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.
Frequently Asked Questions
What is renal mass cryoablation?
Renal mass cryoablation is a minimally invasive procedure used to treat kidney tumors. It involves inserting cryoprobes into the tumor under imaging guidance, such as ultrasound or CT. These probes freeze the tumor cells, causing them to die. This technique is often chosen for patients who are not suitable for surgery due to health concerns or the tumor's location.
A renal mass biopsy involves using a needle to extract a small tissue sample from a kidney tumor. This procedure is usually guided by imaging techniques like CT or ultrasound to ensure accuracy. The sample is then analyzed to determine the nature of the mass, such as whether it is benign or malignant.
What are the risks of CT and ultrasound-guided renal procedures?
The primary risks include bleeding, infection, and potential damage to surrounding blood vessels. These procedures are performed under sterile conditions to minimize infection risk, and imaging guidance helps avoid damage to nearby structures. Patients are monitored closely to manage any complications promptly.
How long does it take to recover from renal mass cryoablation?
Recovery from renal mass cryoablation is generally quicker than traditional surgery. Most patients can go home the same day or the following day. Light activities can usually be resumed within a few days, but it is important to follow the doctor's advice on activity levels and follow-up care.
Informed consent is crucial as it ensures that the patient understands the procedure, its potential risks, benefits, and alternatives. This process involves discussing the procedure in detail and documenting the patient's agreement to proceed, ensuring they are making an informed decision about their healthcare.
What follow-up care is needed after renal mass cryoablation?
Follow-up care typically includes imaging tests like CT or MRI 2-3 months after the procedure to assess the treatment's effectiveness. Regular monitoring ensures early detection of any complications or recurrence. Adhering to follow-up schedules as advised by healthcare providers is crucial for optimal recovery.
What is the role of anesthesia in renal mass cryoablation?
Anesthesia is used to ensure patient comfort during renal mass cryoablation. Typically, local anesthesia with sedatives is administered to numb the area and help the patient relax. A certified anesthesia team monitors the patient's vital signs throughout the procedure to maintain safety.
How are imaging techniques used in guided renal procedures?
Imaging techniques like CT and ultrasound are critical in guiding renal procedures. They help the physician accurately locate the kidney mass and safely insert instruments like biopsy needles or cryoprobes. This precision minimizes risks and improves the effectiveness of the treatment.
What is the significance of a presurgical timeout?
A presurgical timeout is a safety protocol performed before any procedure. It involves verifying the patient’s identity, the procedure to be performed, and the correct site or side of the body. This step helps prevent errors and ensures all team members are aligned on the details of the procedure.
Why might someone choose cryoablation over traditional surgery for renal masses?
Cryoablation is less invasive than traditional surgery, resulting in shorter recovery times and fewer complications. It is often chosen for patients who may not tolerate major surgery due to other health issues or when the tumor's location makes surgery risky. It also preserves more kidney function.