title: Laparoscopic partial nephrectomy with a novel electrosurgical snare in a porcine model.
abstract: OBJECTIVE
  We evaluated the safety and efficacy of laparoscopic partial nephrectomy with an arcing-gap electrosurgical snare in a porcine model.
  
  
  METHODS
  A novel electrosurgical snare, optimizing high current density arcing and parenchymal compression, was utilized for laparoscopic renal transection. Five farm pigs underwent unilateral laparoscopic polar partial nephrectomy; 6 weeks later, these same animals underwent contralateral partial nephrectomy just prior to sacrifice. Five additional animals underwent chronic (6-week follow-up) and acute open partial nephrectomies by the conventional surgical technique.
  
  
  RESULTS
  The average time for transection with the snare was 5.6 minutes. In 9 of 10 cases, the snare provided satisfactory hemostasis. In the remaining case, additional argon-beam coagulation (ABC) controlled the minimal bleeding present after transection. In all 10 animals, the collecting system was transected. In six cases, application of the snare alone sealed the collecting system. No urinomas developed in the five animals followed for 6 weeks. At 6 weeks, the mean depth of injury at the center of the cut surface was 5.1 mm in the laparoscopic group and 3.9 mm in the open group.
  
  
  CONCLUSIONS
  Laparoscopic partial nephrectomy with the arcing-gap electrosurgical snare is feasible in a porcine model. Application of the snare provides excellent hemostasis without the need to control the renal vasculature.
authors.affiliation: Division of Urology, Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: William C
authors.initials: WC
authors.lastname: Collyer
authors.forename: Jaime
authors.initials: J
authors.lastname: Landman
authors.forename: Ephrem O
authors.initials: EO
authors.lastname: Olweny
authors.forename: Cassio
authors.initials: C
authors.lastname: Andreoni
authors.forename: Adam
authors.initials: A
authors.lastname: Kibel
authors.forename: Gerald L
authors.initials: GL
authors.lastname: Andriole
authors.forename: David G
authors.initials: DG
authors.lastname: Bostwick
authors.forename: Chandru P
authors.initials: CP
authors.lastname: Sundaram
authors.forename: Ralph V
authors.initials: RV
authors.lastname: Clayman
mesh_terms: D000818:Animals; D016063:Blood Loss, Surgical / Q000517:prevention & control; D004564:Electrocoagulation / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006488:Hemostasis, Surgical / Q000295:instrumentation* / Q000379:methods; D007150:Immunohistochemistry; D007668:Kidney / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D019060:Minimally Invasive Surgical Procedures; D023421:Models, Animal; D009392:Nephrectomy / Q000295:instrumentation / Q000379:methods*; D011028:Pneumoperitoneum, Artificial; D012680:Sensitivity and Specificity; D013525:Surgical Instruments; D013552:Swine