WATER-JET DISSECTION IN RENAL SURGERY - EXPERIMENTAL-STUDY OF A NEW DEVICE IN THE PIG

The pig model was used for experiments with a new type of water-jet di ssector, which produces high-pressure water by application of a gas an d maintains the water fully sterile in a single-use delivery apparatus . The experiment was conducted ex vivo (14 kidneys) and in vivo to com pare electric cautery section with water-jet dissection (5 vs 11 parti al nephrectomies). Ex vivo study confirmed sparing of blood vessels an d pelvicaliceal system. In vivo study did not show significant differe nces in blood loss but, the water-jet allowed precise dissection and t ight closure of the excretory system. More frequent haemorrages were n oted on histological examination of the WJ group, but no coagulation n ecrosis. These are preliminary findings and further studies of long-te rm results may confirm the benefits of the absence of parenchymal necr osis and the definite advantage of precise closure of the pelvicalicea l system, as morbidity of partial nephrectomy is often related to seco ndary haemorrages and urinary fistulae.