Preclinical study of gasless laparoscopy for radical nephrectomies in canine cadavers

In this study, we aimed to verify the feasibility of the multidirectional traction platform in performing gasless laparoscopic nephrectomies on dog cadavers. The cadavers were divided into two groups: those subjected to gasless laparoscopic radical nephrectomy (GCG) and those subjected to laparoscopic radical nephrectomy with pneumoperitoneum (GCP). The total surgical time, time for each stage of the procedure, and intraoperative complications were recorded. Using the Likert scale and visual analog scale (VAS), the surgeon and assistant assessed the degree of difficulty of each surgical approach. The total surgical time for nephrectomy was longer in the GCG group (p<0.01). Similarly, differences in the steps of positioning portal 2, establishing the abdominal elevation equipment, dissecting the vessels of the renal hilum, and dissecting the kidney from the fascia renal disease were also longer in the GCG group (p<0.05). A significant interaction was observed between the surgical group and the side of surgery, and the variable time to remove the kidney from the abdominal cavity (p=0.02) was longer in the GCG group. In the evaluation of the surgeon and assistant, the groups differed in all parameters, indicating the degree of difficulty of surgical approaches on a Likert scale (p<0.05). On the VAS scale, we observed a higher response in the GCG group (p<0.01). The multidirectional abdominal traction device used in this study enabled the performance of gasless laparoscopic radical nephrectomies on dog cadavers.