Carbodissection is an organ displacement technique that consists of percutaneous carbon dioxide (CO2) insufflation to displace non-target structures and deviate them from needle trajectory during biopsies and/or to prevent thermal injury during microwave, radiofrequency, or cryoablation.
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Indications
Similar to hydrodissection, carbodissection can be performed when there is non-target structure proximity ≤ 10 mm1.
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thoracic carbodissection - prevents vascular or cardiac injury during
percutaneous mediastinal biopsy
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retroperitoneal carbodissection - prevents complications of
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peritoneal carbodissection - prevents complications of
all perionteal mass biopsies
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soft tissue carbodissection
thermal ablation of soft tissue tumors2
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epidural carbodissection - prevents nerve damage during
thermal ablation of spine tumors3
Disadvantages
May hide an iatrogenic pneumoperitoneum when trying to displace the bowel.
Gas distributes in non-dependent areas, and cannot be used for all lesions3 - hydrodissection is a good alternative in this case.
Cannot be used for US-guided cervical and breast procedures, since gas blocks ultrasounds.
Complications
Displacement of the strcutures to protect in the wrong direction, especially in epidural carbodissection3.
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