An evaluation of laparoscopic tissue harvesting for human adult urological smooth muscle physiological experimentation.

摘要

OBJECTIVE: To evaluate the properties of laparoscopically harvested bladder neck and ureteric smooth muscle, compared with tissue obtained at open surgery. MATERIALS AND METHODS: Bladder neck was harvested from patients undergoing open (eight) or laparoscopic radical prostatectomy (11). Ureter was obtained from patients undergoing nephrectomy (laparoscopic or open) and cystectomy (open only); obtained openly from 16 and laparoscopically from seven. Muscle strips dissected from these samples were perfused in a Brading-Sibley organ bath, and stimulated using standard agonists (100 micromol/L carbachol for bladder neck, 100 mmol/L KCl-enriched Krebs' solution for ureteric muscle). Tensions produced were recorded using strain gauges and analysed using data-acquisition software. Results were compared by a two-tailed Fisher's exact test to determine significance. RESULTS: Openly harvested bladder neck muscle strips from six patients showed a measurable response to the standard agonist. Laparoscopically harvested bladder neck strips from only two patients showed any measurable response. Openly harvested ureteric muscle strips from 12 patients responded to K-enriched solution, while one patient's laparoscopically harvested strips responded to stimulation. This difference was significant in both tissue groups separately (P < 0.025). Histological evaluation identified no specific differences between openly and laparoscopically harvested tissue. CONCLUSION: The yield of smooth muscle available for research is significantly less when the resection is laparoscopic; this might be a result of diathermy damage at a subcellular level. With the increasing use of the laparoscopic approach in urological surgery, the effect on tissue availability for human smooth muscle physiological study is important to researchers in this field.