Design and simulation of novel laparoscopic renal denervation system: a feasibility study

Abstract

Purpose: In this study, we propose a novel laparoscopy-based renal denervation (RDN) system for treating patients with resistant hypertension. In this feasibility study, we investigated whether our proposed surgical instrument can ablate renal nerves from outside of the renal artery safely and effectively and can overcome the depth-related limitations of the previous catheter-based system with less damage to the arterial walls.

Method: We designed a looped bipolar electrosurgical instrument to be used with laparoscopy-based RDN system. The tip of instrument wraps around the renal artery and delivers the radio-frequency (RF) energy. We evaluated the thermal distribution via simulation study on a numerical model designed using histological data and validated the results by the in vitro study. Finally, to show the effectiveness of this system, we compared the performance of our system with that of catheter-based RDN system through simulations.

Results: Simulation results were within the 95% confidence intervals of the in vitro experimental results. The validated results demonstrated that the proposed laparoscopy-based RDN system produces an effective thermal distribution for the removal of renal sympathetic nerves without damaging the arterial wall and addresses the depth limitation of catheter-based RDN system.

Conclusions: We developed a novel laparoscope-based electrosurgical RDN method for hypertension treatment. The feasibility of our system was confirmed through a simulation study as well as in vitro experiments. Our proposed method could be an effective treatment for resistant hypertension as well as central nervous system diseases.

Keywords:

• Biological modelling
• hypertension
• numerical simulation
• radiofrequency ablation
• renal denervation

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research was supported by the Ministry of Science and ICT (MSIT), Korea, under the ICT Consilience Creative Program [IITP-2018-2011-1-00783] supervised by the Institute for Information & Communications Technology Promotion (IITP), the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI) funded by the Ministry of Health & Welfare, Republic of Korea [grant number: HI17C1314], and under the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science and ICT [NRF-2017R1A5A1015596].