Over 58,000 patients suffer from renal cell carcinoma annually in the U.S. Treatment for this cancer often requires surgical removal of the cancerous tissue in a partial nephrectomy procedure. In open renal surgery, the kidney is placed on ice to increase allowable ischemia time; however, there is no widely accepted method for reducing kidney temperature during minimally invasive surgery. A device has been designed, prototyped, and evaluated to perform effective renal cooling during minimally invasive kidney surgery to reduce damage due to extended ischemia. The device is a fluid-containing bag with foldable cooling surfaces that wrap around the organ. It is deployed through a 15 mm trocar, wrapped around the kidney, and secured using bulldog clamps. The device then fills with an ice slurry and remains on the kidney for up to 20 min. The ice slurry is then removed from the device and the device is retracted from the body. Modeling results and tests of the prototype in a simulated lab environment show that the device successfully cools porcine kidneys from 37°C to 20°C in 6–20 min.

References

References
1.
National Cancer Institute, 2010, “
Kidney Cancer
,” http://www.cancer.gov/cancertopics/types/kidney.
2.
Dhanani
,
N.
, 2010, “
Renal Cooling in Minimally Invasive Surgery
,” Presentation to 2.75 Class, September 7, Cambridge, MA.
3.
Chan
,
A.
,
Ahrar
,
K.
, and
Matin
,
S.
, 2011. “
Ablative Therapies in Renal Cell Carcinoma
,”
Minerva Urol. Nefrol.
,
63
(
3
), pp.
237
250
.
4.
American Urological Association, 2009, “
Guideline for Management of the Clinical Stage I Renal Mass
,” pamphlet, Linthicum, MD.
5.
Weise
,
E. S.
, and
Winfield
,
H. H.
, 2005, “
Laparoscopic Partial Nephrectomy
,”
J. Endourol.
,
19
, pp.
634
642
.
6.
Gill
,
I. S.
,
Abreu
,
S. C.
,
Desai
,
M. M.
,
Steinberg
,
A. P.
,
Ramani
,
A. P.
,
Ng
,
C.
,
Banks
,
K.
,
Novick
,
A. C.
, and
Kaouk
,
J. H.
, 2003, “
Laparoscopic Ice Slush Renal Hypothermia for Partial Nephrectomy: The Initial Experience
,”
J. Urol.
,
170
, pp.
52
56
.
7.
Ward
,
J.
, 1975, “
Determination for the Optimum Temperature for Regional Renal Hypothermia During Temporary Renal Ischemia
,”
J. Urol.
,
47
, pp.
17
24
.
8.
Bratslavsky
,
G.
, and
Kirkali
,
Z.
, 2010, “
The Changing Face of Renal Cell Carcinoma
,”
J. Endourol.
,
24
(
5
), pp.
753
757
.
9.
Crain
,
D. S.
,
Spencer
,
C. R.
,
Favata
,
M. A.
, and
Amling
,
C. L.
, 2004, “
Transureteral Saline Perfusion to Obtain Renal Hypothermia: Potential Application in Laparoscopic Partial Nephrectomy
,”
JSLS
,
8
, pp.
217
222
.
10.
Dobak
III,
J. D.
,
Lasheras
,
J. C.
, and
Werneth
,
R. L.
, 2006, “
Selective Organ Cooling Apparatus and Method
,” U.S. Patent No. 7,066,948.
11.
Thomas
,
J.
,
Japa
,
S.
,
Bianco
,
M.
, and
Hsu
,
T.
, 2010, “
Laparoscopic Kidney Cooling Device
,” U.S. Patent No. 7,780,712.
12.
Soomro
,
N.
,
Griffiths
,
C.
,
Colechin
,
E.
, and
Riddle
,
J.
, 2010, “
Laparoscopic Kidney Cooling Sheath
,” U.S. Patent No. 0,292,764 A1.
13.
Benak
,
A. M.
, and
Villamater
,
J. V.
, 1991, “
Kidney Cooling Jacket
,” U.S. Patent No. 5,014,695.
14.
Hood
,
A. G.
, 1981, “
Cooling Pad
,” U.S. Patent No. 4,259,961.
15.
Herrell
,
S. D.
,
Jahoda
,
A. E.
,
Husain
,
A. N.
, and
Albala
,
D. M.
, 1998, “
The Laparoscopic Cooling Sheath: Novel Device for Hypothermic Preservation of Kidney During Temporary Renal Artery Occlusion
,”
J. Endourol.
,
2
, pp.
155
161
.
16.
Stokes
,
J. R.
,
Telford
,
J. H.
, and
Williamson
,
A.-M.
, 2005, “
The Flowability of Ice Suspensions
,”
J. Rheol.
,
49
, pp.
139
148
.
17.
Shikanov
,
S.
,
Wille
,
M.
,
Large
,
M.
,
Razmaria
,
A.
,
Lifshitz
,
D. A.
,
Chang
,
A.
,
Wu
,
Y.
,
Kasza
,
K.
, and
Shalhav
,
A. L.
, 2010, “
Microparticulate Ice Slurry for Renal Hypothermia: Laparoscopic Partial Nephrectomy in a Porcine Model
,”
J. Urol.
,
76
(
4
), pp.
1012
1016
.
18.
Wald
,
H.
, 1937, “
The Weight of Normal Adult Human Kidneys and Its Variability
,”
Arch. Pathol. Lab. Med.
,
23
, pp.
493
500
.
19.
Emamian
,
S. A.
,
Nielsen
,
M. B.
,
Pedersen
,
J. F.
, and
Ytte
,
L.
, 1993, “
Kidney Dimensions at Sonography: Correlation With Age, Sex and Habitus in 665 Adult Volunteers
,”
Am. J. Roentgenol.
,
160
, pp.
83
86
.
20.
Lienhard V
,
J. H.
, and
Lienhard
IV,
J. H.
, 2006,
A Heat Transfer Textbook
,
3rd ed.
,
Phlogiston Press
,
Cambridge, MA.
21.
Summers
,
E.
,
Cervantes
,
T.
,
Batzer
,
R.
,
Stark
,
J.
, and
Lewis
,
R.
, 2011,
Renal Cooling Device for Use in Minimally Invasive Surgery,” Proceedings of The ASME Design of Medical Devices Conference
,
American Society of Mechanical Engineers
, April, 12–14, Minneapolis, MN.
22.
Campbell
,
S.
, and
Novick
,
A.
, 2009, “
Guideline for Management of the Clinical T1 Renal Mass
,”
J. Urol.
,
182
, pp.
1271
1279
.
23.
Hollenbeck
,
B. K.
,
Taub
,
D. A.
,
Miller
,
D. C.
,
Dunn
,
R. L.
, and
Wei
,
J. T.
, 2006, “
National Utilization Trends of Partial Nephrectomy for Renal Cell Carcinoma: A Case of Underutilization?
,”
Urology
,
67
, pp.
254
259
.
24.
Heuer
,
R.
, and
Gill
,
I.
, 2010, “
A Critical Analysis of the Actual Role of Minimally Invasive Surgery and Active Surveillance for Kidney Cancer
,”
Eur. Urol.
,
57
, pp.
223
232
.
25.
National Center for Health Statistics, 2007, “
National Hospital Discharge Survey
,” pamphlet, Atlanta, GA.
You do not currently have access to this content.