Experimental nephrectomy via combined transgastric and transvesical approach in porcine / 第二军医大学学报

ABSTRACT

Objective: To assess the feasibility of nephrectomy via combined transgastric and transvesical approach in a porcine model, and to summarize our experience. Methods: Three female pigs were used in this study. The transvesical access was established using ureteroscope. The vesical hole was enlarged with the dilator of ureteroscope sheath and a self-designed Trocar was inserted. The gastroscope was inserted through a hole on gastric wall, which was made using a needle knife and dilator under ureteroscopy. The ultrasound knife, scissor and clips were introduced via the Trocar, and the nephrectomy was completed under the guidance of gastroscope. Results: The six kidneys of the three pigs were successfully resected, with the operation time being (132±10.5) min, without noticeable hemorrhage or complications. Mild hemorrhage occurred after ultrasonic ligation in the first nephrectomy, and was managed by clips. Clips were used to block the vessels before resection for the remaining five kidneys. Conclusion: Our method via combined approach is technically feasible for nephrectomy in a porcine model, but the kidneys have not been taken out and the puncture wounds on the bladder and gastric wall have not been closed, so further study is still needed.