PARTIAL NEPHRECTOMY WITH A COMBINED CO2 AND ND-YAG LASER - EXPERIMENTAL-STUDY IN PIGS

Twenty-eight partial nephrectomies were performed on nine pigs with a simultaneous, coaxial CO2-Nd:YAG laser at power settings of 20 W and 4 0 W, or with a steel scalpel. A vascular pedicle clamp was used withou t renal cooling. The time for hemostasis was 4.5 +/- 3.2 min (mean +/- SD) with the laser and 6.4 +/- 2.5 min with the steel scalpel (P = 0. 064). There was no difference in the total operation time (10.4 +/- 3. 5 min with the laser vs. 11.0 +/- 3.2 min with the steel scalpel, P = 0.470). The mean blood loss with the laser was 17.5 +/- 6.7 g and 22.1 +/- 15.2 g with the steel scalpel (P = 0.299). The number of ligature s needed for complete hemostasis was 2.9 +/- 2.1 with the laser and 5. 0 +/- 2.3 with the steel scalpel (P 0.011). The average thermal damage was 0.23 +/- 0.10 mm. It is concluded that the simultaneous CO2-Nd:YA C; laser method can be used in partial nephrectomy and it offers bette r hemostasis than the conventional technique. Further studies with dif ferent power levels are needed. (C) 1994 Wiley-Liss, Inc.