This course deals with a man that developed two new foci of primary NSLC. He is not a surgical candidate and is referred for percutaneous ablation. Due to the proximity of the pleura and to relativity oblong shape of tumor, cryoablation is preferred to any other ablation technique. Indeed, the use of real time monitoring of abltion during the procedure is tough to help covering the entire tumor volume without too much damage to the chest wall. Moreover better tolerance of cryoablation will probably lower post-ablation pain in tumor so close to chest wall. Several cry oblation needles will be used concomitantly during a single ablation in order to obtain a large volume of ablation by synergy in between the ice balls. CT guidance will help to achieve needle positioning according to treatment planning. The per-procedure image monitoring will clearly demonstrate the ice ball and progressive coverage of the entire tumor along the subsequent freeze and thaw cycles.

Objectives:

• To acquire knowledge of the bioeffect of cryoablation of human tissue
• To know technical aspect of cryoablation in the lung including treatment algorithm
• To understand per-cryoablation image findings
• To know how to use a Seednet cryoabalation system for lung ablation
• To know features of post cryoablation imaging in the lung and to be able to evaluate efficacy and possible complications of the treatment

 

• 3D CT reconstruction   17:50 / 09:39
• Cryoprobes   00:16
• Cryosystem   00:53 / 01:45
• Cryotest   01:12
• Distance in between probes   11:25
• Freezing   14:00 / 20:45 / 13:12 / 15:51
• Ground glass opacity   14:18 / 15:42 / 14:48 / 21:15
• Iceball   04:08 / 00:40 / 06:54 / 01:23 / 06:05 / 01:54
• Inflator   08:24 / 17:24 / 09:07
• Needle in the tumor   09:26 / 05:57 / 10:21 / 00:23 / 03:55
• Skin protection   14:38 / 12:25
• Stick mode   20:30 / 19:00
• Thawing   14:48 / 14:07 / 16:00 / 13:37

Equipment:

• Gallil medical cryoablation needle ( Icerod 90° needle FPRPR 3204 )
• Gallil medical cryoablation needle ( Icesphere 90° needle FPRPR 3260 )
• Gallill medical cryoablation system ( Seednet )

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