In-Vitro renal shrinkage after hypertonic saline perfusion for organ removal during laparoscopic nephrectomy

Background and Purpose: To evaluate the possibility of shrinking the kidney by perfusion with hypertonic solution to facilitate organ removal in laparoscopic surgery. Materials and Methods: After 18 open nephrectomies (ONs) in 9 pigs, one of four saline solutions (5%, 7.5%, 10%, and 15%) was infused through a catheter into the renal artery for 5 minutes in four kidneys each. The volumes and weights of the kidneys were measured before and after renal perfusion; the kidneys were then sent for histologic evaluation. Eight ONs were performed, and the kidneys were removed from the abdominal cavity in a plastic bag in order to mimic organ entrapment during laparoscopy. The kidneys were perfused with hypertonic solution and were again put in a plastic bag and removed from the same animal's abdomen through another incision. The incisions were measured with calipers before and after extraction of the unperfused and perfused organs. Results: The kidneys that underwent perfusion with 5% saline had the greatest decre...