Treating CIN and other lesions with cryosurgery
 

CIN or cervical intraepithelial neoplasia is a very common pre-cancerous condition of the cervix which is usually detected after an abnormal PAP smear and confirmation by colposcopy. Treatment is routine and involves destruction of the dysplasia usually by cryotherapy, laser vapourisation or a cone biopsy should tissue be required for pathology. After cryosurgery or laser, tissue is not available for examination.

Cryosurgery is an excellent therapy. It is simple to perform and it is very effective for treating CIN grades I.II.and III. The procedure involves little or no pain, and because the destroyed tissue remains until the regrowth of healthy tissue is complete, there is virtually no risk of infection.

For other lesions such as condylomata, VAIN (vaginal intraepithelial neoplasia), VIN (vulvar intraepithelial neoplasia), PAIN (perianal intraepithelial neoplasia), Cryotherapy is an excellent solution. As a rule, lesions smaller than 1cm diameter are most effectively handled by cryotherapy.

Genesis Medical supplies the Wallach LL100 cryofreezer (N20 or CO2) which features both an instant effective freeze and instant defrost. Immediately after ending the freeze cycle the Defrost trigger is pressed then the tip detaches from the tissue.

The Wallach LL100 provides controlled freezing so that the area and depth of freeze are easily contained as appropriate. Liquid Nitrogen sprays  are useful for larger shallow lesions (such as keratoses) but because the liquid nitrogen immediately forms a frost barrier on the surface if the tissue sprays are not effective in treating CIN or warts where a depth of freeze is needed to destroy the roots..

Where a liquid nitrogen spray is indicated genesis Medical supplies the excellent Wallach UltraFreeze

Other methods for treating CIN are by Loop biopsy or LEEP. These instruments are also available from Genesis Medical.  Lasers are today rarely used for these procedures.

                                                                                          

The Wallach LL100 Multitip Cryosurgery system

Wallach LL100 Multitip cryosurgery system for a wide variety of general, gynaecological, GU medicine application, and dermatology.

This uses a cylinder of nitrous oxide or carbon dioxide to freeze any one of a variety of tips that are connected. The appropriate tip for the application is selected and screwed in place. The tip is placed against the tissue to be frozen and the Freeze trigger is pressed. One can see an ice-ball radiating around the tip. This is in the form of a hemisphere below the tip. It is important to freeze 1-2 mm into healthy tissue to be certain to destroy the lesion. There is no risk of damage to bone or permanent damage to the nerves or circulation.

The Wallach LL100 is the instrument of choice for treating the cervix, condylomata, warts and verruccae. For further information, and copies of clinical papers, contact Genesis Medical Limited.

The Wallach Ultrafreeze Liquid Nitrogen Spray

This instrument is designed to hold 300ml or 500ml of liquid nitrogen for 12-24 hours, during which time evaporation takes place continuously. For best results, the liquid nitrogen (at -160°C) is sprayed directly onto the lesion through one of a variety of spray apertures.

Liquid nitrogen is particularly effective for larger shallow lesions and suited for many dermatological conditions.

Treating warts requires freezing of tissue to a good depth to destroy the roots. Liquid nitrogen sprays immediately create frost on the tissue which then forms an ise barrier on the surface which inhibits freezing to sufficient depth to effective destroy the roots of warts and papiloma virus. For this reason controlled feezing is most effective.

For confined lesions such as warts, a variety of closed tips are available but the results are less satisfactory than with the Wallach LL100.

These products are manufactured by Wallach Surgical Devices

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