Nd: YAG contact laser in partial nephrectomy. An experimental study in piglets

Area of Science:

• Urology
• Surgical Technology
• Biomedical Engineering

Background:

• Partial nephrectomies are crucial for kidney preservation.
• Minimizing blood loss and operative time is essential for patient outcomes.
• Evaluating novel surgical tools like lasers is important for advancing urological procedures.

Purpose of the Study:

• To compare the efficacy of the Neodymium-doped Yttrium Aluminum Garnet (Nd: YAG) contact laser with a steel scalpel in partial nephrectomies.
• To assess blood loss, operative time, and hemostatic requirements.
• To evaluate thermal effects associated with laser use.

Main Methods:

• Six partial nephrectomies were performed on piglets using a 12 W Nd: YAG contact laser.
• Six partial nephrectomies were performed using a steel scalpel for comparison.
• Blood loss, time to hemostasis, number of ligatures, and temperature rise were measured.

Main Results:

• Mean blood loss was significantly lower with the Nd: YAG laser (53 g) compared to the steel scalpel (108 g) (p < 0.04).
• The Nd: YAG laser group required fewer ligatures (1.5) than the steel scalpel group (8.8).
• Operative time for hemostasis showed a trend towards reduction with the laser (9.5 min vs. 16.2 min, p = 0.2).
• Mean temperature rise at 5, 10, and 20 mm from the resection line was 5.3°C, 1.2°C, and 0.3°C, respectively.

Conclusions:

• The Nd: YAG contact laser is a promising tool for partial nephrectomies, demonstrating reduced blood loss and potentially shorter operative times.
• The technique appears safe regarding thermal spread in the immediate vicinity of the resection.
• Further research is warranted to investigate long-term renal function following laser-assisted partial nephrectomies.