Reconstructive renal surgery using a water jet

Purpose: We describe the successful application of a water jet to reconstru ctive renal surgery. Materials and Methods: Two consecutive patients underwent reconstructive re nal surgery using a waterjet apparatus for a 4.0 x 6.5 cm. well encapsulate d tumor of the lower pole of the left kidney and a 4.5 x 2.5 cm. staghorn c alculus of the left kidney, respectively. The water jet apparatus (Parenchi motom 01 dagger) consists of a pressure generating pump and a flexible hose connected to the hand piece, and a nozzle with a pinhole opening of 0.3 mm . Results: Both patients underwent surgery through a left lumbar incision, Pa rtial nephrectomy was performed in 1 patient and anatrophic nephrotomy for stone removal in the other. Dissection time was 25 and 12 minutes, with blo od loss of 150 and 100 mi., respectively. No temporary vascular clamping or local hypothermia was necessary. Both patients were discharged home 10 day s after surgery and at followup no negative sequelae were attributable to t he procedure. Conclusions: The operative procedures proved easy, fast and effective. No t emporary vessel clamping or hypothermia was required. Using a water jet is a novel approach that is helpful in renal surgery.