Partial Nephrectomy Without Renal Ischemia Using an Electromagnetic Thermal Surgery System in a Porcine Model

Ou, Chien Hui; Yang, Wen-Horng; Tsai, Hung Wen; Lee, Tung Jen; Chen, Szu Yin; Huang, Sheng Chieh; Chang, Yi Yuan; Lee, Gwo‐Bin; Lin, Xi Zhang

doi:10.1016/j.urology.2012.12.036

Cited by 4 publications

(2 citation statements)

References 12 publications

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“…The MWS has the potential to avoid the limitations of the microwave coagulator because the scissor blades can be precisely controlled under operator’s vision, while the renal tissue is coagulated by microwaves radiated between the scissor blades with an arbitrary transition timing based on the bleeding condition. Our off-clamp LPN technique using MWS recorded lower BL compared with off-clamp open PN using ultrasonic 31 or radiofrequency ablation devices 31 in similar porcine renal resections reported previously. Moreover, even though the proposed technique requires no clamping, its RT and BL were lower than those in on-clamp LPNs 32,33 in which renal bleeding was controlled with renorrhaphy, 32,33 renorrhaphy with hemostatic agents, 33 or electrocautery with hemostatic agents, 32 respectively.…”

Section: Discussionsupporting

confidence: 65%

Feasibility of Microwave Scissors-Based Off-Clamp Laparoscopic Partial Nephrectomy in a Porcine Model

et al. 2023

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Objectives To assess the feasibility of off-clamp laparoscopic partial nephrectomy using microwave scissors. Methods We performed transperitoneal laparoscopic partial nephrectomy, without hilar clamping or renorrhaphy, using only microwave scissors for renal resection in a porcine model. For each kidney, 2 types of procedures were performed: a middle pole resection excising an area of 2-cm diameter and approximately 1-cm depth and a lower pole resection at the level of the lower polar line. The renal calyces exposed during renal resection were sealed and transected using microwave scissors. After 3 days of follow-up, the pigs were reoperated to inspect for postoperative complications. Euthanasia was performed to collect the remaining kidneys for histopathological examination. Results Ten procedures were successfully performed, without hilar clamping or suturing of the renal calyces and parenchyma, in 5 kidneys from 3 pigs. The median resecting time, blood loss, and lateral thermal injury were 23.2 min, 47.1 mL, and 6.8 mm in the middle pole resection, and were 15.1 min, 26.5 mL, and 6.9 mm in the lower pole resection, respectively. No complications were noted during reoperation, such as postoperative hemorrhage and major urine leakage. Extravasation occurred in 2 middle pole resections and 3 lower pole resections during retrograde pyelogram. Hematoxylin and eosin staining revealed thermal injury characterized by tissue microwave fixation in the near zone and acute coagulative necrosis in the intermediate zone. Conclusions Microwave scissors-based off-clamp laparoscopic partial nephrectomy is feasible in pigs and can be used for clinical applications.

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Section: Discussionsupporting

confidence: 65%

Feasibility of Microwave Scissors-Based Off-Clamp Laparoscopic Partial Nephrectomy in a Porcine Model

et al. 2023

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“…Even though hilar clamping was not performed, the off-clamp sutureless LPN using MWS ( 21 ) recorded shorter PT and lesser BL compared to porcine on-clamp LPNs ( 37 , 38 ), in which renal bleeding was controlled with renal suturing ( 37 , 38 ), renal suturing with hemostatic agents ( 38 ), or electrocautery with hemostatic agents ( 37 ), respectively. In addition, its BL ( 21 ) was lesser than that of off-clamp open PN using ultrasonic ( 39 ) or radiofrequency ablation devices ( 39 ), in similar porcine renal resections reported previously. To our knowledge, the cost of MWS is lower than that of other devices usually employed for dissection in conventional LPN, such as bipolar radiofrequency or ultrasonic devices.…”

Section: Discussionsupporting

confidence: 55%

Comparison of off-clamp microwave scissors-based sutureless partial nephrectomy versus on-clamp conventional partial nephrectomy in a canine model

Nguyen,

Yamada,

Naka

et al. 2023

Front. Surg.

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ObjectivesTo compare the usefulness and safety of off-clamp microwave scissors-based sutureless partial nephrectomy (MSPN) with on-clamp conventional partial nephrectomy (cPN) in dogs.MethodsWe performed off-clamp MSPN using microwave scissors (MWS) in six dogs, and on-clamp cPN in three dogs, in two-stage experiments. The bilateral kidney upper poles were resected via a midline incision under general anesthesia. After 14 days of follow-up, the lower pole resections were performed. The renal calyces exposed during renal resections were sealed and transected using MWS in off-clamp MSPN and were sutured in on-clamp cPN. In the off-clamp MSPN group, the generator's power output of MWS was set as either 50 W or 60 W for each kidney side. We compared the procedure time (PT), ischemic time (IT), blood loss (BL), and normal nephron loss (NNL) between the two techniques using the Mann–Whitney U-test.ResultsWe successfully performed 24 off-clamp MSPNs and 12 on-clamp cPNs. The off-clamp MSPN was significantly superior to on-clamp cPN in avoiding renal ischemia (median IT, 0 min vs. 8.6 min, p < 0.001) and reducing PT (median PT, 5.8 min vs. 11.5 min, p < 0.001) and NNL (median NNL, 5.3 mm vs. 6.0 mm, p = 0.006) with comparable BL (median BL, 20.9 ml vs. 23.2 ml, p = 0.804). No bleeding and major urine leakage were noted during the reoperations.ConclusionsOff-clamp MSPN outperforms on-clamp cPN in lowering the risks of postoperative renal function impairment in dogs.

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The sheep as a model for healing studies after partial nephrectomy

Souza

Costa

Damasceno-Ferreira

et al. 2016

Journal of Surgical Research

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Partial Nephrectomy Without Renal Ischemia Using an Electromagnetic Thermal Surgery System in a Porcine Model

Cited by 4 publications

References 12 publications

Feasibility of Microwave Scissors-Based Off-Clamp Laparoscopic Partial Nephrectomy in a Porcine Model

Feasibility of Microwave Scissors-Based Off-Clamp Laparoscopic Partial Nephrectomy in a Porcine Model

Comparison of off-clamp microwave scissors-based sutureless partial nephrectomy versus on-clamp conventional partial nephrectomy in a canine model

The sheep as a model for healing studies after partial nephrectomy

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