Experimental Data In Urology Laparoscopic Nephrectomy

Initially, hydro-jet was employed to perform laparoscopic nephrectomy (5). In an experimental model, 14 pigs underwent unilateral laparoscopic nephrectomy using the hydro-jet and a conventional laparoscopic nephrectomy contralaterally. A Muritz 1000b hydro-jet generator was utilized. An adjustable water pressure gauge allowed manual control up to a maximum pressure of 30 bar and coagulation was applied via a bipolar probe. The angled end of the probe allowed both blunt dissections with concomitant high-pressure saline application. Results were compared with regard to ease of anatomic dissection, complications, and operative time between the two techniques. Overall, laparoscopic nephrectomy was successful in all animals. No vascular injury secondary to dissection or significant intraoperative hemorrhage was noted. The minor bleeding was of a diffuse nature secondary to blunt dissection. The estimated blood loss was minimal (<50 mL) in both groups. The mean dissection time was 27 (range: 16-34) and 40 (range: 25-65) minutes for hydro-jet-assisted and conventional technique, respectively (p <0.001). The mean normal saline used during hydro-jet dissection was 195 mL (range, 150-250 mL). No further experimental or clinical studies are currently available using this technology for dissection during laparoscopic nephrectomy.

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