Establishing a porcine model of suture-free nonischemic partial nephrectomy by monopolar electrocoagulation

Abstract

Objective To establish a porcine model of suture-free nonischemic partial nephrectomy by monopolar electrocoagulation technique, and observe the effect of this technique on postoperative residual kidney. Methods The study was conducted on six Guizhou local minipigs. The unilateral kidney was exposed with a surgical incision in parallel with the lumbosacral muscle. A partial nephrectomy (2 cm×2 cm×2 cm) was made in the middle pole without blocking the renal artery. The bleeding at the transaction surface was stopped not by traditional suturing but by electrocoagulation with a monopolar electric hook. The operation time and the renal bleeding volume were recorded. Three pigs were reared for 1 month after the surgery, and the urine color, coat color, and action responsiveness of the animals were monitored. Three pigs were sacrificed on day 7 after the surgery to observe thethe pathological changes at the surface of the partial nephrectomy. Results The operations of the 6 pigs were completed safely and successfully. The higher the power setting of monopolar electrocoagulation, the better the effect of the hemostasis. When the power reached 100 W, the electric hook was in the state of spray coagulation, and hemostasiswas completely achieved. The average operation time was 60 min (range, 30-90 min) and the average blood loss was about 42 ml (range, 30-60 ml). Three pigs were observed for 1 month after surgerywith no evidence of hematuria. They all hadshiny hair color and quick response with obvious sign of blood loss. On postoperative day 7, the kidneys were harvested from the other 3 pigs, and there was no perirenal hematoma or thrombosis in the kidney wound. HE staining identifiedcoagulation layer, necrotic layer and edema layer from the outer to inner of the wound. Conclusion Suture-free and nonischemic partial nephrectomy can be safely and reliablly established in minipigs using the monopolar electrocoagulation technique. Key words: Porcine; Partial nephrectomy; Nonischemia; Suturefree; Monopolar electrocoagulation