Laparoscopic Partial Nephrectomy Using a Flexible CO2 Laser Fiber
Identifieur interne : 000662 ( Ncbi/Merge ); précédent : 000661; suivant : 000663Laparoscopic Partial Nephrectomy Using a Flexible CO2 Laser Fiber
Auteurs : Ofer N. Gofrit ; Abed Khalaileh ; Oleg Ponomarenko ; Mahmoud Abu-Gazala ; Reuven M. Lewinsky ; Ram Elazary ; Noam Shussman ; Arieh Shalhav ; Yoav MintzSource :
- JSLS : Journal of the Society of Laparoendoscopic Surgeons [ 1086-8089 ] ; 2012.
Abstract
The application of a CO2 laser through a flexible fiber for partial nephrectomy produced good parenchymal incision and hemostasis in an animal model.
Url:
DOI: 10.4293/108680812X13462882737258
PubMed: 23484569
PubMed Central: 3558897
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Gofrit</name></author><author><name sortKey="Khalaileh, Abed" sort="Khalaileh, Abed" uniqKey="Khalaileh A" first="Abed" last="Khalaileh">Abed Khalaileh</name></author><author><name sortKey="Ponomarenko, Oleg" sort="Ponomarenko, Oleg" uniqKey="Ponomarenko O" first="Oleg" last="Ponomarenko">Oleg Ponomarenko</name></author><author><name sortKey="Abu Gazala, Mahmoud" sort="Abu Gazala, Mahmoud" uniqKey="Abu Gazala M" first="Mahmoud" last="Abu-Gazala">Mahmoud Abu-Gazala</name></author><author><name sortKey="Lewinsky, Reuven M" sort="Lewinsky, Reuven M" uniqKey="Lewinsky R" first="Reuven M." last="Lewinsky">Reuven M. Lewinsky</name></author><author><name sortKey="Elazary, Ram" sort="Elazary, Ram" uniqKey="Elazary R" first="Ram" last="Elazary">Ram Elazary</name></author><author><name sortKey="Shussman, Noam" sort="Shussman, Noam" uniqKey="Shussman N" first="Noam" last="Shussman">Noam Shussman</name></author><author><name sortKey="Shalhav, Arieh" sort="Shalhav, Arieh" uniqKey="Shalhav A" first="Arieh" last="Shalhav">Arieh Shalhav</name></author><author><name sortKey="Mintz, Yoav" sort="Mintz, Yoav" uniqKey="Mintz Y" first="Yoav" last="Mintz">Yoav Mintz</name></author></analytic><series><title level="j">JSLS : Journal of the Society of Laparoendoscopic Surgeons</title><idno type="ISSN">1086-8089</idno><idno type="eISSN">1938-3797</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>The application of a CO<sub>2</sub> laser through a flexible fiber 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Yamamoto</name></author><author><name sortKey="Kamihira, O" uniqKey="Kamihira O">O Kamihira</name></author><author><name sortKey="Kato, K" uniqKey="Kato K">K Kato</name></author><author><name sortKey="Gotoh, M" uniqKey="Gotoh M">M Gotoh</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nguyen, Mm" uniqKey="Nguyen M">MM Nguyen</name></author><author><name sortKey="Gill, Is" uniqKey="Gill I">IS Gill</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Thompson, Rh" uniqKey="Thompson R">RH Thompson</name></author><author><name sortKey="Lane, Br" uniqKey="Lane B">BR Lane</name></author><author><name sortKey="Lohse, Cm" uniqKey="Lohse C">CM Lohse</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Remacle, M" uniqKey="Remacle M">M Remacle</name></author><author><name sortKey="Matar, N" uniqKey="Matar N">N Matar</name></author><author><name sortKey="Delos, M" uniqKey="Delos M">M 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Hora</name></author><author><name sortKey="Sykora, R" uniqKey="Sykora R">R Sykora</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Meiraz, D" uniqKey="Meiraz D">D Meiraz</name></author><author><name sortKey="Peled, I" uniqKey="Peled I">I Peled</name></author><author><name sortKey="Gassner, S" uniqKey="Gassner S">S Gassner</name></author><author><name sortKey="Ben Bassat, M" uniqKey="Ben Bassat M">M Ben-Bassat</name></author><author><name sortKey="Kaplan, I" uniqKey="Kaplan I">I Kaplan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Barzilay, B" uniqKey="Barzilay B">B Barzilay</name></author><author><name sortKey="Lijovetzky, G" uniqKey="Lijovetzky G">G Lijovetzky</name></author><author><name sortKey="Shapiro, A" uniqKey="Shapiro A">A Shapiro</name></author><author><name