At CSA Medical everything we do centers on Liquid Nitrogen (LN2). Our truFreeze® spray cryotherapy system is used by physicians in the United States to ablate malignant tissue in the esophagus. Since 2012 over 17,000 procedures have been performed. The application of liquid nitrogen is performed during a routine endoscopy procedure, similar to what a patient will undergo for initial diagnosis or continued surveillance.

Why Liquid Nitrogen??

Liquid Nitrogen, or LN2, is a cryogen –– a liquefied gas kept in its liquid state by storing it at an extremely cold temperature. At CSA Medical LN2 is our cryogen of choice because it has the lowest boiling point of all the cryogens that can safely be used in a surgical setting: -196°C to be exact! The truFreeze system is the only technology available that delivers LN2, other technologies deliver other cryogens such a nitrous oxide or carbon dioxide- these cryogens are not as cold as LN2- temperature is an important factor when dealing with malignant tissue.

Why do we want it so cold?

Our goal is to destroy unwanted tissue inside the body in a way that allows new, healthy tissue to grow back in its place. The way to do that is to destroy the cells, but keep the extracellular matrix (ECM) intact. Think of ECM as the scaffolding that holds the cells in place. Cells have a high water content, ECM does not. Spraying LN2 on unwanted tissue flash freezes the water inside the cells. When the area thaws, the frozen cells burst causing cell death. Over a short period of time new healthy cells regenerate in the ECM. There is little to no scarring because the ECM remains intact. We call this “Rejuvenative” Healing.

Not all cells are the same.

  • Cancer cells die at -50°C
  • Pre cancerous cells die at -20°C

LN2 is far colder than is needed to effectively destroy these tissue types, by a factor of >2.

There are 17 US based hospitals which are active in a CSA Medical sponsored patient registry, this was established in 2013 to collect efficacy and outcomes data related to the use of truFreeze spray cryotherapy for the treatment of unwanted tissue in the pulmonary and gastrointestinal settings. For more information related to the truFreeze patient registry, please visit

There have been many peer-reviewed articles published on the safety of liquid nitrogen in the esophagus and its application to malignant tissue. Ablation of esophageal cancer in the presence of dysphagia- difficulty or discomfort in swallowing- is also an area where the spray cryotherapy is used. If you have difficulty swallowing due to persistent malignancy please speak to your physician about liquid nitrogen.

If you are a health care provider or patient, we encourage you to visit to learn more about the rejuvenative properties of liquid nitrogen and the location of physician sites which have the truFreeze spray cryotherapy technology.

The truFreeze spray cryotherapy system has been cleared by the U.S. Food and Drug Administration under K160273 with the following Intended Use/Indication for Use;

The truFreeze system is intended for cryogenic destruction of tissue using Liquid Nitrogen spray that has a boiling point of -196°C requiring either active or passive venting during surgical procedures.

The truFreeze system is indicated for use as a cryosurgical tool in the fields of dermatology, gynecology and general surgery, to ablate benign and malignant lesions.

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