Efficacy and Safety of the Nd:YAG Laser in Canine Partial Nephrectomy

Abstract

Partial nephrectomy using 100 W of focused Neodymium: Y Al Garnet (Nd:YAG) laser power was evaluated to determine its hemostatic capabilities, safety and effect on renal function and histology. Six adult female dogs, ranging from 22-33 lbs, underwent nephrectomy and contralateral partial nephrectomy using the laser. Closure of the collecting system and drains were not used to determine if the laser could seal the collecting system. There was no blood loss with this technique. Four of the 6 dogs had no postoperative complications, but 2 had urinary extravasation, which led to death in 1 dog and required drainage in another. One month postoperative serum creatinine levels were 60% higher than pre-operative values. I.v. urograms revealed no evidence of dilation of the collecting system nor contrast extravasation. The depth of necrosis ranged from 4 mm in the cortex to 7 mm in the medulla. Nd:YAG laser partial nephrectomy is effective, and it provides complete hemostasis, manageable urinary extravasation and acceptable impairment of renal function.