Korean J Urol Oncol.  2020 Aug;18(2):155-160. 10.22465/kjuo.2020.18.2.155.

Open Partial Nephrectomy With Zero IschemiaTechnique Using Thulium Laser: Our Experience of4 Cases

• Prem K
• Kumar P
• Rehman ZU
• Janoria S

• KMID: 2505945
• DOI: http://doi.org/10.22465/kjuo.2020.18.2.155

Abstract

With the advent of newer technologies, the management of small renal masses has shown a paradigm shift.This has resulted in preferring partial nephrectomy over radical nephrectomy, emphasizing the concept of nephronsparing surgery. Various lasers have been used in few cases. We prospectively evaluated the use of thuliumlaser in open partial nephrectomy over last 1 year. The aim is to study thulium laser as an energy source forpartial nephrectomy for peripheral tumor. The role of partial nephrectomy and zero ischemia time in renalpreservation is already proven. Outcomes of total of 4 patients who underwent open partial nephrectomy wereanalyzed prospectively. We used Quanta Cyber TM laser at setting of 30 W both for cutting and coagulation.Preoperative characteristics and outcomes were analyzed. Four patients underwent open partial nephrectomy withzero ischemia. The mean tumor size was 5.26 cm, mean RENAL nephrometry score was 4.5, mean operativetime was 67.5 minutes, active laser time was 2 minutes, mean blood loss related to partial nephrectomy perse was 65 mL. Mean preoperative hemoglobin was 11.12 g% and mean postoperative hemoglobin was 10.05g%. Mean duration of stay was 6 days. Histologically all lesions were renal cell carcinoma pT1/T2, with marginsnegative for tumor and no deterioration in renal function during follow-up. The thulium laser at 2013 nm wavelengthdemonstrates excellent hemostasis and precise cutting capabilities of the renal cortex during open partialnephrectomy for peripheral tumors without requiring renal artery clamping.

Keyword

Open partial nephrectomy; Zero ischemia; Nephron sparing surgery; Thulium laser