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HYDRO-JET ASSISTED LAPAROSCOPIC PARTIAL NEPHRECTOMY: INITIAL EXPERIENCE IN A PORCINE MODEL

2000; Lippincott Williams & Wilkins; Volume: 163; Issue: 3 Linguagem: Inglês

10.1016/s0022-5347(05)67872-x

1527-3792

H. Shekarriz, Bijan Shekarriz, Jyoti Upadhyay, Conny Bürk, DAVID P. WOOD HANS-PETER BRUCH,

Urological Disorders and Treatments

No AccessJournal of UrologyINVESTIGATIVE UROLOGY1 Mar 2000HYDRO-JET ASSISTED LAPAROSCOPIC PARTIAL NEPHRECTOMY: INITIAL EXPERIENCE IN A PORCINE MODEL HODJAT SHEKARRIZ, BIJAN SHEKARRIZ, JYOTI UPADHYAY, CONNY BÜRK, and DAVID P. WOOD HANS-PETER BRUCH HODJAT SHEKARRIZHODJAT SHEKARRIZ , BIJAN SHEKARRIZBIJAN SHEKARRIZ , JYOTI UPADHYAYJYOTI UPADHYAY , CONNY BÜRKCONNY BÜRK , and DAVID P. WOOD HANS-PETER BRUCHDAVID P. WOOD HANS-PETER BRUCH View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)67872-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Hemostasis represents a challenge when performing laparoscopic partial nephrectomy. Hydro-Jet cutting is an advanced technology that has been used to create an ultra-coherent water force that functions like a sharp knife. In the surgical field, it has mainly been used for liver surgery and initial clinical experience with laparoscopic cholecystectomies has been favorable. This technique allowed selective parenchymal cutting with preservation of vessels and bile ducts. We describe a novel Hydro-Jet assisted dissection technique for laparoscopic partial nephrectomy in a porcine model. Materials and Methods: Ten partial nephrectomies were performed in 5 pigs using a Muritz 1000 (Euromed Medizintechnik, A. Pein, Schwerin, Germany) Hydro-Jet generator. A thin stream of ultra coherent fluid is forced at a high velocity through a small nozzle. A modified probe allows both blunt dissection concomitantly with high-pressure water application. Coagulation can be applied via a bipolar thermoapplicator as needed. Results: Laparoscopic partial nephrectomy was successful in all animals. Water-jet cutting through the parenchyma was virtually bloodless and preserved the vasculature and the collecting system. The vessels were then ligated or coagulated under direct vision. The continuous water flow established a bloodless operating field and a clear view for the surgeon. The mean dissection time and warm ischemia time were 45 ± 9 and 17 ± 3 minutes, respectively. Conclusions: This preliminary study supports the suitability of this technique for laparoscopic partial nephrectomy to improve hemostasis. The improved anatomical dissection and hemostasis may further decrease morbidity and operative time. Further studies are underway to compare this technique with laser coagulation for laparoscopic partial nephrectomy. References 1 : Nephron sparing surgery for renal cell carcinoma. J Urol1993; 149: 1. Link, Google Scholar 2 : Laparoscopic surgery in urology: current applications. Am J Roentgenol1993; 160: 1167. Google Scholar 3 : Laparoscopic partial nephrectomy in the pig model. J Urol1991; 149: 1633. Google Scholar 4 : Human laparoscopic partial nephrectomy-a case report. 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Google Scholar From the University of Lübeck, Department of Surgery, Lübeck, Germany, and Wayne State University and School of Medicine, Department of Urology, Detroit, Michigan© 2000 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byMOINZADEH A, HASAN W, SPALIVIERO M, FINELLI A, KILCILER M, MAGI-GALLUZZI C, EL GABRY E, DESAI M, KAOUK J and GILL I (2018) WATER JET ASSISTED LAPAROSCOPIC PARTIAL NEPHRECTOMY WITHOUT HILAR CLAMPING IN THE CALF MODELJournal of Urology, VOL. 174, NO. 1, (317-321), Online publication date: 1-Jul-2005.BROWN J, HUBOSKY S, GOMELLA L and STRUP S (2018) HAND ASSISTED LAPAROSCOPIC PARTIAL NEPHRECTOMY FOR PERIPHERAL AND CENTRAL LESIONS: A REVIEW OF 30 CONSECUTIVE CASESJournal of Urology, VOL. 171, NO. 4, (1443-1446), Online publication date: 1-Apr-2004.PARK E, ULREICH J, SCOTT K, ULLRICH N, LINEHAN J, FRENCH M, HO W, WHITE M, TALLEY J, FELLAH A and RAMAKUMAR S (2018) EVALUATION OF POLYETHYLENE GLYCOL BASED HYDROGEL FOR TISSUE SEALING AFTER LAPAROSCOPIC PARTIAL NEPHRECTOMY IN A PORCINE MODELJournal of Urology, VOL. 172, NO. 6 Part 1, (2446-2550), Online publication date: 1-Dec-2004. Volume 163Issue 3March 2000Page: 1005-1008 Advertisement Copyright & Permissions© 2000 by American Urological Association, Inc.Keywordslaparoscopypartial nephrectomyanimalhydro-jetwater-jetMetricsAuthor Information HODJAT SHEKARRIZ More articles by this author BIJAN SHEKARRIZ More articles by this author JYOTI UPADHYAY More articles by this author CONNY BÜRK More articles by this author DAVID P. WOOD HANS-PETER BRUCH More articles by this author Expand All Advertisement PDF downloadLoading ...