The 2009 Ball Appeal
Seednet Gold Cryo therapy system (Galil Medical) - By Dr Tze Wah
History
The theory of using cold to treat ailments has been around since the ancient Greeks, where people were prescribed cures of sitting in cold streams to relieve symptoms and to alleviate pain. The true concept of Cryotherapy was not really realised until the 19th century, when an English doctor (Gondor) treated skin lesions. By placing blocks of frozen metals directly on to the patients’ lesions he was able to destroy the affected tissue. In the 1960s experiments were carried out using liquid nitrogen to treat certain conditions and this technology is still used.
In the 1990s a new technology has been discovered using the Joule-Thomson effect. This involves using the high pressure gas driven needles which forms the foundation of the Galil system. Over the last few years, the innovation of this technology has been continuously developed and culminating in the invention of the small needle size that could be used via minimally invasive approach. The new needle that is amenable for percutaneous approach by interventional radiologist is only launched over the last couple of years and today this technology is capturing the attention of the physician around the world for treating cancers.
Technology
Machine.
The Seednet Gold Cryotherapy system, offer a convenient, safe and effective platform for the control and planning of the Galil range of Cryotherapy needles. The system offers a robust design, with easy to use interfaces that allow for the precise control of the treatment needles during the ablation of the affected tissue. The system also has full storage of all procedures, allowing for data collection and retrieval.
Needles.
Galil’s range of patented 17gauge (1.47mm diameter) needles allow the physician to choose the most appropriate needle to cover and engulf the lesion in lethal ice. The needles are driven by the physical properties of the Joule –Thomson effect (expansion of high pressure gas into a low pressure environment). By successfully miniaturising the interface into the needle and using Argon and Helium gas at high pressure, the needles are able to deliver temperatures down to -110C and up to +43C in a single device.
Method.
The needles are positioned strategically within the cancer in order to sculpture an ice ball that would totally engulf the cancer in ice with a target temperature of -40C, at which temperature all cellular activity ceases. The temperature is held for a time dictated by the treating physician and then the process is repeated to ensure total cellular destruction.
By creating the correct ice ball size and the accurate placement of the needles, the targeted cancer can be destroyed whilst causing little or no adjacent tissue damage.
Uses
Interventional Radiology
In Interventional Radiology one of the major advantages of using ice over other ablative methods, is the visibility of the produced ice ball. Ice shows up clearly under all common imaging systems (CT, Ultrasound and MRI).
Interventional Radiologists have currently successfully used the Galil systems to treat kidney, liver, adrenal, lung, bone, soft tissue cancers and also looking to treat cancers in other part of the body. The indication for treatment of cancer using this minimally invasive approach and technology is rapidly evolving in interventional radiology.
Urology
Cryotherapy is also well established in Urology for the treatment of prostate cancer and kidney cancer. The flexibility of Cryotherapy means that prostate cancer can be treated as a primary disease, salvage cases and now also as a focal treatment.
For kidney cancer it can be used as an open surgical procedure, or as a laparoscopically guided procedure, as well as the purely percutaneous procedure as used by Interventional Radiologists.
In Conclusion
The Cryotherapy of cancer with small diameter needles renders this a minimally invasive procedure and allows day case/ overnight stay for most patients when performed by interventional radiologist. The technology using the ice ball formation is easy to control and monitor during treatment of the cancer, therefore the risk of collateral damage to the surrounding tissue is low. In addition, it also has the major advantage of not introducing any toxic substance to the body, as it only attacks cells by freezing.
Costs of the cryoablation machine - £40,000