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Endoscopy 2008; 40(9): 759-763
DOI: 10.1055/s-2008-1077520
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic ultrasound-guided application of a new internally gas-cooled radiofrequency ablation probe in the liver and spleen of an animal model: a preliminary study

S.  Carrara1 , P.  G.  Arcidiacono1 , L.  Albarello2 , A.  Addis3 , M.  D.  Enderle4 , C.  Boemo1 , A.  Neugebauer4 , M.  Campagnol3 , C.  Doglioni2 , P.  A.  Testoni1
  • 1Division of Gastroenterology and Gastrointestinal Endoscopy, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Milan, Italy
  • 2Department of Pathology, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Milan, Italy
  • 3Research Center on Biotechnological Applications in Cardiovascular Surgery, University of Milan, Milan, Italy
  • 4Research Department, ERBE Elektromedizin GmbH, Tübingen, Germany
Further Information

Publication History

submitted 26 March 2008

accepted after revision 9 July 2008

Publication Date:
13 August 2008 (online)

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Commentaire de travail de S. Carrara et al., pp. 759Endoscopy 2008; 40(09): 969-970
DOI: 10.1055/s-0032-1306877

Background and study aims: In a previous study, a new flexible bipolar hybrid cryotherm probe was applied with success to the pancreas of a living pig. Here we evaluated feasibility, efficacy, and safety of its application to the porcine liver and spleen.

Material and methods: Ten applications to the liver and nine to the spleen were performed in 19 pigs. Power input (16 – 18 W) and simultaneous cooling with CO2 (standardized pressure: 675psi) as the cryogenic agent were investigated. Application time varied from 120 seconds to 900 seconds. The ablation area was measured by endoscopic ultrasound (EUS) after ablation (T0), and before euthanasia (T1). Gross pathology (T2) and histology after necropsy represented the gold standard. The interval from treatment to euthanasia was 1 or 2 weeks.

Results: For both organs the correlation between EUS and gross pathology was good (correlation coefficient Rliver = 0.71; Rspleen = 0.73). EUS tended to overestimate the area of the ablated zone. EUS observed a time-dependent ablation area: we demonstrated a positive trend of lesion size (T1) over time in liver tissue (R = 0.51 (P = 0.1)). In the spleen we found a clear correlation of lesion area T2 and application time (R = 0.75, P = 0.01). There were no complications.

Conclusions: Selective EUS-guided transgastric cryotherm ablation of the liver and spleen in a pig model is feasible and safe. The new bipolar probe creates a time-dependent ablation area without any complications, and opens a field of new potential indications of RF-ablative therapies.

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P. G. Arcidiacono, MD

Vita-Salute San Raffaele University

Via Olgettina no 60
20132 Milan
Italy

Fax: +39-02-26432504

Email: arcidiacono.paologiorgio@hsr.it

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