The Urology service at Augusta University Medical Center now offers cryoablation, or cryotherapy, one of the safest and most effective methods for treating kidney cancer.
Also referred to as “cryo,” cryotherapy is an FDA-approved, minimally invasive surgical technology. Our surgeons also offer radiofrequency ablation, another minimally invasive treatment. As cryoablation becomes more accessible and more widely used, it’s emerging as a safer and more effective technology.
Ablation is used for many cancers, including lung, liver and prostate. The concept of ablation is relatively new in cancer surgery for any disease, but is proving particularly well suited to kidney cancer. Traditionally, surgeons have treated cancer by literally cutting it out, a process known as extirpation. In contrast, ablation uses cold energy (cryoablation) or heat energy (radiofrequency ablation) to destroy the cancerous tissue at the exact site where it exists in the body.
Cryoablation technology uses a special medical ice to freeze tumors; colder than 100 degrees below zero Celcius, it destroys cancer tissue very efficiently. Skilled surgeons are able target the ice precisely, destroying cancer cells yet preserving healthy tissue and nearby structures.
During cryoablation, surgeons insert small, needle-like probes into the tumor. These probes are less than 1.5mm in diameter and can destroy a large amount of cancer tissue. A single probe or a group of several probes can destroy kidney cancer while preserving the surrounding kidney.
While there are no strict age criteria, cryoablation is usually reserved for slightly older patients who may have some associated medical problems. The procedure typically results in minimal bleeding, few complications and a speedy recovery. Since it’s a relatively easy-to-tolerate procedure, patients with kidney masses and other associated medical conditions are generally good candidates. Cryoablation is not an option if the tumor is too large or close to the blood vessels or the urinary drainage portion of the kidney.
Laparoscopic Cryoablation
Kidney cancer surgeons have two approaches to cryoablation — laparoscopic and percutaneous. During laparoscopic cryoablation, the surgeon makes small incisions, which he/she uses to place a small camera and instruments into the body to perform exactly the same maneuvers as during an open surgery. Once the target kidney cancer is identified, a biopsy determines the type of tissue being treated, and the surgeon places one or several small probes into the kidney. A laparoscopic ultrasound is then inserted through one of the small incisions to help precisely place the cryoablation probes.
When the probes are in place, the surgeon turns on the cryoablation device, which causes iceballs to form. The ice covers the area of the kidney cancer and a small area of normal tissue around the kidney cancer to ensure no cancer cells remain. The ultrasound probe confirms that the ice has killed all of the cancer tissue. The cryomachine is turned off and the iceball simply melts. The surgeon removes the probes and the procedure is complete.
Percutaneous Cryoablation
Percutaneous cryoablation is ideally performed in a CT or MRI suite by a urologist working with an interventional radiologist. During percutaneous cryoablation, the surgeon uses an imaging device (CT, MRI or ultrasound) to precisely place the ablation probes directly through the skin to destroy the tumor. When kidney cancers are located too close to other body structures, such as the bowel or ureter, percutaneous cryoablation is not an option, since these structures could be damaged.
Advantages and Disadvantages of Kidney Cryoablation
Kidney cryoablation is performed laparoscopically (with small incisions) or percutaneously (directly through the skin), making it a minimally invasive procedure for the treatment of kidney cancer. During treatment, that translates into minimal blood loss without a large incision. After surgery, it results in significantly less pain, a shorter hospital stay, and more rapid recovery when compared with open surgery. Patients return to family, work and routine activity in less than half the time that it takes to recover from open surgery.
Patients who undergo ablation also experience a significantly decreased risk of complications, including bleeding and urine leakage.