title: Is It Safe to Use the Same Scissors After Accidental Tumor Incision During Partial Nephrectomy? Results of In Vitro and In Vivo Experiments.
abstract: When accidental tumor incision (ATI) has occurred during open partial nephrectomy (PN), scissors can be changed easily. In contrast, during laparoscopic partial nephrectomy (LPN) or robotic partial nephrectomy (RPN), it is time consuming and expensive especially during RPN to change scissors. This study investigates whether tumor cells remain on the surface of scissors after ATI during PN and investigates an alternative way to avoid changing scissors during LPN and RPN.
  
  
  
  We subcutaneously injected 786-O renal-cell carcinoma (RCC) cells containing enhanced green fluorescent protein (786-O/EGFP) into six mice. We incised the subsequent tumor with straight or Microline scissors. The scissor surfaces were then examined by microscopy for detection of EGFP immunofluorescence. In addition, the scissor surfaces were treated in three ways: no electrical treatment, electrical treatment of 20 W for 5 seconds, and electrical treatment of 40 W for 5 seconds.
  
  
  
  Strings or dots of EGFP were detected on every scissor surface, and 786-O/EGFP cells were alive and able to proliferate in medium in 33% of the nonelectrically treated samples. However, no 786-O/EGFP cells treated with monopolar electricity survived. In another experiment, we also found that 100 786-O cells placed on scissor surfaces could not survive after the same electrical treatment.
  
  
  
  RCC cells remained on scissors after ATI; however, electrical treatment eliminated tumor cells, possibly preventing recurrence or metastasis after surgery.
authors.affiliation: 1 Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University , Kagoshima, Japan .
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Yoshino
authors.affiliation: 1 Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University , Kagoshima, Japan .
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Miyamoto
authors.affiliation: 2 Department of Urology, Chonnam National University Medical School , Gwangju, Korea.
authors.forename: Eu-Chang
authors.initials: EC
authors.lastname: Hwang
authors.affiliation: 1 Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University , Kagoshima, Japan .
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamane
authors.affiliation: 1 Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University , Kagoshima, Japan .
authors.forename: Masayuki
authors.initials: M
authors.lastname: Nakagawa
authors.affiliation: 1 Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University , Kagoshima, Japan .
authors.forename: Hideki
authors.initials: H
authors.lastname: Enokida
mesh_terms: D000818:Animals; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D045744:Cell Line, Tumor; D004560:Electricity; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D051379:Mice; D008819:Mice, Nude; D009364:Neoplasm Recurrence, Local; D009368:Neoplasm Transplantation; D009392:Nephrectomy / Q000379:methods*; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D012371:Robotics; D013525:Surgical Instruments
keywords: accidental tumor incision; partial nephrectomy; positive surgical margin; tumor spillage