Showing papers in "Journal of Endourology Part B, Videourology in 2013"
TL;DR: A novel prostate model for training in TURP using a human cadaver embalmed by the Thiel's method, a novel embalming technique, can be positioned in litho...
Abstract: Introduction: Transurethral resection of prostate (TURP) is a core urology procedure. It is an integral part of urology training. Various artificial models have been used in the past for t...
5 citations
TL;DR: Laroscopic surgery has demonstrated superiority in terms of morbidity compared to open surgery in a variety of urological procedures and with the introduction of laparoendo surgery, the status of these procedures has changed.
Abstract: Introduction: Laparoscopic surgery has demonstrated superiority in terms of morbidity compared to open surgery in a variety of urological procedures.1–3 With the introduction of laparoendo...
5 citations
TL;DR: A new radiographic test can reliably distinguish renal cortical neoplasms from other kidney types using axial imaging alone, and it is shown that the former can be treated with chemotherapy and the latter with radiation.
Abstract: Introduction: Recent advances in axial imaging have resulted in a dramatic increase in the diagnoses of renal cortical neoplasms (RCNs), but no radiographic test can reliably distinguish b...
5 citations
TL;DR: The technique and perioperative results of the first robot-assisted radical nephrectomy and IVC tumor thrombectomy and reconstruction using a synthetic patch graft are presented.
Abstract: Introduction: Despite the increasing popularity of laparoscopic and robotic approaches for renal tumors, open surgery is the standard approach for the surgical management of renal tumors with extension into the inferior vena cava (IVC).1 Abaza reported the first robot-assisted radical nephrectomy with IVC tumor thrombectomy in a series of five patients with good outcomes. Two patients necessitated cross-clamping of the IVC, and in all cases, the IVC cavotomy was closed using a two layer suture.2 We present our technique and perioperative results of the first robot-assisted radical nephrectomy and IVC tumor thrombectomy and reconstruction using a synthetic patch graft. Materials and Methods: A 61-year-old woman presented with an 8-cm right renal mass, bilateral pulmonary embolism, and IVC tumor thrombus extending into the subhepatic IVC. After counseling and discussion of all available treatment options, the patient opted for robotic-assisted surgical management. The procedure was performed by a s...
5 citations
TL;DR: Rectourethral fistulas in men are most commonly seen after therapeutic interventions for prostate cancer, whether via prostatectomy, radiation therapy, or cryotherapy.
Abstract: Introduction: Rectourethral fistulas in men are most commonly seen after therapeutic interventions for prostate cancer, whether via prostatectomy, radiation therapy, or cryotherapy. There ...
4 citations
TL;DR: The purpose of this study was to evaluate the efficacy and safety of ultrasonic propulsion in a live porcine model to expel small kidney stones or residual post-treatment stone fragments from the kidney.
Abstract: Introduction: Our research group is studying a noninvasive transcutaneous ultrasound device to expel small kidney stones or residual post-treatment stone fragments from the kidney.1–3 The ...
3 citations
TL;DR: A 17-year-old male patient with right UPJ obstruction due to a crossing vessel, which underwent SIP in the single-incision triangulated umbilical surgery (SITUS) technique, is presented.
Abstract: Introduction: Ureteropelvic junction (UPJ) obstruction, mainly due to primarily obstructed UPJ or compression related to crossing vessels, is the main indication for pyeloplasty. Laparoscopic pyeloplasty was introduced to reduce the perioperative morbidity and to improve cosmesis of open procedures and is widely accepted as operative standard in experienced urologic centers.1–3 In this video, we present a single-incision pyeloplasty (SIP) in the single-incision triangulated umbilical surgery (SITUS) technique, using straight optics and instruments in triangulation.4,5 Moreover, we present the initial series of nine consecutive patients treated by SIP in the SITUS technique from October 2009 to November 2011. Materials and Methods: In the video, we present a 17-year-old male patient with right UPJ obstruction due to a crossing vessel, which underwent SIP. The umbilicus was incised at 3/4 of its circumference, pneumoperitoneum was achieved by the Verres technique, and a 5-mm camera trocar was place...
3 citations
TL;DR: The Ultra-Mini percutaneous nephrolithotripsy (UMP) sheath is introduced in the pelvicalyceal system and a new technique for removing medium bulk renal stones is introduced.
