INDICATION
SPECIFICITY
ADVERSE EFFECTS
SUMMARY
Cryosurgery, referred to as cryoablation, is a surgical technique in which freezing is used to destroy undesirable tissues. Developed first in the middle of the 19th century it has recently incorporated new imaging technologies and is becoming a fast growing minimally invasive surgical technique, especially in field of cancer treatment.
History
The history of cryosurgery is relatively short and is closely intertwined with developments in low temperature physics, engineering, and instrumentation that were made during the last century. A review of the history of the field will show that cryosurgery appears to advance in jumps triggered by immediately preceding technological advances.
- Around 1845, Michael Faraday achieved a temperature of 163K by mixing solid carbon dioxide and alcohol under vacuum.
- During the same period, James Arnott of Brighton, England, who is recognized as the first physician to use freezing for treatment of cancer, began applying these low temperatures in medicine, useda solution of crushed ice and sodium chloride to freeze advanced cancers in the breast and the uterine cavity .
- In 1892, Dewar of Great Britain designed the first vacuum flask, which facilitated storage and handling of liquefied gases.
- At the end of the 19- century, solid carbon dioxide, liquid air, and other gases were readily commercially available.
- In 1899, Campbell White of New York, reported the use of liquid air for the treatment of diverse skin diseases.
- Since then, several methods were developed for the application of liquid air to undesirable tissue. The liquid air was used for treatment of various diseases of the skin, such as warts, varicose leg ulcers, carbuncles, herpes zoster, epitheliomas, and erysipelas.
- Solid CO2 was first used for therapeutics in 1907 by William Pusey, and soon became the most popular method of tissue freezing during the first half of the century. "Cryotherapy" became an established therapeutically technique in dermatology and gynecology.
- Liquid oxygen became commercially available in the 1920's with the development of new and large air separation facilities and was used in treatment of skin diseases in 1929.
- The development of chloro-fluorocarbon refrigerants led to the first closed cycle refrigeration cryosurgery system in 1942.
- Starting from the early 1940's, Kapitsa in the Soviet Union and Collins in the United States began developing commercial techniques for large-scale liquefaction of hydrogen and helium, with liquid nitrogen as an abundant and low cost by-product.
- In 1950 liquid nitrogen was introduced by Allington and was applied in treatment of verrucae, keratoses, and various non-neoplastic lesions.