Laparoscopic Partial Nephrectomy: Use of the TissueLink TM Hemostatic Dissection Device

Abstract

Hemostasis remains the major challenge in laparoscopic partial nephrectomy (LPN). The TissueLink^TM Floating Ball (TissueLink Medical, Inc., Dover, NH), a high-density monopolar saline-cooled radiofrequency device, is an effective coagulation and dissection device to aid in LPN. Our porcine laboratory model and human clinical experience have shown the device capable of deep renal parenchymal hemostasis without the need for hilar vascular occlusion. We review the excisional technique and initial clinical results, as well as device function, setup, and clinical literature. We find the TissueLink capable of avoiding warm ischemia for excision of selected endophytic masses and, in combination with other techniques, a valuable adjunct for even deeper lesions.