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Background <p>Multifunctional instruments like the TriSect rapide<sup>®</sup> (Erbe Elektromedizin GmbH, Tübingen, Germany) aim to simplify complex surgical procedures by integrating dissection, cutting, and coagulation in a single device. This study aims to evaluate its clinical utility in laparoscopic pyeloplasty. Specifically, we sought to determine whether the use of the TriSect rapide<sup>®</sup> could significantly reduce the preparatory phase of laparoscopic pyeloplasty by 30% or more compared to conventional instruments.</p> Methods <p>In this prospective, randomized trial, 22 patients undergoing laparoscopic pyeloplasty for ureteropelvic junction (UPJ) obstruction were allocated to receive surgery using either the TriSect rapide<sup>®</sup> instrument set or conventional instruments. The primary endpoint was the duration of the operation (preparation time). Secondary outcomes were perioperative complications and reported quality of life.</p> Results <p>The median follow-up was 46 weeks. No significant differences were observed between groups regarding demographic factors, renal function, or intra- and perioperative complications. The intervention group demonstrated a significantly shorter preparation time (83 ± 29.8 vs. 122 ± 32.5&#xa0;min, <i>p</i> = 0.009), resulting in a reduced total operative time (170 ± 32.0 vs. 211 ± 41.6&#xa0;min, <i>p</i> = 0.017) and shorter anesthesia duration (221 ± 41.0 vs. 259 ± 41.5&#xa0;min, <i>p</i> = 0.046). Reconstruction time did not differ significantly (87 ± 14.6 vs. 89 ± 11.1&#xa0;min, <i>p</i> = 0.639).</p> <p><?noindent??>Complication rates according to the Clavien–Dindo classification were comparable between groups (<i>p</i> = 0.935).</p> <p><?noindent??>Quality-of-life analysis using the RAND SF-36 questionnaire revealed no between-group differences at either time point, although both groups showed significant postoperative improvement compared with baseline (<i>p</i> &lt; 0.001).</p> Conclusion <p>The use of the TriSect rapide® multifunctional device in laparoscopic pyeloplasty is safe and effective for preparation, dissection and incision. Its application significantly reduces preparation time by approximately 32% without increasing perioperative complications or affecting postoperative quality of life. These findings support the clinical value of multifunctional instruments in improving procedural efficiency while maintaining safety in reconstructive urologic surgery.</p> Trial registration <p>In compliance with international guidelines for clinical trial transparency, this study was retrospectively registered in the ISRCTN registry (registration number: ISRCTN15328718) on August 7, 2025.</p>

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Prospective randomized analysis of operating time and safety of laparoscopic pyeloplasty with or without TriSect rapide® in adult patients with ureteropelvic junction obstruction

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月15日

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  • Bastian Hummel,
  • Gereon Schaelte,
  • Bogdan Baleanu-Curaj,
  • Stefan Istin,
  • Tibor Szarvas,
  • David Schroeders,
  • Boris Hadaschik,
  • Christian Niedworok

摘要

Background

Multifunctional instruments like the TriSect rapide® (Erbe Elektromedizin GmbH, Tübingen, Germany) aim to simplify complex surgical procedures by integrating dissection, cutting, and coagulation in a single device. This study aims to evaluate its clinical utility in laparoscopic pyeloplasty. Specifically, we sought to determine whether the use of the TriSect rapide® could significantly reduce the preparatory phase of laparoscopic pyeloplasty by 30% or more compared to conventional instruments.

Methods

In this prospective, randomized trial, 22 patients undergoing laparoscopic pyeloplasty for ureteropelvic junction (UPJ) obstruction were allocated to receive surgery using either the TriSect rapide® instrument set or conventional instruments. The primary endpoint was the duration of the operation (preparation time). Secondary outcomes were perioperative complications and reported quality of life.

Results

The median follow-up was 46 weeks. No significant differences were observed between groups regarding demographic factors, renal function, or intra- and perioperative complications. The intervention group demonstrated a significantly shorter preparation time (83 ± 29.8 vs. 122 ± 32.5 min, p = 0.009), resulting in a reduced total operative time (170 ± 32.0 vs. 211 ± 41.6 min, p = 0.017) and shorter anesthesia duration (221 ± 41.0 vs. 259 ± 41.5 min, p = 0.046). Reconstruction time did not differ significantly (87 ± 14.6 vs. 89 ± 11.1 min, p = 0.639).

Complication rates according to the Clavien–Dindo classification were comparable between groups (p = 0.935).

Quality-of-life analysis using the RAND SF-36 questionnaire revealed no between-group differences at either time point, although both groups showed significant postoperative improvement compared with baseline (p < 0.001).

Conclusion

The use of the TriSect rapide® multifunctional device in laparoscopic pyeloplasty is safe and effective for preparation, dissection and incision. Its application significantly reduces preparation time by approximately 32% without increasing perioperative complications or affecting postoperative quality of life. These findings support the clinical value of multifunctional instruments in improving procedural efficiency while maintaining safety in reconstructive urologic surgery.

Trial registration

In compliance with international guidelines for clinical trial transparency, this study was retrospectively registered in the ISRCTN registry (registration number: ISRCTN15328718) on August 7, 2025.