Open partial nephrectomy using saline-enhanced monopolar radiofrequency device: evaluation of novel surgical...

Nephron-sparing surgery has emerged as the preferred surgical management of select renal masses. Advancements in surgical and hemostatic techniques, together with long-term data on cancer-free survival, have led to greater use of these procedures. The TissueLink Dissecting Sealer is a new device that couples radiofrequency energy with low-volume saline irrigation to give improved hemostasis during dissection. We assessed this device as an alternative dissecting tool during open partial nephrectomy.

A total of 32 consecutive patients underwent open partial nephrectomy during a 20-month period. These masses were resected using the TissueLink Dissecting Sealer or the surgeon's conventional method of dissection (needlepoint electrocautery). Perioperative parameters, including operative time, tumor size, blood loss, and hilar vessel occlusion times, were retrospectively reviewed and compared. The average age in the TissueLink group (n = 16) was 60 years (range 46 to 87) compared with 61 years (range 45 to 89) in the conventional group (n = 16). The average tumor size in the TissueLink group was 3.1 +/- 1.4 cm (range 1.2 to 7.0) compared with 2.5 +/- 1.3 cm (range 0.8 to 6.0) in the conventional group. The hilar vessels were clamped in select patients (with similar occlusion times) from both groups because of deep tumor penetration or a central location. The average blood loss was 126 +/- 40 mL (range 50 to 200) for the TissueLink group versus 194 +/- 105 mL (range 50 to 400) in the conventional group, a statistically significant difference (P = 0.027). No perioperative complications occurred.

TissueLink-assisted open partial nephrectomy is a novel technique that couples radiofrequency energy with low-volume saline irrigation to provide excellent hemostasis during and after renal tumor dissection.