1985 Volume 76 Issue 6 Pages 889-894
During the 14 months from August 1983 to September 1984, nephrotomy was performed using the cavitron ultrasonic surgical aspirator (CUSA) in six cases of renal calculus. These six cases consisfed of two cases of staghorn calculus and four cases of multiple renal calculi. Nephrolithotomy was performed in four cases, both nephrolithotomy and partial nephrectomy in one, and partial nephrectomy in one. The power of CUSA was 30 to 50% (90 to 150 micron) and pressure for aspiration was 180 to 250mmHg. In five out of the six cases, nephrotomy could be performed without clamping the renal vessels. In one case, the renal artery had to be occluded since bleeding was seen on the incised surface. In all of these six cases, postoperative course was uneventful. Gross hematuria disappeared one day after the operation, with no after-bleeding. CUSA aspirated the renal tissue after imploding and fragmenting it. Since elastic blood vessels are conserved without being damaged, they can surely be coagulated electrically or ligated with ease. Fimer blood vessels can be coagulated through heat of friction resulting from shaking. Therefore, this technique assured safe nephrotomy without occluding the renal vessels. We consider that CUSA is useful for nephrotomy such as partial nephrectomy and nephrolithotomy.
