Cryosurgery

Cryosurgery

Ari Aso
Ary Khayrolla

What is cryosurgery ?

-Intense cold kills living tissue.
-Cryosurgery involves controlled destruction of tissue by freezing,using Liquid nitrogen, Nitrous oxide and carbon dioxide.
-The clinical application of a freezing probe to living tissues is termed Cryosurgery by Poswillo.

Mechanism of tissue destruction by cryosurgery

1-freezing of extracellular environment.
2-reduction of intracellular water .
3-cellular shrinkage.
4-increased concentration of intracellular solutes.
5-duaring thawing the water moves rapidly into the cell.
6-cell membrane damage.
7-cell death.


Cryosurgical device

Methods of cryosurgery

1-dipstick method :
Used for lesion that are about 0.5 to 1 centimeter.
Topical anaesthetic may be applied to minimize discomfort.
The technique consist of dipping a cotton swab into the liquid nitrogen for 1 to 2 second and applying it on the lesion with pressure till the formation of ice crystals that is within 30 to 60 seconds.
In this method temperature may be –20*C and depth up to 2 to 3 mm may be needed. This technique is limited for superficial lesions.








2-Spray method : Based on the shape and size of the lesions There are various spray technique:
A-Spot spray free technique for small round lesion < 2 cm in diameter.

B-Paint brush technique for larger lesions, much longer time is needed for concrete spray. This technique is employed for adequate freezing for irregularly shaped lesions.







C-Spiral spray technique The spray started in the center of the lesions and carried in an ever- widening spiral. This is also useful for treating larger lesions.

D-Rotatory spray technique This spray is directed in multiple, concentric circles of increasing diameter, till the whole lesion is frozen.

Advantages of cryosurgery

Simple and painless.
No bleeding.
No scaring.
Less treatment time.