Abstract: Introduction and Objectives: We want to introduce a new technique for removing medium bulk renal stones. The parenchymal damage is less if the dilation is less,1,2 and therefore, we dilate up to 11F and use a sheath of 11F only. The design of the sheath is the invention and we want to present the design and the outcome because of that design. We disintegrate the stone with a 365 μm Holmium laser fiber and keep the fragment size to 2 mm approximately. At the end, we create a whirlpool effect (an eddy of water) by injecting saline through a very small side channel—the fragments come out automatically. Methods: A standard puncture is done to access the preferred calyx. Over the guide wire, an 8F teflon dilator is used, and then a 11F dilation is done.3 The Ultra-Mini percutaneous nephrolithotripsy (UMP) sheath is introduced in the pelvicalyceal system. The telescope used is a 3.5F slender telescope, which has a 17000 pixel resolution (Schoelly-LUT). The stone is visualized and disintegration is done...
2 citations
TL;DR: This work demonstrates the technique of retroperitoneal robot-assisted laparoscopic port placement on patients with right- and left-sided renal masses, respectively and offers an improved approach to nephron-sparing surgery, especially posterior tumors.
Abstract: Introduction: With the increasing popularity of robot-assisted laparoscopic surgery, nephron-sparing renal surgery is becoming the treatment of choice for small renal masses. Historically, laparoscopic access to the kidney has been approached transperitoneally. A retroperitoneal approach offers direct access to the kidney and may offer an improved approach to nephron-sparing surgery, especially posterior tumors.1 The confined space of the retroperitoneum can be navigated effectively by articulating robotic instruments. Effective instrument placement is critical to success retroperitoneal surgery. Several manuscripts describe the procedure, but obtaining access is largely ignored.2,3 In this video, we demonstrate the technique of retroperitoneal robot-assisted laparoscopic port placement. Materials and Methods: We demonstrate the technique of robot-assisted laparoscopic port placement on patients with right- and left-sided renal masses, respectively. Obtaining retroperitoneal access off the tip of...
2 citations
TL;DR: A robotic-assisted partial cystectomy is presented for treatment of a 14-year-old male with a history of VHL, and a retrospective review of all cases of BP treated by the Urologic Oncology Branch at the National Institutes of Health Clinical Center from 1989 to 2013 is performed.
Abstract: Introduction: Bladder paragangliomas (BP) (also commonly called bladder pheochromocytomas) account for 0.06% of bladder tumors, but may occur more frequently with familial syndromes, inclu...
2 citations
TL;DR: Inferior vena cava involvement with large or complex renal neoplasms occurs in 4%–10% of patients with renal cell carcinoma and the gold standard treatment is chemotherapy.
Abstract: Introduction and Objective: Inferior vena cava (IVC) involvement with large or complex renal neoplasms occurs in 4%–10% of patients with renal cell carcinoma.1 The gold standard treatment ...
TL;DR: To determine the value of digital flexible ureteroscopy combined with NBI in upper urinary tract pathology diagnosis, the relatively new narrow band imaging (NBI) technology allows a better detection.
Abstract: Introduction: Diagnosis flexible ureteroscopy becomes a routine procedure.1 However, identifying characteristics suggestive for the malignant nature of a lesion, and consequently the indication for biopsy is difficult. In this regard, the relatively new narrow band imaging (NBI) technology allows a better detection.2 Purpose: To determine the value of digital flexible ureteroscopy combined with NBI in upper urinary tract pathology diagnosis. Materials and Methods: Between January 2010- September 2012, 64 white light and NBI digital flexible ureteroscopic procedures were performed in the Department of Urology of St. John Emergency Clinical Hospital, which were divided in two groups. Group I (50 cases) included patients in which, the procedures were performed for upper urinary tract filling defects (20 cases), unilateral hematuria (19 cases), and abnormal urinary cytology (11 cases). The second group (14 procedures in seven cases) included follow-up cases with conservatively treated upper urinary t...
TL;DR: This evaluation of the feasibility and safety of robotic distal ureterectomy (RDU) for benign ureteral stricture disease and the urothelial carcinoma of the distal Ureter found it to be feasible and safe.
