NOVEL SURGICAL MANAGEMENT OF RENAL TRAUMA: INLINE RADIOFREQUENCY ABLATION COAGULATION

Background:  Renal injury accounts for 10% of all abdominal trauma. Low-grade renal injuries can be managed without surgery. However, patients with grade IV or grade V injuries may require nephrectomy. In this study, InLine radiofrequency ablation device (ILRFA), which we developed for liver surgery was tested in the animal model of simulated renal injury. Methods:  A grade IV renal injury was induced in eight landrace pigs. Then treatment with ILRFA was compared to conventional diathermy and suture; totally 24 surgeries were carried out (12 ILRFA vs 12 control). Results:  No massive bleeding occurred and no animal died during the experiments. Immediately after surgery, the pigs were given euthanasia. The average of RFA coagulation time was 3.5 min. The mean intraoperative blood loss was 42 ± 16 mL in the ILRFA and 195 ± 58 mL in the control, a 78.5% reduction (P < 0.001). The mean blood loss per centimetre squared of resection area was 4.50 ± 2.84 mL/cm2 in the ILRFA compared with 18.73 ± 6.89 mL/cm2 in controls, the reduction was 76.0% (P = 0.001). Conclusion:  InLine RFA is efficient for the management of haemorrhage in renal trauma in an animal model and deserves clinical evaluation.