Thirty-two partial nephrectomies were performed without renal cooling
on 13 pigs with a contact fibre Nd:YAG laser (10 W) or a steel scalpel
with or without a vascular pedicle clamp. Nine pigs had a 2-week foll
ow-up with an abdominal ultrasound 1 week postoperatively. The time fo
r haemostasis was 6.9 +/- 5.2 min (mean +/- SD) with the laser and 9.1
+/- 5.8 min with the steel scalpel when the clamp was used (P = 0.028
). There was no significant difference in the total operating time (13
.2 +/- 4.5 min with the laser vs 12.6 +/- 4.6 min with the steel scalp
el, P = 0.203). Intraoperative blood loss was similar in the two group
s when the clamp was used. Clamping the renal pedicle decreased the bl
ood loss by 61 % in the laser group and 31 % in the steel scalpel grou
p. The number of ligatures used was significantly lower in the laser g
roup (3.7 +/- 2.6) compared with the steel scalpel group (6.6 +/- 3.4)
(P = 0.013). Five urinomas developed on the laser side and four on th
e steel scalpel side. These results indicate that the contact fibre Nd
:YAG laser method can be used in partial nephrectomy, but it offers no
definitive advantage over the conventional technique.