Abstract
Objectives. The Hydro-Jet technique has been used to cut various industrial materials.
In the medical field, this technique has been successfully used for selective dissection
of the parenchyma of organs such as the liver. Recently, this technique was successfully
used for laparoscopic cholecystectomy in humans. We developed a new Hydro-Jet probe
and a technique of Hydro-Jet dissection during laparoscopic nephrectomy (LN) in a
porcine model and compared the results with those of conventional laparoscopy.
Methods. Fourteen pigs underwent unilateral LN using the Hydro-Jet and a conventional
LN on the contralateral side. A Muritz 1000 Hydro-Jet generator was used. An adjustable
water pressure gauge allowed manual control up to a maximum of 30 atm, and coagulation
was applied by way of a bipolar thermoapplicator. The bent end of the probe allowed
both blunt dissection and concomitant high-pressure water application. Results were
compared with regard to ease of anatomic dissection, complications, and operative
time between the two techniques.
Results. LN was successful in all animals with no conversion to open surgery. The
dissector allowed anatomic planes to be created in a relatively bloodless field, and
continuous water flow allowed a clear view for the operator. The high-pressure stream
resulted in excellent dissection of adventitial and soft tissue adjacent to vascular
structures, with complete preservation of vessels and ureter for selective ligation.
The dissection time was shortened (mean 27 minutes for the Hydro-Jet versus 40 minutes
for the conventional technique).
Conclusions. To our knowledge, we describe the first report of Hydro-Jet dissection
for LN as an alternative to the conventional technique. The improved anatomic dissection
may decrease complications. Moreover, shorter operating times were achieved, which
may result in cost savings. Further studies in humans are necessary to investigate
this technique.
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Article info
Publication history
Accepted:
July 30,
1999
Received in revised form:
July 30,
1999
Received:
June 18,
1999
Identification
Copyright
© 1999 Elsevier Science Inc. Published by Elsevier Inc. All rights reserved.
