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Objectives : To assess the potential safety and utility of the microwave tissue coagulation technique for laparoscopic partial nephrectomy, we applied this technique to a canine model, using a nobel laparoscopic dissector for manipulation of the kidney.
Methods : Ten adult mongrel dogs underwent laparoscopic partial nephrectomy using the microwave tissue coagulator to obtain hemostasis without clamping the renal artery and a nobel dissector to stabilize the kidney without renal mechanical injury. Three, 4 and 6 months after the operation, the renal remnants obtained by autopsy and histologically examined.
Results : The laparoscopic partial nephrectomy wave performed without renal ischemia using the microwave tissue coagulator and a nobel dissector in all animals without any intraoperative accidents. The estimate blood loss was 19.0 ± 7.3 ml (mean ± S.D.). The mean operative time was 49 ± 10 minutes (mean ± S.D.). Temperature of the kidney and circumferencial organs could be controlled among 37.0 to 45.0 °C by the ventilation of the intraabdominal warmed carbon dioxide. The postoperative course of all dogs was satisfactory and uncomplicated. All animals resumed normal preoperative activities by postoperative day 4. By autopsy, all dogs had no evidence of the injury of organs, retroperitoneal hematomas and urinomas. Histological findings of the renal specimens revealed no heat injury of renal remnants and the coagulated area was well limited to 10 mm in depth from the cut surface of the renal remnant.
Conclusions : Results of laparoscopic operation, thermal distribution, postoperative course and histological findings in a canine model suggest that the microwave tissue coagulation may be a safe, feasible, and useful technique for laparoscopic partial nephrectomy of patients with selected renal tumors.
