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Cryosurgery: How cold destroys tumors and protects tissue in medicine

Destruction by cold: a surgical principle with a long tradition

The therapeutic use of cold is by no means a modern invention. Ice was already being used to treat inflammation in ancient Egypt. However, the targeted destruction of tissue through extreme cold - cryosurgery - only became a practicable clinical method in the 19th century with the availability of liquid nitrogen.

Today, cryosurgery is an established procedure in dermatology, oncology, urology and gynecology. The principle is elegant in its simplicity: a cryogenic probe is applied to or inserted into the tissue to be treated, and the extreme cold - typically generated by vaporized liquid nitrogen - destroys the target cells while the surrounding healthy tissue is largely spared.

Although cryosurgery is a different field of application for cryotechnology than cryopreservation, both share the same physical core: the controlled application of extreme cold to living tissue.

How cryosurgery works

The physical principle

When tissue is cooled to temperatures below -40°C to -50°C, intracellular ice crystals form, which mechanically destroy the cell membranes. At the same time, dehydration and osmotic stress lead to cell death. At temperatures below -20°C, the small blood vessels in the treatment area are also damaged, which leads to ischemia and increases the destruction of the tumor cells due to a lack of oxygen.

Freeze-thaw cycles

The effectiveness of cryosurgery is maximized by several successive freeze-thaw cycles. The first cycle primarily damages the cells by forming ice crystals, while the second cycle affects already damaged tissue and intensifies the destruction through recrystallization.

Clinical areas of application

Dermatology

The most common application of cryosurgery is the treatment of skin lesions: Warts, actinic keratoses, basal cell carcinomas and other superficial skin lesions. A spray or contact probe with liquid nitrogen is applied directly to the lesion - a quick, outpatient procedure with minimal scarring.

Oncology

In oncology, cryoablation is increasingly being used as a minimally invasive alternative to surgical resection:

  • Liver tumors: Cryoprobes are inserted directly into the tumor under imaging control and create an ice ball that destroys the tumor.
  • Kidney tumors: Small kidney tumors can be cryoablated percutaneously without having to remove the entire kidney.
  • Prostate cancer: Cryoablation of the prostate is an established alternative to radiotherapy or surgery.

Gynecology

Cryosurgical procedures are used to treat cervical dysplasia (precancerous stages of cervical cancer) - a painless and effective method.

Cryosurgery vs. cryopreservation: two sides of the same coin

At first glance, cryosurgery and cryopreservation pursue opposing goals: One wants to destroy cells, the other wants to protect them. However, the underlying physics is identical. The difference lies in the control of the parameters:

  • Cryosurgery: Rapid, uncontrolled freezing without cryoprotectants → maximum ice crystal formation → cell destruction.
  • Cryopreservation: Controlled freezing with optimum cooling rate and cryoprotectant → Minimal ice crystal formation → Cell survival.

The role of Consarctic®

Consarctic® does not supply cryosurgical probes, but the liquid nitrogen supply required for the operation of cryosurgical facilities. Nitrogen tanks and vacuum lines from Consarctic® supply operating theaters and treatment rooms with the LN2 required for cryosurgical procedures.

Cold as a versatile medical tool

Cryosurgery impressively demonstrates the versatility of the controlled application of cold in medicine. It complements cryopreservation as the second major field of application for medical cryotechnology.

Do you need an LN2 supply for your clinical facility? Contact our experts for a customized solution.