Experimental and Preliminary Clinical Experience with Thermography for Avascular Nephrotomy

Abstract

A simple method is presented for demarcation between different arterial areas, which allows the performance of nephrotomies with minimal bleeding and subsequent renal ischemia. The thermal gradient that exists between the segment with occluded blood supply and the adjacent ones retaining their blood supply is defined by a liquid cholesterol crystal sheet.

Avascular Nephrotomy by Means of Thermography

“…This complication is not specific for avascular nephrotomy by thermography alone but can occur with whatever method used. The comparison of the thermography method with the intraarterial injection of patent blue (Grégoir, 1975) in dogs 0Oosterlinck and De Sy, 1978) and in clinical prac tice clearly demonstrates the reliability of the method. Thermography, however, has some indis putable advantages as it avoids troublesome punc ture of the renal artery and the possible toxic effects of the injected dyes.…”

“…It is a safe and simple method which is preferred to the intraarterial injection of dyes which is done for the same purpose. In 1978 we presented the experimental and pre liminary clinical results of the use of thermography for demarcation of different arterial areas of the kidney (Oosterlinck and De Sy, 1978). With this technique the thermal gradient that exists between the segment with occluded blood supply and the adjacent parenchyma, retaining its blood supply, is defined by a liquid cholesterol crystal sheet.…”

Doppler and Real-Time Ultrasound in Renal Stone Surgery

“…This is especially true if a calyceal stone is relatively large in relation to the calyceal neck. These stones have to be removed via a transparenchymal ap proach, using either a longitudinal anatrophic incision [2,3] or radial incisions of the renal parenchyma [4], Boyce [5] favors the longitudinal incision of the renal parenchy ma, which opens the renal pelvis via the dorsal calyces.For this purpose, one branch of the renal artery is clamped to display color [3,5,14,15] or temperature [5,16] differences between the perfused and ischemic paren chyma. However, these labelling methods do not prevent bleeding from surgical lesions of intrarenal vessels.…”