Transperitoneal lower pole laparoscopic partial nephrectomy was performed in six pigs. Two nonsurvival animals were used initially to develop the laser technique. Four animals underwent a right-sided laparoscopic laser partial nephrectomy followed by an identical left-sided procedure 2 weeks later. Renal hilar occlusion was used in all cases. A novel 365-μm end-firing laser fibre and 80-W KTP laser were used for resection and hemostasis. All renal remnants underwent retrograde pyelography and histologic examination.

Laser resection and hemostasis was successfully completed in all cases, and no perioperative complications occurred. Mean estimated blood loss was 80ml (25–250ml). Mean laser and warm ischemia times were 35 and 34 minutes, respectively. Resection speed was limited by smoke formation but not by cutting or hemostatic efficiency of the laser. Mean resected kidney mass was 30g or 25% of total kidney mass. There were no urinomas, but, on retrograde pyelogram, extravasation was noted in seven of eight kidneys (87.5%).

The KTP laser provides hemostasis during large-volume resection in the porcine kidney. This technique appears promising for laparoscopic partial nephrectomy in humans.

J. Kyle Anderson, Meredith R. Baker, Guy Lindberg, Jeffrey A. Cadeddu

Department of Urologic Surgery, University of Minnesota and Veterans Affairs Medical Center, Minneapolis, Minnesota, USA
Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA

Accepted 15 May 2006 published online 6 June 2006.