A cryosurgical instrument that is selectively positioned in a patient tissue by rotation. The instrument includes: a manipulation section that permits a user to rotate the instrument; a cryogen supply portion; and a positioning section having a sharp tip at an end and a helical configuration, the positioning section configured to receive cryogen and to permit the received cryogen to cool the positioning section. The positioning section urges the cryosurgical instrument deeper into the patient when the instrument is rotated in a first direction, via the manipulation section, and urges the cryosurgical instrument outward when the instrument is rotated in a second direction that is opposite the first, via the manipulation section.