USE OF THE HARMONIC SCALPEL FOR NEPHRON SPARING SURGERY IN RENAL-CELLCARCINOMA

Purpose: The harmonic scalpel is a new tool for excising and coagulati ng tissue with ultrasound using higher frequencies than an ultrasonic aspirator. We evaluated the usefulness of the harmonic scalpel in neph ron sparing surgery. Materials and Methods: We used the harmonic scalp el to incise the renal parenchyma during nephron sparing surgery in 10 patients with renal cell carcinoma. Results: Bleeding from the renal parenchyma was minimal but hemostasis of the larger vessels was not ob tained even when the harmonic scalpel was used at maximal coagulation power. The cut surface of the kidneys, especially the vessels, were mo re clearly recognized than if an ultrasonic aspirator had been used, e nabling hemostasis by figure-of-8 suture. Conclusions: The harmonic sc alpel is useful for obtaining a clear parenchymal stump and hemostasis during nephron sparing surgery, although complete hemostasis of the a rcuate or larger vessels cannot be achieved.