title: Thulium laser supported nephron sparing surgery for renal cell carcinoma.
abstract: OBJECTIVE
  We analyze the feasibility, advantages and results of the use of a thulium laser in nephron sparing surgery for renal cell carcinoma.
  
  
  METHODS
  In this single center prospective study 10 consecutive high risk patients underwent open or laparoscopic thulium laser assisted enucleation for small peripheral renal cell carcinoma at our department. We used a 2.0 μm continuous or pulsed thulium laser. This diode pumped solid state laser emits a wavelength of 2,013 nm in the infrared spectrum and penetrates tissue to a depth of 0.5 mm.
  
  
  RESULTS
  The entire tumor enucleation was performed using the frontal thulium laser fiber. In all cases the thulium laser produced a smooth incision of the renal parenchyma and a safe delineation of the plane between the tumor and the surrounding tissue. In addition, in the off clamp procedures bleeding was limited during the dissection and did not interfere with the definition of the surgical plane. Median surgical time from the beginning of the laser assisted tumor dissection to the end, after verification of bleeding control on the cut surface, was 15 minutes (range 12 to 20). No significant (less than 40 cc) blood loss occurred during the laser assisted tumor dissection. All cases were clear cell renal cell carcinoma and no positive surgical margins were found. In all cases postoperative management was uncomplicated without evidence of hemorrhage.
  
  
  CONCLUSIONS
  In our prospective preliminary experience, thulium laser assisted enucleation for renal cell carcinoma is a feasible, safe and effective procedure.
authors: Department of Urology, University Sapienza, Rome, Italy. sciarra.md@libero.it
authors: Alessandro
authors: A
authors: Sciarra
authors: Magnus
authors: M
authors: Von Heland
authors: Francesco
authors: F
authors: Minisola
authors: Stefano
authors: S
authors: Salciccia
authors: Susanna
authors: S
authors: Cattarino
authors: Vincenzo
authors: V
authors: Gentile
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy; D053685:Laser Therapy / Q000379:methods*; D054023:Lasers, Semiconductor; D008297:Male; D009399:Nephrons / Q000601:surgery; D011446:Prospective Studies; D013932:Thulium; D016896:Treatment Outcome
chemical_list: D013932:Thulium
keywords: RCC; kidney neoplasms; laser therapy; renal cell carcinoma; thulium