Second prize: simple method for achieving renal parenchymal hypothermia for pure laparoscopic partial nephrectomy

Area of Science:

• Urology
• Surgical Innovation
• Nephrology

Background:

• Laparoscopic partial nephrectomy requires renal parenchymal hypothermia during temporary ischemia.
• Achieving effective hypothermia can be challenging with existing methods.

Purpose of the Study:

• To develop and evaluate an innovative device and technique for renal parenchymal hypothermia.
• To assess the safety and efficacy of this method during laparoscopic partial nephrectomy.

Main Methods:

• The study involved four phases: device design and testing, proof of concept in nonsurvival porcine surgery, survival porcine surgery, and human trials.
• A cooling coil was designed and tested for its ability to induce and maintain hypothermia.

Main Results:

• The cooling coil demonstrated adequate cooling in phase 1.
• In porcine models (phases 2 and 3), renal parenchyma cooled to below 15°C within approximately 10 minutes, maintaining hypothermia for over 25 minutes.
• Human trials confirmed the method's simplicity and effectiveness, with no significant difference in creatinine levels post-reperfusion and pathological analysis indicating a protective effect.

Conclusions:

• The developed method for renal parenchymal hypothermia is simple, effective, and reproducible.
• This technique offers a valuable tool for laparoscopic partial nephrectomy, potentially improving outcomes.