Partial nephrectomy with a combined CO2 and Nd:YAG laser: Experimental study in pigs

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Abstract
Twenty‐eight partial nephrectomies were performed on nine pigs with a simultaneous, coaxial CO2‐Nd:YAG laser at power settings of 20 W and 40 W, or with a steel scalpel. A vascular pedicle clamp was used without renal cooling. The time for hemostasis was 4.5 ± 3.2 min (mean ± SD) with the laser and 6.4 ± 2.5 min with the steel scalpel (P = 0.064). There was no difference in the total operation time (10.4 ± 3.5 min with the laser vs. 11.0 ± 3.2 min with the steel scalpel, P = 0.470). The mean blood loss with the laser was 17.5 ± 6.7 g and 22.1 ± 15.2 g with the steel scalpel (P = 0.299). The number of ligatures needed for complete hemostasis was 2.9 ± 2.1 with the laser and 5.0 ± 2.3 with the steel scalpel (P = 0.011). The average thermal damage was 0.23 ± 0.10 mm. It is concluded that the simultaneous CO2‐Nd:YAG laser method can be used in partial nephrectomy and it offers better hemostasis than the conventional technique. Further studies with different power levels are needed.