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Prostate Cryoablation Technique

Prostate Cryoablation Technique. Four Steps. Ultrasound Capture Probe Planning Probe Placement Freeze / Thaw Cycles. Step #1 Ultrasound Capture. Place Foley Catheter, fill bladder with saline

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Prostate Cryoablation Technique

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  1. Prostate Cryoablation Technique

  2. Four Steps • Ultrasound Capture • Probe Planning • Probe Placement • Freeze / Thaw Cycles

  3. Step #1 Ultrasound Capture • Place Foley Catheter, fill bladder with saline • Align ultrasound probe, center image, assure that plane of urethra and plane of transducer is parallel • Urethra should stay on centerline as you move ultrasound cradle from base to apex • Measure volume (height, width, length)

  4. Transverse Mid Gland Ultrasound

  5. Pubis *ES Foley * AnalSphincter Periprostatic Fat and Fascia of capsule Sagittal Ultrasound Anatomy

  6. Ultrasound Capture

  7. Step #2Cryoprobe & Temprobe Planning • Outline the prostate margin (stay outside the capsule for high risk disease where capsular disease is suspected) • Outline urethra (allow a large margin for salvage cases) • Outline rectal wall

  8. Cryoprobe & Temprobe Planning Software • Outline • Margin • Urethra • Rectal

  9. Cryoprobe & Temprobe Planning Software • Cryoguide placement • logic recommends: • - Cryoprobe • - Temprobe Add/Subtract Probes Check measurements

  10. <2cm < 1cm .> 0.5 cm CryoProbeTM Placement Logic •  1 cm from the capsule •  2 cm apart • > 0.5 cm from rectal wall • > 0.5 cm from urethral wall -40 C: D= 1.96 cm L= 3.85 cm

  11. CryoProbe and Temprobes placement can be verified with software measurement function Cryoprobe & Temprobe Planning Software

  12. 2 1 6 5 3 4 Step # 3Probe Placement Sequence Placement Sequence Anterior - CryoProbes 1 & 2 Midline - Ant, ES, Apex, DEN TempProbes Posterior Medial - CryoProbes 5 & 6 Posterior Lateral - CryoProbes 3 & 4 Lateral - RNVB, LNVB TempProbes Urethra - Urethral Warming Catheter

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