Instrumentation and Technique: Cryotherapy

The outcome of increased abdominal imaging is a significant rise in incidental renal cortical neoplasms predominantly in the elderly population. Emerging data on long-term sequelae of open and laparoscopic nephrectomy created a wish for minimal invasive treatment alternatives. Recent technological advancements have introduced ablative therapies as an alternative modality to extirpative surgery. In the current state of small renal cortical neoplasm management, cryoablation is the most studied ablative modality with promising midterm oncological follow-up data. Emerging data have demonstrated that careful selection of patients and appropriate surgical armamentarium are of paramount importance for a successful completion of the procedure and effective outcomes. In this chapter we describe patient selection and procedure techniques in a step-by-step fashion with detailed description of the instrumentation required to facilitate successful cryotherapy. Additionally, we describe prevention and management of complications associated with percutaneous cryoablation.