Open Access Research article

Partial nephrectomy using radiofrequency incremental bipolar generator with multi electrode probe: experimental study in bench pig kidneys

Piero Rossi1*, Pierluigi Bove2, Mauro Montuori1, Adriano De Majo1, Edoardo Ricciardi1, Maurizio Mattei3, Roberta Bernardini3, Luigino Calzetta4, Paolo Mauti5, Lorenzo Intini5, Valentino Quattrini5, Carlo Chiaramonte6 and Giuseppe Vespasiani2

Author Affiliations

1 Department of General Surgery, University Hospital of Tor Vergata, Rome, Italy

2 Department of Urology, University Hospital of Tor Vergata, Rome, Italy

3 Department of Biology STA, University Hospital of Tor Vergata, Rome, Italy

4 Laboratory of Systems Approaches and Non-Communicable Diseases, San Raffaele Pisana Hospital, IRCCS, Rome, Italy

5 L.E.D. S.p.a., Aprilia, Latina, Italy

6 Department of Statistics, University Hospital of Tor Vergata, Rome, Italy

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BMC Urology 2014, 14:7  doi:10.1186/1471-2490-14-7

Published: 10 January 2014

Abstract

Background

The aim of this research project was the realization of an incremental bipolar radiofrequency generator with inline 4-electrode probe for partial renal resection without clamping of the vessels.

Methods

The experimentation was carried out across two phases: the preliminary realization of a specific generator and an inline multielectrode probe for open surgery (Phase 1); system testing on 27 bench kidneys for a total of 47 partial resection (Phase 2).

The parameters evaluated were: power level, generator automatisms, parenchymal coagulation times, needle caliber, thickness of the coagulated tissue “slice”, charring, ergonomy, feasibility of the application of “bolster” stitches.

Results

The analysis of the results referred to the homogeneity and thickness of coagulation, energy supply times with reference to the power level and caliber of the needles. The optimal results were obtained by using needles of 1.5 mm caliber at power level 5, and with coagulation times of 54 seconds for the first insertion and 30 seconds for the second.

Conclusions

The experimentation demonstrated that the apparatus, consisting of a generator named “LaparoNewPro” and fitted with a dedicated probe for open surgery, is able to carry out a coagulation of the line of resection of the renal parenchyma in a homogeneous manner, in short times, without tissue charring, and with the possibility of stitching both on coagulated tissue and the caliceal system.

The generator automatism based on the flow of the current supplied by each electrode is reliable, and the cessation of energy supply coincides with optimal coagulation.

Keywords:
Nephron sparing surgery; Partial nephrectomy; Bipolar radiofrequency; Multi-electrode probe; LaparoNewPro