OBJECTIVE: To evaluate the effectiveness of the PlasmaKinetic Cutting Forceps® in coagulating and dividing the renal artery in a porcine model.
MATERIALS AND METHODS: Eight domestic pigs underwent a transperitoneal laparoscopic nephrectomy with 3 trocars. The renal artery was laparoscopically sealed and severed without clipping or stapling using a novel bipolar cauterization device, which has an incorporated cutting
function (Cutting Forceps, PlasmaKineticTM, Berkshire, UK). A segment of the aorta, with an average length of 10 cm including the renal artery stump, was harvested by open laparotomy. Both ends of the aorta and its small branches were ligated with 3-0 silk sutures. Two polyethylene tubes
were placed into the aorta lumen: 1 tube was connected to an infusion pump, and the other to a pressure monitor. Water was used to fill the aorta, and the pumping speed was promptly adjusted,so that the bursting pressure of the renal artery stump could be measured.RESULTS: The experiment was completed in 5 subjects. The average diameter of the renal
artery stump was 4.8±0.2 mm. Two failures occurred due to stump bleeding immediately after the renal artery was cut with the Cutting Forceps. When the surface of the blade was detached from the renal artery stump, adhesion between the tissue and the instrument occurred in 1 case. It tore
the sealed stump, and led to massive bleeding. In the other case, the arterial stump did not seal.The renal artery was successfully controlled in 6 of 8 (75%) animals. The maximal intraluminal pressure at bursting was 215.8±17.5 mmHg.CONCLUSIONS: The renal arterial stump was successfully sealed using only the PlasmaKinetic Cutting Forceps® in 6 of 8 animals. However, further refinement of the instrument to prevent
tissue adhesion by the blade is required before the PlasmaKinetic Cutting Forceps® can safely be used clinically for control of the renal artery without clipping.