Laparoscopic Adventitial Renal Denervation (RDN) for Refractory Hypertension

Inclusion Criteria: Age ≥18 years and ≤65 years, any sex. Diagnosed with primary hypertension. History of hypertension for at least 6 months. Blood pressure meets the following two conditions: Office systolic blood pressure ≥140mmHg and ≤180mmHg, and office diastolic blood pressure ≥90mmHg. If not taking a beta-blocker, resting heart rate must be ≥70bpm. 24-hour ambulatory blood pressure measurement shows an average systolic pressure ≥130mmHg or a daytime average systolic pressure ≥135mmHg. Has a history of antihypertensive medication use within the last 6 months with uncontrolled blood pressure. Before enrollment, must undergo at least 28 days of a standardized medication regimen (including a diuretic and at least three drugs in total) with ≥80% compliance, while office SBP remains ≥140mmHg and ≤180mmHg, and office DBP remains ≥90mmHg. Patient is willing and able to comply with follow-up requirements and has signed the informed consent form. Exclusion Criteria: Secondary hypertension. Target renal artery anatomy is unsuitable, including: Renal artery diameter \>9mm or \<4mm. Multiple renal arteries. Severe calcification, stenosis \>50%, malformation, fibromuscular dysplasia, or aneurysm in either renal artery. History of renal artery intervention (e.g., balloon angioplasty or stenting). Unsuitable for laparoscopic surgery via the retroperitoneal approach, including prior retroperitoneal surgery, retroperitoneal fibrosis, or severe obesity (BMI \> 40 kg/m²). …