Cryo-therapy used in key hole surgery with photographs

22 November 2011

Cryo-therapy used in key hole surgery with photographs

Two Tauranga women were recently the first recipients of specialist Renal Cryo-therapy surgery using key-hole surgery in Tauranga Hospital. This is the first time the treatment has been offered as part of a suite of less radical forms of urologic surgery in a New Zealand public hospital.

Surgeon, Associate Professor Peter Gilling used cryo-therapy to freeze cancerous kidney tumours in both women. He has successfully used this treatment in his private practice since 2005 and through a unique public-private partnership with the Bay of Plenty District Health Board, was recently able to offer this treatment in the public health sector.

Venturo, a company owned 50/50 by the Bay of Plenty DHB and Urology Bay of Plenty Ltd, was set up in 1993 and the cryo-therapy surgery is not the first innovative surgery that Bay of Plenty public urology patients have benefited from this public/private partnership.

Head of Department, Mr Mark Fraundorfer, said, “In the past there have been many initiatives including keyhole surgery, laser prostate surgery and the introduction of a variety of other new techniques which have kept Tauranga at the cutting edge. The Venturo deal is to provide all public urology care in the Bay of Plenty. The surgeons control the budget and they are also contracted to see patients in Tauranga Hospital’s outpatient clinic and operate within hospital”.

Also part of this partnership is provision of on-going education for Bay of Plenty surgeons themselves, with world authorities coming to Tauranga to perform urological reconstructive and paediatric surgery.

Michele Fisher one of the two women to have received the cryo-therapy surgery said she feels truly blessed to have been offered such world leading surgery in a New Zealand public hospital.

”When I was first seen by the specialist I was told I would be receiving more traditional surgery which would have left me with a scar circling my torso from the middle of my tummy round to my back bone. Instead, I have four little cuts covered by four small bandages and some swelling and tenderness on my right side. You would never know that I had undergone major surgery,” Michele said.

Michele was admitted to Tauranga Hospital on the morning of her surgery and was discharged two days later. Moreover, two days after discharge from Tauranga Hospital was at a school social event. The other surgery would have had her in hospital for 3-4 days, and with majorly reduced activity for at least six weeks, and an ugly scar.

She said she has to hold herself back from doing too much.

Peter Gilling describes the technique as giving the tumour ‘bad frost-bite’ by turning it into an ice ball. While the operation lasted three hours, most of the time was spent getting to the tumour and exiting the surgery.

The cryo-therapy involved inserting four tiny probes and a tiny thermometer into the tumour. Once the probes were in place Argon gas was fed into them to bring the temperature of the tumour down to below -60 degrees. The temperature was held at that for 10 minutes before quickly thawing the tumour, by changing the gas to Helium. Argon gas was used again to lower the temperature to -60 degrees, held for five minutes and again Helium gas was used to quickly thaw the growth.

Technician Pene Miecklejohn said the probes are sealed and no gas enters the tumour. She said the gases are under enormous pressure and while the probes are tiny, they are extremely strong.

Pene was responsible for controlling the freezing and thawing components of the surgery.

She said it has been wonderful to be part of a team bringing such modern surgical techniques to Tauranga.

ENDS

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