Abstract: Introduction: The benign ureteral stricture disease and the urothelial carcinoma of the distal ureter can be managed by distal ureterectomy and ureteral reimplantation. The da Vinci robotic surgical system has been increasingly used in the management of a variety of urologic diseases. To assess the application of robotic surgery in the management of the distal ureter, we evaluated the feasibility and safety of robotic distal ureterectomy (RDU). We highlight our surgical technique with a surgical video. Materials and Methods: Nineteen patients with benign or malignant disease involving the ureter were enrolled between June 2004 and March 2012. Preoperative, intraoperative, and postoperative parameters were recorded and analyzed. The modified Clavien system was used to grade postoperative complications. Results: Ten patients underwent RDU for urothelial carcinoma of the distal ureter, and the other nine for benign stricture disease or iatrogenic injury. The median age at surgery was 65 years (inter...
TL;DR: Based on the literature, this retroperitoneoscopic technique was performed only in patients with small benign tumors and low body mass index (BMI) and to the knowledge, this is the first video in urological literature showing this technique.
Abstract: Introduction: Since the introduction of transperitoneal laparoscopic adrenalectomy,1 several retroperitoneal techniques have emerged. Retroperitoneoscopy can be performed with the patient ...
TL;DR: The aim is to present the minimally invasive treatment of ectopic obstructive megaureter as an initial and temporizing approach in duplicated ectopic megaureters with preserved moiety function.
Abstract: Introduction and Objective: Management of the obstructive megaureter is one of the most difficult problems in urological surgery, especially in the neonate and young infant.1 It can be managed using a number of operative techniques with the primary goal being to minimize the potencial for further injury to the affected kidney. However, the commonly used methods of providing drainage have their limitations. A method for internal drainage would provide a more acceptable means of relieving obstruction in infants,2 especially with uncontrolled urinary tract infection or deteriorating renal function, until a time at which these patients could undergo a more definitive surgical repair. Our aim is to present the minimally invasive treatment of ectopic obstructive megaureter3 as an initial and temporizing approach in duplicated ectopic megaureters with preserved moiety function. The video describes the technique in detail with the results and has a run time of 5 mins. Materials and Methods: We have treat...
TL;DR: This work presents the technique of robotic partial nephrectomy with selective arterial clamping by a case illustration, and discusses the indications, selection, and options of nephron-sparing surgery.
Abstract: Introduction: With widespread use of modern imaging methods, more renal cell carcinoma is diagnosed at an earlier stage. These tumors are often of lower grade and stage, and nephron-sparin...
TL;DR: The preferred treatment for patients with a large stone burden is percutaneous nephrolithotomy (PCNL), but although it offers excellent stone clearance rates, PCNL...
Abstract: Introduction and Objectives: The preferred treatment for patients with a large stone burden is percutaneous nephrolithotomy (PCNL) Although it offers excellent stone clearance rates, PCNL
TL;DR: The Cook Resonance™ metallic ureteric stent has recently been introduced as an alternative method for upper urinary-tract obstruction and in this short video, initially, it was suggested that this stent should be used in conjunction with conventional stent placement.
Abstract: Introduction: The Cook Resonance™ metallic ureteric stent has recently been introduced as an alternative method for upper urinary-tract obstruction.1–3 In this short video, initially, we d...
TL;DR: The most difficult step of percutaneous renal surgery is to obtain an appropriate access to the renal cavities, which reduces the risk of vascular injury and leads to a bette...
Abstract: Introduction: The most difficult step of percutaneous renal surgery is to obtain an appropriate access to the renal cavities, which reduces the risk of vascular injury and leads to a bette...
TL;DR: A 101-year-old male with a history of Guillain-Barre syndrome, gastroesophageal reflux disease, and hypertension underwent placement of a UroLume stent in 2006 for lower urinary tract symptoms and had been voiding without difficulty and low postvoid residuals over the past decade.
Abstract: Introduction: The UroLume stent has been used for treatment of urethral stricture disease and benign prostatic hyperplasia since 1988.1 This procedure is not without complications, includi...
TL;DR: Pediatric urologists are increasingly using robot-assisted laparoscopic pyeloplasty (RAL-PYELO) to treat ureteropelvic junction obstruction (UPJO), however, the procedure is still relatively new and complicated.
