Bipolar Radiofrequency Ablation of the Kidney: Comparison with Monopolar Radiofrequency Ablation

Stephen Y. Nakada, Travis Jerde, Thomas F. Warner, Andrew S. Wright, Dieter Haemmerich, David M. Mahvi, Fred T. Lee

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Purpose: We report initial ex vivo and in vivo studies using bipolar radiofrequency (RF) ablation of porcine kidneys. An internal ground electrode is positioned in the kidney opposite the RF electrode, resulting in ablation of all the intervening renal tissue. Materials and Methods: Ex vivo preparations of 10 porcine kidneys were perfused continuously with Ringer's solution and treated with either standard external grounded RF (N = 3) or bipolar RF ablation with 1 (N = 2), 2 (N = 3), or 3 (N = 2) cm of separation between the ground probe and the RF probe using a Model 30 RITA generator (RITA, Mountain View, CA). Target temperatures were 90°C for 8 minutes. Gross and histologic assessments were made acutely. Four domestic pigs were treated with monopolar RF ablation of the lower pole of one kidney and bipolar RF with a 12-mm separation between the probes of the contralateral lower pole. Animals were harvested 48 hours later to maximize tissue damage for gross measurements and histologic evaluation. Results: Ex vivo studies revealed grossly monopolar lesions 1.5 cm in maximum diameter and 1.75 cm3 in volume. In comparison, bipolar lesions were 2.8 cm in maximum diameter and 10.3 cm 3 in volume using 3 cm of electrode separation. There was histologic evidence of cell death in all specimens. In vivo studies showed two distinct gross lesions with RF: one blanched and one hemorrhagic. Using bipolar RF, larger blanched lesions were achievable than with monopolar RF (2.80 cm 3 v 1.63 cm3). Overall, the combinations of blanched and hemorrhagic lesions were similar with monopolar and bipolar RF (5.01 v 5.31 cm3). Histologic evaluation verified cell death in the blanched lesions and rare areas of normal tissue in the hemorrhagic lesions. Conclusions: As shown by ex vivo data, bipolar RF can create larger lesions than does monopolar RF. In vivo, at 48 hours, both blanched and hemorrhagic gross lesions were seen using RF. In this model, blanched lesions predominated when performing bipolar RF.

Original languageEnglish (US)
Pages (from-to)927-933
Number of pages7
JournalJournal of Endourology
Volume17
Issue number10
StatePublished - Dec 2003
Externally publishedYes

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Kidney
Electrodes
Cell Death
Swine
Sus scrofa
Temperature

ASJC Scopus subject areas

  • Urology

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Nakada, S. Y., Jerde, T., Warner, T. F., Wright, A. S., Haemmerich, D., Mahvi, D. M., & Lee, F. T. (2003). Bipolar Radiofrequency Ablation of the Kidney: Comparison with Monopolar Radiofrequency Ablation. Journal of Endourology, 17(10), 927-933.

Bipolar Radiofrequency Ablation of the Kidney : Comparison with Monopolar Radiofrequency Ablation. / Nakada, Stephen Y.; Jerde, Travis; Warner, Thomas F.; Wright, Andrew S.; Haemmerich, Dieter; Mahvi, David M.; Lee, Fred T.

In: Journal of Endourology, Vol. 17, No. 10, 12.2003, p. 927-933.

Research output: Contribution to journalArticle

Nakada, SY, Jerde, T, Warner, TF, Wright, AS, Haemmerich, D, Mahvi, DM & Lee, FT 2003, 'Bipolar Radiofrequency Ablation of the Kidney: Comparison with Monopolar Radiofrequency Ablation', Journal of Endourology, vol. 17, no. 10, pp. 927-933.
Nakada SY, Jerde T, Warner TF, Wright AS, Haemmerich D, Mahvi DM et al. Bipolar Radiofrequency Ablation of the Kidney: Comparison with Monopolar Radiofrequency Ablation. Journal of Endourology. 2003 Dec;17(10):927-933.
Nakada, Stephen Y. ; Jerde, Travis ; Warner, Thomas F. ; Wright, Andrew S. ; Haemmerich, Dieter ; Mahvi, David M. ; Lee, Fred T. / Bipolar Radiofrequency Ablation of the Kidney : Comparison with Monopolar Radiofrequency Ablation. In: Journal of Endourology. 2003 ; Vol. 17, No. 10. pp. 927-933.
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abstract = "Purpose: We report initial ex vivo and in vivo studies using bipolar radiofrequency (RF) ablation of porcine kidneys. An internal ground electrode is positioned in the kidney opposite the RF electrode, resulting in ablation of all the intervening renal tissue. Materials and Methods: Ex vivo preparations of 10 porcine kidneys were perfused continuously with Ringer's solution and treated with either standard external grounded RF (N = 3) or bipolar RF ablation with 1 (N = 2), 2 (N = 3), or 3 (N = 2) cm of separation between the ground probe and the RF probe using a Model 30 RITA generator (RITA, Mountain View, CA). Target temperatures were 90°C for 8 minutes. Gross and histologic assessments were made acutely. Four domestic pigs were treated with monopolar RF ablation of the lower pole of one kidney and bipolar RF with a 12-mm separation between the probes of the contralateral lower pole. Animals were harvested 48 hours later to maximize tissue damage for gross measurements and histologic evaluation. Results: Ex vivo studies revealed grossly monopolar lesions 1.5 cm in maximum diameter and 1.75 cm3 in volume. In comparison, bipolar lesions were 2.8 cm in maximum diameter and 10.3 cm 3 in volume using 3 cm of electrode separation. There was histologic evidence of cell death in all specimens. In vivo studies showed two distinct gross lesions with RF: one blanched and one hemorrhagic. Using bipolar RF, larger blanched lesions were achievable than with monopolar RF (2.80 cm 3 v 1.63 cm3). Overall, the combinations of blanched and hemorrhagic lesions were similar with monopolar and bipolar RF (5.01 v 5.31 cm3). Histologic evaluation verified cell death in the blanched lesions and rare areas of normal tissue in the hemorrhagic lesions. Conclusions: As shown by ex vivo data, bipolar RF can create larger lesions than does monopolar RF. In vivo, at 48 hours, both blanched and hemorrhagic gross lesions were seen using RF. In this model, blanched lesions predominated when performing bipolar RF.",
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T2 - Comparison with Monopolar Radiofrequency Ablation

