Description
Cryobiopsy is a less invasive procedure performed during bronchoscopy. In cryobiopsy, a probe is positioned through bronchoscope which is placed near the chest wall, this probe is cooled for some time and causes the lung tissue to stick to the probe.
Today our guest speaker is going to tell us about this new procedure and its importance.
Résumé
- Cryotherapy, specifically cryobiopsy, is an advanced interventional pulmonology technique involving a flexible cryoprobe inserted via bronchoscope to freeze and extract target tissue. It's considered a high-risk procedure primarily used when lung architecture preservation is crucial for diagnosis.
- The principle behind cryotherapy is the Joule-Thomson effect, where compressed gas, such as CO2, rapidly expands upon release, causing a sudden drop in temperature. This freezes the target tissue, enabling a larger and better-preserved biopsy sample compared to traditional forceps biopsies.
- Cryobiopsy is most effective on tissues like skin, mucous membranes, and endothelium, but less so on fat, cartilage, and connective tissue. Contraindications include high anesthesia risk, hemodynamic instability, pulmonary hypertension, uncorrected bleeding, severe hypoxemia, and diffused lung disease.
- Potential risks associated with cryobiopsy include bleeding, hypoxia, pneumothorax, and anesthesia-related complications. Precautions involve using an artificial airway during the procedure under general anesthesia and having an occlusion balloon and cold saline/epinephrine readily available to manage bleeding.
- A thorough pre-procedure checklist is essential, including CT scans, complete blood counts, coagulation profiles, serum creatinine levels, spirometry, ECG, echocardiography, and possibly DLCO, ABG, and serology for HIV, hepatitis B, and C.
- The procedure requires a skilled team including a pulmonologist, assistant, and anesthetist, along with specific equipment like a rigid or flexible bronchoscope, cryoprobe, cryobiopsy machine, occlusion balloon, and potentially fluoroscope for navigation. Navigation tools such as radial EBUS can also be helpful in targeting peripheral lesions.
- New advancements include disposable cryoprobes with sheaths to minimize bronchoscope damage and research into spray cryotherapy for targeted tissue ablation. EBUS-guided cryobiopsy allows for cryoprobe insertion via the EBUS scope, obtaining cryobiopsy samples instead of traditional TBNA samples.
Exemple de certificat
À propos des intervenants
Dr Sameer Arbat
Le Dr Sameer est un pneumologue interventionnel de Nagpur, il est le premier médecin à disposer de la seule installation EBUS et de cryothérapie du centre de l'Inde.
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