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Application of Microwave Ablation in Laparoscopic Partial Splenectomy
Published on: November 15, 2024
Impact of microwave tissue coagulation during laparoscopic partial nephrectomy on postoperative renal function
Takahiro Yasui1, Yasunori Itoh, Yoshiyuki Kojima
1Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan. yasui@med.nagoya-cu.ac.jp
International Urology and Nephrology
|September 29, 2007
Summary
Laparoscopic partial nephrectomy using a microwave tissue coagulator for small renal tumors can be technically easy. However, it may cause renal impairment, limiting its use to small, exophytic tumors.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Nephrology
Background:
- Laparoscopic partial nephrectomy (LPN) is increasingly used for small renal tumors.
- Assessing renal function post-LPN is crucial, especially without clamping the renal hilum.
Purpose of the Study:
- To prospectively evaluate preoperative and postoperative differential renal function after LPN using a microwave tissue coagulator without hilar clamping.
- To assess the safety and efficacy of this technique for small renal tumors.
Main Methods:
- Seven patients with small exophytic renal tumors (≤2 cm) and a functioning contralateral kidney underwent LPN.
- A microwave tissue coagulator was used without hilar clamping.
- Renal scanning (99mTc-DTPA) was performed preoperatively and postoperatively at 7 days and 6 months to assess glomerular filtration rate (GFR) and split renal function (SF).
Main Results:
- Mean tumor size was 17.0 mm; mean surgical duration was 161.1 minutes.
- Mean preoperative GFR and SF in the affected kidney were 45.7 ml/min and 50.5%, respectively.
- Postoperative GFR and SF decreased to 36.2-36.8 ml/min and 44.3-45.0%, respectively, at 7 days and 6 months.
- No postoperative complications were observed.
Conclusions:
- Laparoscopic nonischemic partial nephrectomy with a microwave tissue coagulator offers technical ease and good hemostasis.
- The technique is associated with a decline in renal function, suggesting its use should be limited to small, exophytic renal tumors to minimize collateral damage.
