Partial porcine kidney resection in vivo using a 1.92 μm fiber laser system

A cw Laser system (Medical Laser Centre Lübeck GmbH, Germany) emitting a wavelength at 1.92μm and a laser power up to 50 W was used for partial porcine renal parenchyma resection and hemi nephrectomy. Laser radiation (30 Watt) was transmitted via 365μm fiber with polished distal fiber tip which was fixed in a stainless steel tube. Power density at the distal fiber tip was 28.6 kW/cm². On 3 kidneys a partial renal parenchyma resection without opening of the renal pelvis was performed (Group A). On 8 kidneys a hemi nephrectomy with opening of the renal pelvis was performed (Group B). Total resection time including haemostasis of the remaining tissue was 501 ± 103 s in group "A" and 730 ± 415 s in group "B". Blood lost was 28 ± 3 ml in group "A" and 98 ± 73 ml in group "B". The ischemic time for the kidneys in group "B" was 157 s in average, while for group "A" no ligation was necessary at all. Healing process was observed over 3 weeks, survival rate was 100 %, no inflammation or renal fistulas were found. In conclusion, the first experiments show that the 1.92 μm Laser-System is a very promising device for bloodless and fast kidney resection.