AU - Nakada, Stephen Y.

AU - Jerde, Travis

AU - Warner, Thomas F.

AU - Wright, Andrew S.

AU - Haemmerich, Dieter

AU - Mahvi, David M.

AU - Lee, Fred T.

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N2 - Purpose: We report initial ex vivo and in vivo studies using bipolar radiofrequency (RF) ablation of porcine kidneys. An internal ground electrode is positioned in the kidney opposite the RF electrode, resulting in ablation of all the intervening renal tissue. Materials and Methods: Ex vivo preparations of 10 porcine kidneys were perfused continuously with Ringer's solution and treated with either standard external grounded RF (N = 3) or bipolar RF ablation with 1 (N = 2), 2 (N = 3), or 3 (N = 2) cm of separation between the ground probe and the RF probe using a Model 30 RITA generator (RITA, Mountain View, CA). Target temperatures were 90°C for 8 minutes. Gross and histologic assessments were made acutely. Four domestic pigs were treated with monopolar RF ablation of the lower pole of one kidney and bipolar RF with a 12-mm separation between the probes of the contralateral lower pole. Animals were harvested 48 hours later to maximize tissue damage for gross measurements and histologic evaluation. Results: Ex vivo studies revealed grossly monopolar lesions 1.5 cm in maximum diameter and 1.75 cm3 in volume. In comparison, bipolar lesions were 2.8 cm in maximum diameter and 10.3 cm 3 in volume using 3 cm of electrode separation. There was histologic evidence of cell death in all specimens. In vivo studies showed two distinct gross lesions with RF: one blanched and one hemorrhagic. Using bipolar RF, larger blanched lesions were achievable than with monopolar RF (2.80 cm 3 v 1.63 cm3). Overall, the combinations of blanched and hemorrhagic lesions were similar with monopolar and bipolar RF (5.01 v 5.31 cm3). Histologic evaluation verified cell death in the blanched lesions and rare areas of normal tissue in the hemorrhagic lesions. Conclusions: As shown by ex vivo data, bipolar RF can create larger lesions than does monopolar RF. In vivo, at 48 hours, both blanched and hemorrhagic gross lesions were seen using RF. In this model, blanched lesions predominated when performing bipolar RF.

AB - Purpose: We report initial ex vivo and in vivo studies using bipolar radiofrequency (RF) ablation of porcine kidneys. An internal ground electrode is positioned in the kidney opposite the RF electrode, resulting in ablation of all the intervening renal tissue. Materials and Methods: Ex vivo preparations of 10 porcine kidneys were perfused continuously with Ringer's solution and treated with either standard external grounded RF (N = 3) or bipolar RF ablation with 1 (N = 2), 2 (N = 3), or 3 (N = 2) cm of separation between the ground probe and the RF probe using a Model 30 RITA generator (RITA, Mountain View, CA). Target temperatures were 90°C for 8 minutes. Gross and histologic assessments were made acutely. Four domestic pigs were treated with monopolar RF ablation of the lower pole of one kidney and bipolar RF with a 12-mm separation between the probes of the contralateral lower pole. Animals were harvested 48 hours later to maximize tissue damage for gross measurements and histologic evaluation. Results: Ex vivo studies revealed grossly monopolar lesions 1.5 cm in maximum diameter and 1.75 cm3 in volume. In comparison, bipolar lesions were 2.8 cm in maximum diameter and 10.3 cm 3 in volume using 3 cm of electrode separation. There was histologic evidence of cell death in all specimens. In vivo studies showed two distinct gross lesions with RF: one blanched and one hemorrhagic. Using bipolar RF, larger blanched lesions were achievable than with monopolar RF (2.80 cm 3 v 1.63 cm3). Overall, the combinations of blanched and hemorrhagic lesions were similar with monopolar and bipolar RF (5.01 v 5.31 cm3). Histologic evaluation verified cell death in the blanched lesions and rare areas of normal tissue in the hemorrhagic lesions. Conclusions: As shown by ex vivo data, bipolar RF can create larger lesions than does monopolar RF. In vivo, at 48 hours, both blanched and hemorrhagic gross lesions were seen using RF. In this model, blanched lesions predominated when performing bipolar RF.

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