Laparoscopic approach for renal denervation: an experimental study on animals

Abstract

Aim. To study the efficacy and safety of laparoscopic mechanical renal denervation. Methods. Thirty sheep with mean weight 92.3±2.1 kg were divided in 2 groups: control group (group I, n=15) and mechanical laparoscopic renal denervation group (group II, n=15). The follow-up period was 6 months. The following parameters were assessed: blood pressure in response to high-frequency electrical intraluminal stimulation, creatinine, blood urea nitrogen test (BUN), damage to the renal arteries according to the result of angiography, the degree of destruction of nerve fibers according to histological examination. Results. All animals were alive during the entire observation period. The creatinine and BUN were within the normal ranges during the observation period. Angiography of the renal arteries did not reveal iatrogenic stenotic lesions. After 6 months in group 2 there was hypertensive response of blood pressure to high-frequency electrical stimulation (increased systolic blood pressure ∆70.27±5.31 (p>0.005), diastolic blood pressure ∆49.87±6.05 (p>0.005)). After 6 months, the animals were euthonised, further histological examination was completed. Histological examination: in the group II, there was swelling and vacuolization of the nerve fiber without signs of demyelination. Conclusions. Laparoscopic mechanical renal denervation is a safe technique. However, the hypotensive effect is short-term.