Partial nephrectomy driven by cavitron ultrasonic surgical aspirator under zero ischemia: a pilot study

Area of Science:

• Urology
• Surgical Oncology
• Nephrology

Background:

• Renal tumors necessitate surgical intervention, with partial nephrectomy being the preferred method for preserving renal function.
• Ischemic conditions during partial nephrectomy can negatively impact kidney function.
• Minimally invasive techniques are continuously being explored to improve surgical outcomes.

Purpose of the Study:

• To evaluate the efficacy and technical feasibility of using a cavitron ultrasonic surgical aspirator (CUSA) for zero-ischemia open partial nephrectomy in patients with renal tumors.
• To assess the safety and effectiveness of this technique in a prospective patient cohort.

Main Methods:

• Prospective collection of data from 13 consecutive patients undergoing open partial nephrectomy without ischemia.
• Utilized an ultrasonic device (CUSA/SONOCA 300) for tumor resection.
• Collected and analyzed demographic, laboratory, tumor characteristics, and perioperative/postoperative variables, including PADUA scores.

Main Results:

• The study included patients with a median age of 60, with tumors predominantly diagnosed incidentally (84.6%).
• Median operative time was 175 minutes, with a median tumor extirpation time of 12 minutes and median blood loss of 250 ml.
• Renal function (serum creatinine, GFR) and hemoglobin levels remained largely unchanged post-surgery in most patients (84.6%), with manageable complications.

Conclusions:

• The ultrasonic device (CUSA) demonstrated effective hemostasis and resection properties during non-ischemic open partial nephrectomy.
• The technique shows promising perioperative and postoperative results, supporting its potential for maximizing renal function preservation in partial nephrectomy candidates.