McDougall E M, Clayman R V, Chandhoke P S, Kerbl K, Stone A M, Wick M R, Hicks M, Figenshau R S
Department of Surgery (Division of Urology), Washington University School of Medicine, St. Louis, Missouri 63141.
J Urol. 1993 Jun;149(6):1633-6. doi: 10.1016/s0022-5347(17)36465-0.
In an effort to further evaluate the potential application of laparoscopy to urologic surgery, we explored the feasibility of using this minimally invasive approach for performing a partial nephrectomy. Nine female pigs underwent laparoscopic partial nephrectomy (LPN) utilizing a plastic cable tie (15 mm. x 4 mm. x 1 mm.) to achieve renal ischemia and an Argon Beam Coagulator probe (ABC) (Birtcher Medical Systems) to fulgurate the transected surface. Six weeks after LPN, 6 pigs underwent creatinine clearance, renin level, arteriography, BP samples and were then killed. The renal remnants were weighed and sectioned for histological studies. These studies revealed excellent function of the renal remnant, no AV fistula, and no evidence of renovascular hypertension. LPN is a feasible, repeatable procedure in the pig. Control of the renal hilum, transient parenchymal compression with a plastic cable, and use of the argon beam coagulator are key elements in performing this procedure.
为了进一步评估腹腔镜在泌尿外科手术中的潜在应用，我们探讨了使用这种微创方法进行部分肾切除术的可行性。9只雌性猪接受了腹腔镜部分肾切除术（LPN），使用塑料扎带（15毫米×4毫米×1毫米）实现肾脏缺血，并使用氩气刀探头（ABC）（Birtcher Medical Systems）烧灼切面。LPN术后6周，6只猪进行了肌酐清除率、肾素水平、动脉造影、血压样本检测，然后处死。称取肾残余组织重量并切片进行组织学研究。这些研究显示肾残余组织功能良好，无动静脉瘘，也无肾血管性高血压的证据。LPN在猪身上是一种可行、可重复的手术。控制肾门、用塑料扎带短暂压迫实质组织以及使用氩气刀是进行该手术的关键要素。
