A novel laparoscopic renal denervation system in a preclinical swine model

Laparoscopic renal denervation (RDN) represents a specialized approach for hypertension, particularly when conventional methods face limitations. While catheter-based RDN has demonstrated significant efficacy in recent large-scale clinical trials and has been integrated into international guidelines, its effectiveness can be constrained by complex renal anatomy or incomplete ablation. We developed a novel laparoscopic RDN system, comprising an integrated radiofrequency (RF) clamp, RF generator, and cooling pump, to achieve more controlled adventitial ablation. This study aims to evaluate the safety, feasibility, and optimal parameters of this new system in a preclinical swine model. Sixteen pigs were divided into an immediate group (n = 10) for power optimization and a 28-day follow-up group (n = 6). An optimal setting of 10 W for 10 s was identified, balancing effective nerve injury with minimal vascular damage. In the 28-day follow-up group, this setting was associated with a significant reduction in systolic blood pressure (median 125.5 to 109.0 mmHg, p = 0.010) and serum norepinephrine (217.56 to 170.47 ng/L, p = 0.017). Our novel laparoscopic RDN system demonstrates feasibility and safety, providing a potential rescue strategy or supplementary therapy for specific patient populations, such as non-responders to endovascular treatment or those with complex vascular anatomy.