InLine bipolar radiofrequency ablation device-assisted partial nephrectomy in a porcine model.

Background:  Nephron-sparing surgery has become an acceptable alternative to radical nephrectomy in the treatment of renal tumours. Control of intraoperative blood loss can be an important challenge during partial nephrectomy. InLine radiofrequency ablation (ILRFA) device has shown promising results of significant reduction of intraoperative blood loss in liver resection. In this study, we tested ILRFA-assisted partial nephrectomy in a porcine model. Methods:  Eight landrace pigs were used in this study. Every pig underwent 2–3 partial nephrectomies. The proposed line of parenchymal incision was circumferentially scored with a diathermy. Then, ILRFA was deployed into this resection plane. After complete coagulation, the resection was then simply carried out using the scalpel. For the control resection, we used diathermy to transect the other pole, further sutures were then used to secure the residual bleeding. Results:  The ILRFA deployments were set to 3 cm power algorithm. The average radiofrequency ablation coagulation time was 5 min. The mean intraoperative blood loss 35 ± 7 mL in the ILRFA and 152 ± 94 mL in the control, a 77.0% reduction (P = 0.024). The mean blood loss per centimetre of resection area was 2.09 ± 1.41 mL/cm2 in the ILRFA compared with 12.79 ± 1.68 mL/cm2 in controls; the reduction was 79.0% (P = 0.019). Conclusion:  Our study indicates that ILRFA for partial nephrectomy in a porcine model is effective in reducing blood loss. Precoagulation before parenchymal transection appears to be a valid concept in nephron-sparing surgery.