A New Surgical Approach to Treat the Resistant Hypertension

Abstract

The sympathetic nervous system was known to play an important role in resistant hypertension. Surgical sympathectomy for renal sympathetic nerve removal were performed since the 1930s. Although effective, it had many serious side effects and complications due to severe invasiveness and non-selective property. Recently, catheter based renal denervation (RDN) system using radiofrequency (RF) ablation was developed to overcome invasiveness of sympathectomy. While RF ablation technology was considered promising, it failed to show effectiveness in a recent sham controlled trial. Therefore, there is a strong need for safe and effective RDN strategies considering the anatomical structure of the renal arteries and sympathetic nerves. In this paper, we propose a novel surgical instrument for laparoscopic RDN and show its feasibility through a 3D realistic model using nephrectomy tissues. Laparoscopic RDN will become a new surgical approach to effectively and safely remove renal sympathetic nerves.