Efficacy and safety of the Nd:YAG laser in canine partial nephrectomy

Partial nephrectomy using 100 watts of focused Neodymium: Yttrium Aluminum Garnet (Nd:YAG) laser power was evaluated to determine its hemostatic capabilities, safety, and effect on renal function and histology. Six adult female dogs ranging from 22 to 33 lbs. underwent nephrectomy and contralateral partial nephrectomy using the laser. Closure of the collecting system and drains were not used to determine if the laser could seal the collecting system. There was no blood loss with this technique. Four of the 6 dogs had no postoperative complications but two had urinary extravasation which led to death in one dog and required drainage in another. One month postoperative serum creatinine levels were 66 per cent higher than pre-operative values. Intravenous urograms revealed no evidence of dilation of the collecting system nor contrast extravasation. The depth of necrosis ranged from 4 mm. in the cortex to 7 mm. in the medulla. The data indicate that Nd:YAG laser partial nephrectomy is effective, and provides complete hemostasis, manageable urinary extravasation and acceptable impairment of renal function.