing (3 min), were routinely used. The aim of CA and the guiding method for CA were the same as those for RFA. During the procedure, the ice-ball formation was continuously monitored with the real-time US. Therefore, the operators could decide whether the ablative margin was insufficient as the ice-ball was clearly demarcated on US. In cases in which the ablative margin was insufficient, additional CA was performed after needle repositioning. Procedures were completed when the iceball induced by CA on US was large enough to cover the entire tumor and the surrounding liver [10]. During the procedure, warm saline-soaked gauze was used to protect the overlying skin from frostbite. After the procedure, cryoprobes were gently removed as tract ablation was not applicable to a cryoprobe.