sortKey="Caine, M" uniqKey="Caine M">M Caine</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Taari, K" 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<front><journal-meta><journal-id journal-id-type="nlm-ta">JSLS</journal-id><journal-id journal-id-type="iso-abbrev">JSLS</journal-id><journal-id journal-id-type="hwp">jsls</journal-id><journal-id journal-id-type="pmc">jsls</journal-id><journal-id journal-id-type="publisher-id">JSLS</journal-id><journal-title-group><journal-title>JSLS : Journal of the Society of Laparoendoscopic Surgeons</journal-title></journal-title-group><issn pub-type="ppub">1086-8089</issn><issn pub-type="epub">1938-3797</issn><publisher><publisher-name>Society of Laparoendoscopic Surgeons</publisher-name><publisher-loc>Miami, FL</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23484569</article-id><article-id pub-id-type="pmc">3558897</article-id><article-id pub-id-type="publisher-id">12-04-074</article-id><article-id pub-id-type="doi">10.4293/108680812X13462882737258</article-id><article-categories><subj-group subj-group-type="heading"><subject>Scientific Papers</subject></subj-group></article-categories><title-group><article-title>Laparoscopic Partial Nephrectomy Using a Flexible CO<sub>2</sub> Laser Fiber</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Gofrit</surname><given-names>Ofer N.</given-names></name><degrees>MD, PhD</degrees><aff>Department of Urology, Hadassah Hebrew University Hospital, Jerusalem, Israel</aff></contrib><contrib contrib-type="author"><name><surname>Khalaileh</surname><given-names>Abed</given-names></name><degrees>MD</degrees><aff>Department of General Surgery, Hadassah Hebrew University Hospital, Jerusalem, Israel</aff></contrib><contrib contrib-type="author"><name><surname>Ponomarenko</surname><given-names>Oleg</given-names></name><degrees>MD</degrees><aff>Department of General Surgery, Hadassah Hebrew University Hospital, Jerusalem, Israel</aff></contrib><contrib contrib-type="author"><name><surname>Abu-Gazala</surname><given-names>Mahmoud</given-names></name><degrees>MD</degrees><aff>Department of General Surgery, Hadassah Hebrew University Hospital, Jerusalem, Israel</aff></contrib><contrib contrib-type="author"><name><surname>Lewinsky</surname><given-names>Reuven M.</given-names></name><degrees>MD</degrees><aff>Lumenis Ltd, Yokneam, Israel</aff></contrib><contrib contrib-type="author"><name><surname>Elazary</surname><given-names>Ram</given-names></name><degrees>MD</degrees><aff>Department of General Surgery, Hadassah Hebrew University Hospital, Jerusalem, Israel</aff></contrib><contrib contrib-type="author"><name><surname>Shussman</surname><given-names>Noam</given-names></name><degrees>MD</degrees><aff>Department of General Surgery, Hadassah Hebrew University Hospital, Jerusalem, Israel</aff></contrib><contrib contrib-type="author"><name><surname>Shalhav</surname><given-names>Arieh</given-names></name><degrees>MD</degrees><aff>Department of Urology, University of Illinois, Chicago, IL USA</aff></contrib><contrib contrib-type="author"><name><surname>Mintz</surname><given-names>Yoav</given-names></name><degrees>MD</degrees><aff>Department of General Surgery, Hadassah Hebrew University Hospital, Jerusalem, Israel</aff></contrib></contrib-group><author-notes><fn fn-type="supported-by"><p><funding-source>Lumenis, Inc.</funding-source>, Yokneam, Israel provided the waveguide fibers and supported the purchase and maintenance of the animals.</p></fn><corresp>Address correspondence to: Ofer N. Gofrit, MD, PhD, <addr-line>Urology Department, Hadassah University Medical Center, PO Box 12000, Jerusalem 91120, Israel</addr-line>. Telephone: <phone>972-2-6776874</phone>, Fax: <fax>972-2-26430929</fax>, E-mail: <email>ogofrit@gmail.com</email></corresp></author-notes><pub-date pub-type="ppub"><season>Oct-Dec</season><year>2012</year></pub-date><volume>16</volume><issue>4</issue><fpage>588</fpage><lpage>591</lpage><permissions><copyright-statement>© 2012 by JSLS, Journal of the Society of Laparoendoscopic Surgeons.