Physicians at the University of Virginia Medical Center (UVA) treated a renal cell carcinoma in the remaining left kidney of a 64 year-old man, with the Galil Medical SeedNet Gold system and they did it without making an incision. The minimally invasive, first-ever procedure of its kind used cryotherapy, took less than 55 minutes, and the patient had no complications.
Urologist Dan Theodorescu, MD, PhD, and radiologist Matthew Bassignani, MD, froze the tumor with ultra-thin CryoNeedles inserted directly through the skin, using SeedNet Gold advanced cryotherapy technology. UVA radiologists used real-time ultrasound to guide the CryoNeedles to their target, and a state-of-the-art template aligned and held them in place through two freeze/thaw cycles, completely ablating the tumor.
In cryosurgery, tumors or wayward cells are frozen to death by strategically placed probes. The procedure has gained particular acceptance as a treatment for prostate cancer. But the new ultra-thin CryoNeedles enable the technology to go where conventional probes (those two millimeters and larger in diameter) cannot.
"These small CryoNeedles make this type of surgery possible," said Dr. Theodorescu, Paul Mellon professor of urology in UVA's department of urology. "Large conventional probes would be difficult to insert percutaneously and to direct into the kidney as well as control during the freezing process."
The ultra-thin needles serve another important role with regard to the totality of the freeze, according to Galil President and CEO James McGlone. He likens the freeze area to a can filled with marbles instead of sand. "You can imagine how the can filled with marbles would leave pockets of unfrozen areas, while the sand-filled can would have a consistent freeze throughout. The ultra-thin needles create smaller ice balls that can fill more of the space, so they provide a wonderful technological advantage -- for both kidney and prostate cancer ablation," he said.
Dr. Theodorescu removed the patient's right kidney over a year ago to eradicate a large carcinoma. When a C-T scan showed the 2.5-centimeter mass on the left side two months ago, a partial nephrectomy seemed to be the only option. But the risk of losing the remaining kidney during the partial nephrectomy, and the otherwise-healthy patient's strong desire to avoid another surgery, led to this innovative procedure.
Patients who undergo this procedure can leave the hospital the same day and expect a few-day recuperation period, versus those whose tumors are removed laparoscopically (one to two days in hospital and about two weeks at home) or through open surgery (one week in hospital and six weeks at home).
"Our SeedNet Gold and CyroNeedle technology performed exactly as we expected," said Yan Moore, MD, medical director at Galil. "We believe we have opened a new frontier for cryosurgery--one that will improve quality of life for patients and reduce healthcare costs to the system."
Dr. Theodorescu says patient selection is the key to success. He already has scheduled several others for this procedure who have tumors less than three centimeters in size and in an anatomical position to be viewed clearly by ultrasound.
Elron Electronics Industries Ltd. (Nasdaq: ELRN) is the major shareholder of Galil Medical.
Published by Globes [online] - www.globes.co.il - on 23 July 2002