Abstract
The Tissuelink floating ball, a new radiofrequency monopolar device, allows us to remove small renal parenchimal tumours during a laparoscopic procedure in a safe, simple way. It applies radiofrequency energy with low volume saline irrigation for simultaneous blunt dissection of the renal mass and haemostatic sealing and coagulation of the renal parenchyma without the need of a preventive occlusion of the major renal vessels.
Materials and Methods.
From November 2001 to November 2003, we performed 5 laparoscopic enucleoresections of renal parenchimal tumours using the Tissuelink technology. Four were in the right kidney, 1 was in the left kidney. The patients were male in 3 and female in 2 cases. Mean patient's age was 61.2 years (range 33–71). All the tumors were small in size (range 10–40 mm) and had a peripheral location. None of them was in close proximity to the collecting system. This was the reason why we never inserted a stent in the urinary tract before the laparoscopic procedure. No patients required blood transfusion. The histology revealed a renal clear cell carcinoma in 4 cases (grade 1 in two, grade 2 in two) while the remaining was an old haematoma.
Overall we had 2 complications.
The haematoma broke during the procedure, because of its softness. Another patient suffered of a burning of the skin, just on the place of an ECG electrode.
Conclusions.
The laparoscopic enucleoresection of small, peripheral renal tumours by mean of the Tissuelink floating ball devise seems to be, even in an initial experience, simple and effective, even without the need of the preventive occlusion of the renal artery and vein. No relapse occurred after 12 months follow-up.
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