Bipolar needle electrocautery for laparoscopic partial nephrectomy without renal vascular occlusion in a porcine model

Albert M. Ong, Sam B. Bhayani, Thomas H.S. Hsu, Peter A. Pinto, KoonHo Rha, Matt Thomas, Theresa Nicol, Li Ming Su

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objectives. To report a novel method of accomplishing laparoscopic lower pole partial nephrectomy in an acute porcine model using a bipolar needle electrode without the need for renal arterial occlusion. Methods. Six animals (12 renal units) underwent laparoscopic polar nephrectomy using the bipolar needle electrode. After complete laparoscopic mobilization of the lower pole of the kidney, the bipolar needle electrode was repeatedly inserted full-thickness into the renal parenchyma and applied transversely, creating regional ischemia to the entire lower pole without renal vascular occlusion. The specimen was then amputated using laparoscopic scissors. Results. For the 12 laparoscopic partial nephrectomies, the mean operative time was 39 ± 30 minutes, and the mean blood loss was 90 ± 112 mL. Of the 12 cases, 10 (83%) were performed successfully with the bipolar needle electrocautery as the only source of hemostasis and without the need for ancillary hemostatic measures. Two of the procedures (17%) required temporary arterial control for hemostasis. For the successful procedures, the mean operative time was 29 ± 4 minutes, and the mean blood loss was 48 ± 11 mL. Histologic analysis of the specimens demonstrated coagulative necrosis between 2 and 4 mm from the line of the surgical incision. Conclusions. Bipolar needle electrocautery is a promising device that can be used to facilitate laparoscopic partial nephrectomy with minimal blood loss and without the need for renal arterial occlusion and warm ischemia. Additional studies are required to optimize the delivery parameters of this device.

Original languageEnglish
Pages (from-to)1144-1148
Number of pages5
JournalUrology
Volume62
Issue number6
DOIs
Publication statusPublished - 2003 Jan 1

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Electrocoagulation
Nephrectomy
Needles
Blood Vessels
Swine
Kidney
Electrodes
Operative Time
Hemostasis
Warm Ischemia
Equipment and Supplies
Hemostatics
Necrosis
Ischemia

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Ong, Albert M. ; Bhayani, Sam B. ; Hsu, Thomas H.S. ; Pinto, Peter A. ; Rha, KoonHo ; Thomas, Matt ; Nicol, Theresa ; Su, Li Ming. / Bipolar needle electrocautery for laparoscopic partial nephrectomy without renal vascular occlusion in a porcine model. In: Urology. 2003 ; Vol. 62, No. 6. pp. 1144-1148.
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abstract = "Objectives. To report a novel method of accomplishing laparoscopic lower pole partial nephrectomy in an acute porcine model using a bipolar needle electrode without the need for renal arterial occlusion. Methods. Six animals (12 renal units) underwent laparoscopic polar nephrectomy using the bipolar needle electrode. After complete laparoscopic mobilization of the lower pole of the kidney, the bipolar needle electrode was repeatedly inserted full-thickness into the renal parenchyma and applied transversely, creating regional ischemia to the entire lower pole without renal vascular occlusion. The specimen was then amputated using laparoscopic scissors. Results. For the 12 laparoscopic partial nephrectomies, the mean operative time was 39 ± 30 minutes, and the mean blood loss was 90 ± 112 mL. Of the 12 cases, 10 (83{\%}) were performed successfully with the bipolar needle electrocautery as the only source of hemostasis and without the need for ancillary hemostatic measures. Two of the procedures (17{\%}) required temporary arterial control for hemostasis. For the successful procedures, the mean operative time was 29 ± 4 minutes, and the mean blood loss was 48 ± 11 mL. Histologic analysis of the specimens demonstrated coagulative necrosis between 2 and 4 mm from the line of the surgical incision. Conclusions. Bipolar needle electrocautery is a promising device that can be used to facilitate laparoscopic partial nephrectomy with minimal blood loss and without the need for renal arterial occlusion and warm ischemia. Additional studies are required to optimize the delivery parameters of this device.",
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Bipolar needle electrocautery for laparoscopic partial nephrectomy without renal vascular occlusion in a porcine model. / Ong, Albert M.; Bhayani, Sam B.; Hsu, Thomas H.S.; Pinto, Peter A.; Rha, KoonHo; Thomas, Matt; Nicol, Theresa; Su, Li Ming.

In: Urology, Vol. 62, No. 6, 01.01.2003, p. 1144-1148.

Research output: Contribution to journalArticle

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AU - Ong, Albert M.

AU - Bhayani, Sam B.

AU - Hsu, Thomas H.S.

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AU - Rha, KoonHo

AU - Thomas, Matt

AU - Nicol, Theresa

AU - Su, Li Ming

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N2 - Objectives. To report a novel method of accomplishing laparoscopic lower pole partial nephrectomy in an acute porcine model using a bipolar needle electrode without the need for renal arterial occlusion. Methods. Six animals (12 renal units) underwent laparoscopic polar nephrectomy using the bipolar needle electrode. After complete laparoscopic mobilization of the lower pole of the kidney, the bipolar needle electrode was repeatedly inserted full-thickness into the renal parenchyma and applied transversely, creating regional ischemia to the entire lower pole without renal vascular occlusion. The specimen was then amputated using laparoscopic scissors. Results. For the 12 laparoscopic partial nephrectomies, the mean operative time was 39 ± 30 minutes, and the mean blood loss was 90 ± 112 mL. Of the 12 cases, 10 (83%) were performed successfully with the bipolar needle electrocautery as the only source of hemostasis and without the need for ancillary hemostatic measures. Two of the procedures (17%) required temporary arterial control for hemostasis. For the successful procedures, the mean operative time was 29 ± 4 minutes, and the mean blood loss was 48 ± 11 mL. Histologic analysis of the specimens demonstrated coagulative necrosis between 2 and 4 mm from the line of the surgical incision. Conclusions. Bipolar needle electrocautery is a promising device that can be used to facilitate laparoscopic partial nephrectomy with minimal blood loss and without the need for renal arterial occlusion and warm ischemia. Additional studies are required to optimize the delivery parameters of this device.

AB - Objectives. To report a novel method of accomplishing laparoscopic lower pole partial nephrectomy in an acute porcine model using a bipolar needle electrode without the need for renal arterial occlusion. Methods. Six animals (12 renal units) underwent laparoscopic polar nephrectomy using the bipolar needle electrode. After complete laparoscopic mobilization of the lower pole of the kidney, the bipolar needle electrode was repeatedly inserted full-thickness into the renal parenchyma and applied transversely, creating regional ischemia to the entire lower pole without renal vascular occlusion. The specimen was then amputated using laparoscopic scissors. Results. For the 12 laparoscopic partial nephrectomies, the mean operative time was 39 ± 30 minutes, and the mean blood loss was 90 ± 112 mL. Of the 12 cases, 10 (83%) were performed successfully with the bipolar needle electrocautery as the only source of hemostasis and without the need for ancillary hemostatic measures. Two of the procedures (17%) required temporary arterial control for hemostasis. For the successful procedures, the mean operative time was 29 ± 4 minutes, and the mean blood loss was 48 ± 11 mL. Histologic analysis of the specimens demonstrated coagulative necrosis between 2 and 4 mm from the line of the surgical incision. Conclusions. Bipolar needle electrocautery is a promising device that can be used to facilitate laparoscopic partial nephrectomy with minimal blood loss and without the need for renal arterial occlusion and warm ischemia. Additional studies are required to optimize the delivery parameters of this device.

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