PMC5908421_01
Preoperative contrast-enhanced CT scan of the kidney. (A) A mass in the right kidney and a mass in the upper pole of the left kidney. (B) A mass in the right kidney and a mass in the middle pole of the left kidney. (C) One mass in the lower pole of the left kidney. (D) Another mass in the lower pole of the left kidney. The dotted circles indicate the tumor before surgery.
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The two tumors in the right kidney were located one in the upper pole and one in the middle pole, with a diameter of about 1.4 and 0.7 cm, respectively (Fig. 1).
Laparoscopic internal scenes of intraoperative operation. (A) Puncture biopsy of the tumor in the upper pole of the right kidney. (B) A 2-mm cold knife is put into the tumor in the upper pole of the right kidney. (C) The ice hockey is advanced to the upper pole of the kidney and covers the entire tumor. (D) Puncture biopsy of the tumor in the middle pole of the right kidney. (E) A 2-mm cold knife is put into the tumor body in the middle pole of the right kidney. (F) The ice hockey is advanced to the middle pole of the kidney and covers the entire tumor.
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Using a puncture needle, puncture biopsy was performed for pathological evaluation (Fig. 2A, D). According to the tumor size, location and depth, a 2-mm cold knife was put into the upper pole tumor (Fig. 2B). C ice hockey area, the temperature of the cold knife tip was dropped from -80 C to -150 C quickly and remained in a frozen state for 10 minutes; the ice hockey was then progressed to cover the entire tumor within the laparoscopic observation (Fig. 2C); after 5-minute active 100% power rewarming, two-cycle freezing and repeated heating, the frozen knife tip was withdrawn. Cryoablation of the tumor in the middle pole of the right kidney was performed in the same way (Fig. 2E, F).
Laparoscopic external scenes of intraoperative operation. (A) Port position. (B) Intraoperative cryoablation (location). (C) A postoperative gross specimen. (D) A view of the postoperative incision.
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The Single-Hole Multichannel Combination Kit was placed according the manufacturer's instructions. The ventral machine was connected to a constant pressure of 13 mm Hg (1 mm Hg = 0.133 kPa) to fill the Storz 3D Laparoscopic Kit (Fig. 3A). The location of cryoablation is shown in Figure 3B. Trocar was removed. The peritoneum and the myocutaneous and subcutaneous skin were sewed up (Fig. 3C, D).