Prerequisites for Developing New Generation Cryosurgical Devices (Review)

Abstract

The study represents the implementation areas, key advantages and application problems of a cryotechnique in recent times, as well as the classification, the main characteristics and disadvantages of the existing cryosurgical units. The review considers the prerequisites for developing new generation cryosurgical units. Among them there were distinguished five main research lines. The first line is the development of a high-precision cryotherapy dosing technique. The second line is related to the formation of prediction and result control techniques of establishing a predetermined cryonecrosis area, since practice requires a detailed calculation of a procedure to choose the modes of cryosurgical devices, which meet the dosing conditions. The third line is the study of thermal properties of biotissues in a wide temperature range (including pathologically altered tissues), as well as their modification to improve cryotherapy quality. The fourth line is the improvement of control cryotherapy methods. Work automation of the elements of cryosurgical devices and the diagnostic support on a real-time basis are necessary. It enables to provide a surgeon with a complete presentation. The fifth research line is connected with the creation of cryosurgical robotic technologies. Robot-assisted medicine has widespread application, it becoming more technically and medically advanced. Robotic technologies open great challenges for future development of the entire branches of clinical medicine including cryosurgery.The problem of insufficient opportunities of cryosurgical units to meet the medical and technical requirements is found to be related to the lack of control procedure options rather than the imperfection of equipment technical characteristics. To achieve a high efficiency of cryotherapy, the problem is to be solved comprehensively. The development of medical imaging technologies, computational power and equipment maintenance of the technique can make it possible to extend significantly the functionality and application area of cryosurgical apparatuses so that in the future to increase the competitive capability of a cryotechnique.

Study of local low-temperature effect on biotissues

“…The destructive effect of local low-temperature exposure is widely used in various medicine fields. Operations are performed in dermatology, urology, gynecology, pediatric surgery and oncology [2]. This is collectively called cryosurgery.…”

One-stage cryoablation of two renal tumors

“…Развитие методик применения криоаппаратов 3-го поколения еще не достигло насыщения. Один из путей их совершенствования -создание компьютерных программ предоперационного прогнозирования температурных полей для поиска оптимальных положений криоинструментов и повышения точности обеспечения дозы криовоздействия на патологически измененные биологические образования сложной конфигурации [23]. Разработанные программы должны учитывать большинство факторов, влияющих на процессы в биоткани при криовоздействии [24], а также проходить тщательную экспериментальную верификацию.…”

Comparison of Probe Materials for Tissue Cryoablation: Operational Properties of Metal and Sapphire Cryoprobes

“…Despite the variety of nosologies and localizations of tissue lesions that can be treated by cryoablation, it is possible to distinguish percutaneous and superficial applications. Percutaneous cryoablation implies thin needle-like probes, which are often based on Joule-Thomson effect and flow of high-pressure gas, for example, argon [12,[18][19][20][21][22]. Such probes can be even combined with an endoscope, since it is possible to make them flexible and thermally insulated, except for metal tips that are in the direct contact with tissues [23].…”