Understanding the Frozen Section Procedure: A Closer Look at Intraoperative Pathology

The Frozen Section Procedure is a diagnostic test used predominantly in surgical pathology to provide a rapid microscopic specimen analysis during surgery. This technique plays a crucial role in guiding surgeons to make immediate decisions about the extent of surgery needed based on the presence or absence of disease. The procedure is named "frozen" because the tissue sample is quickly frozen, which allows thin sections to be cut and examined under a microscope.

Why it’s done-

The primary reason for performing a frozen section analysis is to provide immediate diagnostic information that can influence the course of surgery. Here are some of the critical situations in which it is employed:

1. Cancer Surgery: While removing a tumor, surgeons must ensure they have excised all cancerous tissue while preserving as much healthy tissue as possible. Frozen section analysis helps determine if the edges (margins) of the removed tissue are free of cancer cells, indicating that the tumor has been completely excised.

2. Determination of Tissue Type: In some cases, the nature of the lesion or mass is unclear before surgery. A frozen section can help determine whether the tissue is benign or malignant, aiding the surgeon in deciding the extent of surgery needed.

3. Sentinel Lymph Node Biopsy: In certain cancers, such as breast cancer, a sentinel lymph node biopsy is performed to check if the cancer has spread to the lymph nodes. A frozen section of the sentinel lymph node can provide quick information about the presence of cancer cells.

Surgery Procedure -

The frozen section begins when a surgeon identifies a tissue of interest during surgery and requires immediate pathological examination. The tissue sample is quickly sent to the pathology lab, undergoing a rapid freezing process. This is achieved using compounds like liquid nitrogen or a cryostat machine, freeing the tissue solid enough to be sliced into fragile sections.

These thin sections are then mounted on slides, stained with dyes to highlight different cell structures, and examined under a microscope by a pathologist. The entire process, from the receipt of the specimen to the delivery of results, can be accomplished in approximately 20 to 30 minutes, providing vital information without significant interruption to the ongoing surgery.

Applications -

The primary application of the frozen section procedure is in oncologic surgery, where it helps in determining the nature of a tumor - benign or malignant - and the margins of the tumor. If the margins are clear of cancer cells, the surgeon may conclude the procedure, knowing the tumor has been entirely excised. If cancer cells are found at the edges of the specimen, additional tissue may be removed during the same surgical session.

Apart from oncology, frozen section analysis is used in various other surgical contexts, such as organ transplant surgery, to assess the viability of the donor organ or in endocrine surgery to examine parathyroid glands or thyroid nodules.

Risk and Complications -

While the Frozen Section Procedure is invaluable, it is not without risks and complications. These include:

• False Negatives/Positives: The possibility of misdiagnosis, although rare, can lead to inadequate removal of diseased tissue or unnecessary removal of healthy tissue.

• Sampling Error: The small sample size may not represent the overall nature of the disease, leading to incorrect conclusions.

• Technical Limitations: The quality of frozen sections may not match that of permanently processed tissues, potentially affecting the diagnosis accuracy.

• Advantages and Limitations

  The frozen section procedure offers the significant advantage of immediate results, which can be crucial in surgical decision-making. It allows for real-time adjusting of surgical plans, potentially sparing patients from additional surgeries. However, it has limitations. Rapidly freezing can sometimes distort the tissue architecture, making interpretation challenging. Additionally, not all tissue types are suitable for frozen section analysis, and in some cases, a more thorough examination using traditional methods may be necessary after surgery.

At Medipulse Hospital, Jodhpur, integrating the frozen section procedure into our surgical pathology services underscores our commitment to providing state-of-the-art care. Our dedicated team of pathologists and surgeons collaborates closely, utilizing this rapid diagnostic tool to ensure precise and timely surgical interventions. The availability of frozen section analysis at Medipulse Hospital enhances our ability to make intraoperative decisions that are informed, patient-centric, and tailored to achieve the best possible outcomes. This reflects our overarching mission to blend innovative medical practices with compassionate care, ensuring every patient receives the highest standard of treatment. For more information about Frozen section, visit the hospital’s website or can contact on 8239345635.