Partial nephrectomy with a combined CO2 and Nd:YAG laser: experimental study in pigs.
Twenty-eight partial nephrectomies were performed on nine pigs with a simultaneous, coaxial CO2-Nd:YAG laser at power settings of 20 W and 40 W, or with a steel scalpel. A vascular pedicle clamp was used without renal cooling. The time for hemostasis was 4.5 +/- 3.2 min (mean +/- SD) with the laser and 6.4 +/- 2.5 min with the steel scalpel (P = 0.064). There was no difference in the total operation time (10.4 +/- 3.5 min with the laser vs. 11.0 +/- 3.2 min with the steel scalpel, P = 0.470). The mean blood loss with the laser was 17.5 +/- 6.7 g and 22.1 +/- 15.2 g with the steel scalpel (P = 0.299). The number of ligatures needed for complete hemostasis was 2.9 +/- 2.1 with the laser and 5.0 +/- 2.3 with the steel scalpel (P = 0.011). The average thermal damage was 0.23 +/- 0.10 mm. It is concluded that the simultaneous CO2-Nd:YAG laser method can be used in partial nephrectomy and it offers better hemostasis than the conventional technique. Further studies with different power levels are needed.
Taari
K
K
Department of Urology, Helsinki University Central Hospital, Finland.
Salo
J O
JO
Rannikko
S
S
Nordling
S
S
D000535:Aluminum; D000818:Animals; D002245:Carbon Dioxide; D006488:Hemostasis, Surgical / Q000379:methods; D053685:Laser Therapy / Q000379:methods*; D008026:Ligation; D009354:Neodymium; D009392:Nephrectomy / Q000379:methods*; D013552:Swine; D013997:Time Factors; D015019:Yttrium
D002245:Carbon Dioxide; D009354:Neodymium; D015019:Yttrium; D000535:Aluminum