Habib Laparoscopic Bipolar Radiofrequency Device: A Novel Way of Creating an Avascular Resection Margin in Laparoscopic Partial Nephrectomy
Habib Laparoscopic Bipolar Radiofrequency Device: A Novel Way of Creating an Avascular Resection Margin in Laparoscopic Partial Nephrectomy
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DOI：
10.1089/lap.2008.0050
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发表时间：
2008-12-01
影响因子：
1.3
通讯作者：
Lee, Benjamin R.
中科院分区：
文献类型：
--
作者：
Andonian, Sero;Adebayo, Adebukola;Lee, Benjamin R.
简介：腹腔镜部分肾切除术（LPN）期间的止血是一个挑战。通常，将肾脏夹具夹住以最大程度地减少失血。但是，长时间的缺血会导致不可逆转的损害。因此，需要新的技术来最大程度地减少失血而无需骗夹。 HABIB 4 X腹腔镜装置（Angio Dynamics，纽约昆斯伯里）是一种四支沟通的双极辐射探针，被证明可以减少腹腔镜肝切除术的失血而无需造鼠钳。这项试验研究的目的是在LPN中评估这项新技术。方法：三名患者，具有外源性肾脏病变（1.1-4 cm），使用Hilar夹紧的LPN，使用HABIB腹腔镜装置来创建腹腔切除率。 ：平均手术时间为150.3分钟，平均估计失血为100 cc，没有患者需要输血。平均术前和术后血清肌酐水平之间没有显着差异（p> 0.05）。所有3个切除的肿块均为肾细胞癌。术中冷冻切片在所有情况下均显示出负缘。然而，在第二种情况下，肾脏病变为4 cm，关于边缘的永久性部分分析被理解为局部阳性。没有并发症。结论：HABIB 4 X腹腔镜装置允许切除外源性肾脏病变，而无需造嘴夹具，因此无需肝脏切除术。然而，驱动伪影可能会导致解释切除缘的冷冻截面分析。因此，其使用应仅限于小于2 cm的病变。
Introduction: Hemostasis during the laparoscopic partial nephrectomy (LPN) is a challenge. Usually, the renal hilum is clamped to minimize blood loss. However, prolonged ischemia leads to irreversible damage. Therefore, new technology is needed to minimize blood loss while performing LPN without hilar clamping. The Habib 4 x Laparoscopic device (Angio Dynamics, Queensbury, NY) is a four-pronged bipolar radiofrequency probe that is proven to reduce blood loss in laparoscopic liver resections without hilar clamping. The aim of this pilot study was to evaluate this new technology in LPN.Methods: Three patients, with exophytic renal lesions (1.1-4 cm), underwent LPN without hilar clamping, using the Habib Laparoscopic device to create an avascular resection margin.Results: Mean operative time was 150.3 minutes, mean estimated blood loss was 100 cc, and none of the patients required transfusions. There was no significant difference between the mean pre- and postoperative serum creatinine levels (P > 0.05). All 3 resected masses were renal-cell carcinomas. Intraoperative frozen sections demonstrated negative margins in all cases. However, in the second case, with a renal lesion of 4 cm, the permanent section analysis on margins was read as focally positive. There were no complications. On follow-up imaging of up to 12 months, there were no recurrences.Conclusions: The Habib 4 x Laparoscopic device permits the resection of exophytic renal lesions without the need for hilar clamping. However, a cautery artifact can cause difficulty in interpreting the frozen-section analysis of resection margins. Therefore, its use should be restricted to lesions of less than 2 cm.