Patient Name:     ,           

DOB:        SEX:    

Ordering Physician:     ,    

PROCEDURE: Cryoablation of ____ with CT guidance

DATE:    

CLINICAL HISTORY:    

OPERATING PHYSICIAN:   John Doe, MD (Attending)/Jane Doe, MD (Fellow)     

MEDICATION: Versed     mg IV, fentanyl     mcg IV

CRYOABLATION PROBE(S):    

COMPLICATIONS: None

 

PROCEDURE:

Informed consent was obtained and placed in the patient’s chart after the risk of infection, bleeding, damage to ureter, collecting system, as well as the risks of sedation were explained.  Constant physiologic monitoring and moderate sedation were performed by radiology nursing staff.

With the patient in the     position, the     prepped and draped in standard sterile fashion. Under CT guidance,     cryoablation probes were positioned throughout the lesion.  Cryoablation was performed for 10 minutes, followed by passive thawing, and another 10 minute ablation.  Intermittent CT imaging was obtained during the ablation cycle to visualize the ice ball formation.  After the thaw, the probes were removed without incident and hemostasis achieved with manual compression.  The patient tolerated this procedure well and was transferred to the recovery room in stable condition.

 

FINDINGS:    

 

IMPRESSION: Successful CT-guided cryoablation of _______ .