Cryosurgery and irreversible electroporation: The state of the art, advantages, and limitations

Abstract

Irreversible electroporation (IRE) and cryoablation (Cryo) are, among the many others in use, respectively, the youngest and the oldest tissue ablation modalities. No other treatment has spread in the world as quickly as IRE since it was developed from concept to clinical reality by Rubinsky, Mikus, and Onik. Cryo has a longer history, starting centuries ago. While dormant for many years, it experienced a revival in the early 1960s with the introduction of a controllable liquid nitrogen-based apparatus by Cooper and Lee. In the early 1980s, the introduction of the concept of intraoperative medical imaging for tissue ablation by Onik and Rubinsky has made cryosurgery attractive for minimally invasive tissue ablation deep in the body. Further advances in cryosurgery device technology were made by Mikus in the 1990s. In this presentation the current state of the art of IRE and Cryo, their clinical applications, and advantages and disadvantages will be discussed. The following discussion leads to the conclusion that Cryo and IRE are currently two feasible and safe procedures and could represent a viable alternative among ablative therapies.