InLine bipolar radiofrequency ablation device-assisted partial nephrectomy in a porcine model

Area of Science:

• Urology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Nephron-sparing surgery is a viable alternative to radical nephrectomy for renal tumors.
• Controlling intraoperative blood loss remains a challenge in partial nephrectomy.
• InLine radiofrequency ablation (ILRFA) has shown efficacy in reducing blood loss during liver resections.

Purpose of the Study:

• To evaluate the efficacy of ILRFA-assisted partial nephrectomy in a porcine model.
• To assess the impact of ILRFA on intraoperative blood loss during renal tumor resection.
• To determine if precoagulation via ILRFA is a valid concept in nephron-sparing surgery.

Main Methods:

• Eight landrace pigs underwent multiple partial nephrectomies.
• The parenchymal incision line was circumferentially scored with diathermy.
• ILRFA was applied for coagulation before resection with a scalpel; control resections used diathermy and sutures.

Main Results:

• ILRFA reduced mean intraoperative blood loss by 77.0% (35 mL vs. 152 mL, P=0.024).
• Blood loss per centimeter of resection area decreased by 79.0% with ILRFA (2.09 mL/cm² vs. 12.79 mL/cm², P=0.019).
• Average ILRFA coagulation time was 5 minutes.

Conclusions:

• ILRFA is effective in reducing blood loss during partial nephrectomy in a porcine model.
• Precoagulation with ILRFA prior to parenchymal transection is a potentially valid strategy for nephron-sparing surgery.
• This technique may improve outcomes in renal tumor surgery.