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Use of bipolar laparoscopic forceps to occlude and transect the retroperitoneal vasculature: a porcine model.

Publication ,  Journal Article
Santa-Cruz, RW; Auge, BK; Lallas, CD; Preminger, GM; Polascik, TJ
Published in: J Endourol
April 2003

BACKGROUND AND PURPOSE: Surgical clips are commonly employed during laparoscopic radical nephrectomy to ligate perihilar vessels reliably, yet these clips can interfere with the application of a vascular stapler to major vessels, potentially leading to catastrophic hemorrhage. We assessed the efficacy of the PlasmaKinetic trade mark (PK) bipolar cutting forceps (Gyrus Medical, Minneapolis, MN) as a single modality in coagulating and dividing the retroperitoneal vessels in a swine model. MATERIALS AND METHODS: Three 40- to 50-kg domestic swine (six renal units) underwent celiotomy and retroperitoneal exposure. The inferior vena cava (IVC) and the renal, gonadal, and iliac vessels were isolated, and, using 5- and 10-mm forceps, coagulated and divided. The mean diameter of the renal vein was 8.7 mm, the renal artery 6.5 mm, and the IVC 14 mm. RESULTS: Hemostasis was achieved consistently using the 5-mm and 10-mm PK Cutting Forceps on the renal artery, renal vein, and gonadal vein. The 10-mm forceps coagulated the iliac veins and IVC 83% of the time with only a single application. Larger vessels or vessels with higher inherent vascular pressure required additional applications of the device to achieve hemostasis. All animals were hemodynamically stable through division of the IVC, as measured by heart rate and pulse oximetry. No complications were noted with the device or using the cutting element. CONCLUSIONS: The PK bipolar cutting forceps appear to be effective in controlling and dividing the renal hilar vessels and larger low-pressure vessels of the porcine retroperitoneum, with no gross damage to adjacent structures. Although further studies are necessary before use during laparoscopic nephrectomy in humans, these results are promising. Bipolar cutting forceps may prove to be a safe, cost-effective, and time-saving device with numerous applications during urologic laparoscopy.

Duke Scholars

Published In

J Endourol

DOI

ISSN

0892-7790

Publication Date

April 2003

Volume

17

Issue

3

Start / End Page

181 / 185

Location

United States

Related Subject Headings

  • Vena Cava, Inferior
  • Urology & Nephrology
  • Urologic Surgical Procedures
  • Swine
  • Surgical Instruments
  • Retroperitoneal Space
  • Renal Veins
  • Renal Artery
  • Laparoscopy
  • Iliac Vein
 

Citation

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Santa-Cruz, R. W., Auge, B. K., Lallas, C. D., Preminger, G. M., & Polascik, T. J. (2003). Use of bipolar laparoscopic forceps to occlude and transect the retroperitoneal vasculature: a porcine model. J Endourol, 17(3), 181–185. https://doi.org/10.1089/089277903321618761
Santa-Cruz, Robert W., Brian K. Auge, Costas D. Lallas, Glenn M. Preminger, and Thomas J. Polascik. “Use of bipolar laparoscopic forceps to occlude and transect the retroperitoneal vasculature: a porcine model.J Endourol 17, no. 3 (April 2003): 181–85. https://doi.org/10.1089/089277903321618761.
Santa-Cruz RW, Auge BK, Lallas CD, Preminger GM, Polascik TJ. Use of bipolar laparoscopic forceps to occlude and transect the retroperitoneal vasculature: a porcine model. J Endourol. 2003 Apr;17(3):181–5.
Santa-Cruz, Robert W., et al. “Use of bipolar laparoscopic forceps to occlude and transect the retroperitoneal vasculature: a porcine model.J Endourol, vol. 17, no. 3, Apr. 2003, pp. 181–85. Pubmed, doi:10.1089/089277903321618761.
Santa-Cruz RW, Auge BK, Lallas CD, Preminger GM, Polascik TJ. Use of bipolar laparoscopic forceps to occlude and transect the retroperitoneal vasculature: a porcine model. J Endourol. 2003 Apr;17(3):181–185.
Journal cover image

Published In

J Endourol

DOI

ISSN

0892-7790

Publication Date

April 2003

Volume

17

Issue

3

Start / End Page

181 / 185

Location

United States

Related Subject Headings

  • Vena Cava, Inferior
  • Urology & Nephrology
  • Urologic Surgical Procedures
  • Swine
  • Surgical Instruments
  • Retroperitoneal Space
  • Renal Veins
  • Renal Artery
  • Laparoscopy
  • Iliac Vein