CLINICAL HISTORY:

CT DOSE:

CONSENT: Following discussion procedure its risks benefits (including bleeding and vessel damage) and alternatives, review of readily available relevant imaging prior to the procedure informed consent was obtained witnessed and documented upon the chart. Standard presurgical timeout confirming patient procedure and when relevant side and site was performed. Any discrepancies were resolved via consultation with appropriate readily available data sources. The patient was prepared and draped in standard sterile fashion.

TECHNIQUES:
Following explanation of the potential risks and benefits of the procedure, including bleeding and infection and prior to obtaining procedural consent, informed consent was obtained.
Timeout was performed per protocol.

Anesthesia was provided by the certified anesthesia team. Please see anesthesia record for details.

Procedure was done under sterile technique and local anesthesia using 1 % lidocaine.
The lesion in the left kidney was localized under CT and ultrasound with patient placed prone.

Percutaneous needle biopsy of the renal mass was performed with an 18 gauge biopsy gun.
Gel foam was applied for embolization along the biopsy tract using the coax, as the needle was pulled, to decrease the risk of bleeding.

Cryoablation of the renal mass was performed with placement of ** tandem Per-17 cryoprobes. Cryoablation procedure was then performed according to the manufacture’s protocol with periodic monitoring by sequential CT scan. Two 10 minutes sessions were performed. At the end of procedure, the probes were thawed and removed.

Patient tolerated procedure well without immediate complication.

IMPRESSION : S/P needle biopsy and cryoablation of ** renal mass.

Plan: Follow up examination of CT (or MRI) in 2-3 month is recommended.