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Partial Nephrectomy Without Renal Ischemia Using an Electromagnetic Thermal Surgery System in a Porcine Model - 21/04/13

Doi : 10.1016/j.urology.2012.12.036 
Chien-Hui Ou a, Wen-Horng Yang a, Hung-Wen Tsai b, Tung-Jen Lee c, Szu-Yin Chen c, Sheng-Chieh Huang d, Yi-Yuan Chang d, Gwo-Bin Lee d, Xi-Zhang Lin c,
a Department of Urology, College of Medicine, National Cheng Kung University, Tainan, Taiwan 
b Department of Pathology, College of Medicine, National Cheng Kung University, Tainan, Taiwan 
c Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan 
d Department of Power Mechanical Engineering, National Tsing Hua University, Hsinchu, Taiwan 

Reprint requests: Xi-Zhang Lin, M.D., Department of Medicine, College of Medicine, National Cheng Kung University and Hospital, 138 Sheng-Li Road, Tainan 704, Taiwan.

Abstract

Objective

To test the feasibility of partial nephrectomy using needle arrays under alternating current (AC) electromagnetic field without renal artery clamping.

Methods

We performed an experimental study for partial nephrectomy without renal artery clamping in a porcine model, comparing a new thermal surgery system consisting of an AC electromagnetic field generator and stainless steel needle arrays (using 10 pigs) vs an ultrasonic Harmonic Scalpel (on 8 pigs). Two cm of the upper pole of the kidneys were resected, and then the feasibility, operation time, blood loss, biochemical parameters, pathology, and complications were observed for 14 days.

Results

There was no difference by weight in the mean percentage of kidney removed between the 2 groups (8.1 ± 3.4% vs 12.7 ± 5.5%). The estimated blood loss for the partial nephrectomy with electromagnetic thermal surgery system was significantly less compared to the ultrasonic Harmonic Scalpel (53.0 ± 73.0 vs 188.8 ± 49.3 mL). Transection time was shorter with the electromagnetic thermal surgery system (10 vs 12 minutes). Bleeding from the cut surface after partial nephrectomy was noted in 2 pigs (electromagnetic surgery group) and 8 pigs (control group); all the bleeding was controlled with additional monopolar electrocoagulation and sutures. No urinoma was identified in either group when a second laparotomy was performed 2 weeks later.

Conclusion

Our study of a partial nephrectomy in a porcine model demonstrates that the heat generated by the electromagnetic thermal surgery system is sufficient to coagulate renal parenchyma and to seal off the blood vessels without pedicle clamping.

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 Financial Disclosure: The authors declare that they have no relevant financial interests.
 This study was supported by the National Cheng Kung University of Taiwan. We also thank the Metal Industry Research Institute co-funding grant #10010030.


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Vol 81 - N° 5

P. 1101-1107 - maggio 2013 Ritorno al numero
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