An Evaluation of Techniques Used for the Production of Temporary Renal Ischaemia*

McLoughlin, Gráinne; Heal, M. R.; Tyrell, I. M.

doi:10.1111/j.1464-410x.1978.tb04212.x

Cited by 25 publications

(11 citation statements)

References 6 publications

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“…Also of concern is evidence that manual compression to control bleeding from the kidney is more deleterious to renal function than is simple arterial occlusion. 33 Recently, the use of coagulative incisional devices (Harmonic Scalpel, Cavitron Ultrasonic Surgical Aspirator, and the Electrosurgical Snare Electrode [ESE]) were studied by Elashry et al in a swine model.34 The ESE proved to be the most rapid and effective in polar guillotine excisions. Sutured closures of the collecting system were performed in some animals.…”

Section: Discussionmentioning

confidence: 99%

The Laparoscopic Cooling Sheath: Novel Device for Hypothermic Preservation of Kidney during Temporary Renal Artery Occlusion

Herrell¹,

Jahoda²,

Husain³

et al. 1998

Journal of Endourology

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Hypothermia is commonly used to prevent ischemic renal damage during complex nephron-sparing surgical procedures requiring temporary renal artery occlusion. We developed a novel Cooling Sheath device, which is compatible with laparoscopy, to protect the kidney hypothermically during 60 minutes of temporary arterial occlusion in a laparoscopic swine model. Comparison of temperature curves and histology to control groups undergoing open slush surface cooling and laparoscopic warm ischemia for similar time periods was performed. Optimal hypothermic temperatures were reached rapidly and maintained with the use of the Cooling Sheath. Ischemic damage, present in all kidneys subjected to warm ischemia, was not found on histopathologic examination of the cooled kidneys. This new device provides hypothermic protection of the kidney during ischemia. The use of the Cooling Sheath combined with temporary arterial occlusion will allow more complex nephron-sparing renal surgery to be performed using laparoscopy.

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Section: Discussionmentioning

confidence: 99%

The Laparoscopic Cooling Sheath: Novel Device for Hypothermic Preservation of Kidney during Temporary Renal Artery Occlusion

Herrell¹,

Jahoda²,

Husain³

et al. 1998

Journal of Endourology

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“…[11] However, in contrast to this, there is evidence in the literature that intermittent clamping of the renal artery with short periods of recirculation may also be more damaging than continuous arterial occlusion. [14] In the surface hypothermia obtained with ice-slush, a volume of about 300-750 mL is required and 15 min should be ensured in order to cool the cortex. This leaves 5-20 min time for manipulation.…”

Section: Discussionmentioning

confidence: 99%

Preliminary feasibility study of a new method of hypothermia in an experimental canine model

Sert

Akand

Kılıç

et al. 2017

Turkish Journal of Urology

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Objective: To build up a new microcontroller thermoelectric system to achieve renal hypothermia. Material and methods:Renal hypothermia system was tested under in vivo conditions in the kidneys of ten Mongrel dogs. Ambient temperature was evaluated using two different microcontrollers. In order to ensure hypothermia in the renal parenchyma, selection can be made among 4 modules and sensors which detect the temperature of the area. The temperature range of the system was adjusted between -50°C and +50°C.Results: When single and double poles of the kidney were cooled, initial mean intraperitoneal temperature values were found 37.7°C for rectum and 36.5°C for renal cortex and medulla. After the temperature of the cooling module was set to 12°C, the module was placed on the poles of the kidney. After fifteen minutes, temperature was 15.4°C in the lower pole of the kidney, 28.1°C in the cortex of the other side and 29.2°C in the intramedullary region. The temperature was found to be 15°C in the vicinity and 26.1°C in the cortex across the module. After the system was stabilized, a very slight change was observed in the temperature. Conclusion:Hypothermia system developed ensured desired cooling of the targeted part of the kidney; however, it did not cause a change in the temperature of other parts of the kidney or general body temperature. Thus, it was possible to create a long-term study area for renal parenchymal surgery.Keywords: Hypothermia; partial nephrectomy; renal surgery; thermo-electric system. Cite this article as: Sert İÜ, Akand M, Kılıç Ö, Yavru N, Bulut E. Preliminary feasibility study of a new method of hypothermia in an experimental canine model. Turk J Urol 2017; 43: 330-6

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“…Another explanation of this difference may be clamping of both the artery and the vein in the study by Groshar et al [24] versus only arterial clamping in our study. Because, it is well known that only renal arterial clamping is less harmful to renal parenchyma than total renal vascular pedicle clamping [22,27] . Many confounding factors may affect renal function during this complex procedure such as different hilar clamping techniques, the amount of excised normal renal tissue surrounding the tumor, application of different suturing techniques or tissue adhesive substance.…”

Section: Discussionmentioning

confidence: 99%

Nephron-Sparing Surgery: The Effect of Surface Cooling and Temporary Renal Artery Occlusion on Renal Function

et al. 2009

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Aims: To evaluate whether transient renal artery clamping and external renal hypothermia cause any detrimental effect on the remaining renal parenchyma after nephron-sparing surgery with the use of ^99mTc-DMSA-SPECT. Methods: Twenty-eight patients with a unilateral renal mass but a normal contralateral kidney underwent nephron-sparing surgery. Serum biochemistry, 24-hour urinary creatinine clearance and absolute uptakes of the injected dose (%ID) of both kidneys as measured by renal ^99mTc-DMSA-SPECT were compared preoperatively and in the 3rd postoperative month. ^99mTc-DMSA uptakes in the contralateral kidney were used as controls. Results: The average tumor size and mean renal artery clamping time were 37.4 ± 11.3 (range 25–68) mm and 53.7 ± 13 (range 38–90) min, respectively. Pre- and postoperative mean absolute uptakes of %ID in the remaining parenchyma of the operated kidneys were 15.13 ± 3.30 and 14.74 ± 3.38%, respectively (p = 0.052). In the contralateral kidneys, there was also no significant difference between the two studies (18.82 ± 6.26 vs. 19.14 ± 7.19%, respectively; p = 0.546). Likewise, there was no statistically significant difference between pre- and postoperative serum creatinine (p = 0.179) and creatinine clearance values (p = 0.108). Conclusion: Renal artery clamping and external cooling during nephron-sparing surgery have no demonstrable harmful effects on the renal parenchyma as measured by ^99mTc-DMSA-SPECT analysis.

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An Evaluation of Techniques Used for the Production of Temporary Renal Ischaemia*

Cited by 25 publications

References 6 publications

The Laparoscopic Cooling Sheath: Novel Device for Hypothermic Preservation of Kidney during Temporary Renal Artery Occlusion

The Laparoscopic Cooling Sheath: Novel Device for Hypothermic Preservation of Kidney during Temporary Renal Artery Occlusion

Preliminary feasibility study of a new method of hypothermia in an experimental canine model

Nephron-Sparing Surgery: The Effect of Surface Cooling and Temporary Renal Artery Occlusion on Renal Function

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