</copyright-statement><copyright-year>2012</copyright-year><copyright-holder>Society of Laparoendoscopic Surgeons, Inc.</copyright-holder><license license-type="open-access"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc-nd/3.0/us/">http://creativecommons.org/licenses/by-nc-nd/3.0/us/</ext-link>), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way.</license-p></license></permissions><self-uri xlink:title="pdf" xlink:type="simple" xlink:href="jls00412000588.pdf"></self-uri><abstract abstract-type="precis"><p>The application of a CO<sub>2</sub> laser through a flexible fiber for partial nephrectomy produced good parenchymal incision and hemostasis in an animal model.</p></abstract><abstract><sec><title>Background and Objectives:</title><p>Laparoscopic partial nephrectomy (LPN) is a challenging surgery that requires precise tissue cutting and meticulous hemostasis under warm ischemia conditions. In this study, we tested the feasibility of performing LPN using CO<sub>2</sub> laser energy transmitted through a specialized flexible mirror optical fiber.</p></sec><sec><title>Methods:</title><p>General anesthesia and pneumoperitoneum were induced in 7 farm pigs. Various portions of a kidney, either a pole or a midportion of the kidney, were removed using a novel flexible fiber to transmit CO<sub>2</sub> laser energy set at a power of 45W and energy per pulse of 100mJ. The collecting system was approximated with a suture or 2, but no hemostatic measures were taken besides applying a few pulses of the laser to bleeding points. The pigs were sacrificed 3 wk later.</p></sec><sec><title>Results:</title><p>Average renal mass removed was 18% of the total kidney weight. All pigs tolerated surgery well. Sharp renal cutting was accomplished in a single continuous incision, with minimal tissue charring and minimal blood loss (<10cc) in all animals. Necropsy revealed no peritoneal or retroperitoneal abnormalities. Histologic examination of the cut surface showed a thin sector of up to 100 μm of coagulation necrosis.</p></sec><sec><title>Conclusions:</title><p>We report on the first LPN done using a CO<sub>2</sub> laser transmitted through a flexible fiber in an animal model. This novel application of the CO<sub>2</sub> laser produced excellent parenchymal incision and hemostasis along with minimal damage to adjacent renal tissue, thus, potentially shortening ischemia time and kidney function loss. Further studies comparing this laser to standard technique are necessary to verify its usefulness for partial nephrectomy.</p></sec></abstract><kwd-group><kwd>Partial nephrectomy</kwd><kwd>CO<sub>2</sub> laser</kwd><kwd>Flexible fiber</kwd><kwd>Laparoscopy</kwd></kwd-group></article-meta></front></pmc><affiliations><list></list><tree><noCountry><name sortKey="Abu Gazala, Mahmoud" sort="Abu Gazala, Mahmoud" uniqKey="Abu Gazala M" first="Mahmoud" last="Abu-Gazala">Mahmoud Abu-Gazala</name><name sortKey="Elazary, Ram" sort="Elazary, Ram" uniqKey="Elazary R" first="Ram" last="Elazary">Ram Elazary</name><name sortKey="Gofrit, Ofer N" sort="Gofrit, Ofer N" uniqKey="Gofrit O" first="Ofer N." last="Gofrit">Ofer N. Gofrit</name><name sortKey="Khalaileh, Abed" sort="Khalaileh, Abed" uniqKey="Khalaileh A" first="Abed" last="Khalaileh">Abed Khalaileh</name><name sortKey="Lewinsky, Reuven M" sort="Lewinsky, Reuven M" uniqKey="Lewinsky R" first="Reuven M." last="Lewinsky">Reuven M. Lewinsky</name><name sortKey="Mintz, Yoav" sort="Mintz, Yoav" uniqKey="Mintz Y" first="Yoav" last="Mintz">Yoav Mintz</name><name sortKey="Ponomarenko, Oleg" sort="Ponomarenko, Oleg" uniqKey="Ponomarenko O" first="Oleg" last="Ponomarenko">Oleg Ponomarenko</name><name sortKey="Shalhav, Arieh" sort="Shalhav, Arieh" uniqKey="Shalhav A" first="Arieh" last="Shalhav">Arieh Shalhav</name><name sortKey="Shussman, Noam" sort="Shussman, Noam" uniqKey="Shussman N" first="Noam" last="Shussman">Noam Shussman</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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