Abstract: Introduction: Pediatric urologists are increasingly using robot-assisted laparoscopic pyeloplasty (RAL-PYELO) to treat ureteropelvic junction obstruction (UPJO); however, the procedure is ...
TL;DR: An initial experience utilizing a circumferential urinary reconstruction technique utilizing the suprapubic approach during robotic radical prostatectomy in men with markedly enlarged prostates and urinary obstruction is reported.
Abstract: Purpose: Robot-assisted laparoscopic simple prostatectomy (RALSP) is a feasible option in men with markedly enlarged prostates (over 100 g) and urinary obstruction.1 Since January 2011, we have modified our surgical method in hope of further enhancing the perioperative outcomes related to RALSP. Herein, we report our initial experience utilizing a circumferential urinary reconstruction technique. Methods: A total of nine patients underwent RALSP with a surgical modification for symptomatic benign prostatic hypertrophy (BPH) in 2011. All, but one patient, were in complete urinary retention preoperatively. All RALSP were performed via the suprapubic approach. Upon removal of the obstructing prostate adenomas, a circumferential anastomosis was completed by advancing and approximating the bladder neck to the prostate urethral stump with 8 to 10 interrupted 2-0 vicryl suture, similar to that of the urethral vesical anastomosis during robotic radical prostatectomy. Six patients who underwent a standard...
TL;DR: A video demonstration of laparoscopic transmesocolic pyeloplasty is presented and the left renal pelvis and upper ureter were clearly visible through the mesocolon in this patient.
Abstract: Inroduction: Laparoscopic dismembered pyeloplasty is considered as the gold standard for the management of pelviureteric junction obstruction. Conventional laparoscopic pyeloplasty through a transperitoneal approach mandates colonic mobilization for access to the pathological segment. In selected individuals (with minimal mesenteric fat), a transmesocolic approach may be attempted and colonic handling can be avoided. The transmesocolic approach offers several advantages. Colonic mobilization may be attended with a prolonged procedural duration, increased blood loss, possibility of iatrogenic insults, and delayed recovery.1,2 With the transmesocolic approach, these problems can be reduced. We present a video demonstration of laparoscopic transmesocolic pyeloplasty. Port positions are depicted in the illustration. After achieving the pneumoperitoneum, the left renal pelvis and upper ureter were clearly visible through the mesocolon in this patient. This motivated us to embark on the transmesocolic ...
TL;DR: This video is to illustrate and to point ways of managing vascular injuries during laparoscopic procedures may occur by blunt applicators, such as an aspirator.
Abstract: Purpose: Vascular injuries during laparoscopic procedures may occur by blunt applicators, such as an aspirator.1 The aim of this video is to illustrate and to point ways of managing these ...
TL;DR: Retrocaval ureter is a rare congenital anomaly with an incidence of 1 in 1100 and the ureters become entrapped behind the inferior vena cava.
Abstract: Introduction: Retrocaval ureter, also called circumcaval ureter, is a rare congenital anomaly with an incidence of 1 in 1100. The ureter becomes entrapped behind the inferior vena cava (IV...
TL;DR: It is shown the possibility of a retrograde ureteral endoscopic approach and the endoscopic presentation of this reimplantation using the split-cuff nipple is possible and assessed.
Abstract: Introduction: In patients with urinary diversion, retrograde ureteral access can be technically challenging because of the anatomic distortion and the difficult or impossible identificatio...
TL;DR: The use of minimally invasive techniques in the management of urologic malignancies and reports of port-site metastasis (PSM) have raised concerns regarding the use of these techniques are investigated.
Abstract: Introduction: With the increasing use of minimally invasive techniques in the management of urologic malignancies, reports of port-site metastasis (PSM) have raised concerns regarding the ...
TL;DR: A novel technique called catheter-controlled dilatation (CCD) of suprapubic tract for antegrade bladder access using the same, but recently made, suprapUBic tract is developed.
Abstract: Introduction and Objective: Suprapubic catheterization (SPC) provides bladder drainage when urethral access is either not possible or not advisable.1 Once the SPC tract gets matured, acces...
TL;DR: Extended pelvic lymph node dissection during radical cystectomy may be important not only for improved staging, but also for a survival benefit.
Abstract: Introduction: Extended pelvic lymph node dissection (PLND) during radical cystectomy may be important not only for improved staging, but also for a survival benefit. To assess the utility ...