Showing papers in "Journal of Endourology Part B, Videourology in 2014"
TL;DR: Anterior pelvic exenteration is the standard operation for muscle-invasive bladder cancer in females, but recent data suggest that involvement of reproductive organs in this operation is more limited than previously thought.
Abstract: Introduction: Anterior pelvic exenteration is the standard operation for muscle-invasive bladder cancer in females. However, recent data suggest that involvement of reproductive organs wit...
3 citations
TL;DR: It has been shown consistently that laparoscopic partial nephrectomy (LPN) has similar oncological effects on patients with cT1a renal tumors as well as other types of cancer.
Abstract: Introduction: Nephron sparing surgery is the standard treatment for cT1a renal tumors. It has been shown consistently that laparoscopic partial nephrectomy (LPN) has similar oncological ou...
2 citations
TL;DR: This educational video demonstrates the important measures urologists could undertake to protect patients, themselves, and other healthcare professionals from excessive radiation exposure without compromising outcomes.
Abstract: Background and Objectives: Radiation is one of the occupational hazards urologists are exposed to during their day-to-day practice. Excessive radiation exposure is associated with multiple short- and long-term consequences. This educational video demonstrates the important measures urologists could undertake to protect patients, themselves, and other healthcare professionals from excessive radiation exposure without compromising outcomes. Methods: As Low As Reasonably Achievable principles, including minimizing time, maximizing distance, and always using shields, are demonstrated. Intraoperative tricks to minimize radiation exposure are recommended, including using the foot pedal to activate fluoroscopy by the surgeon himself/herself, using pulsed fluoroscopy, and documenting fluoroscopy time. In addition, the American Urological Association (AUA) guidelines regarding imaging modalities used for follow-up of urolithiasis are reviewed. Results: Surgeon behavior is one of the important modifiable p...
2 citations
TL;DR: POP affects 130,000 women annually, and this number is likely to rise as the population increases in age, and the number of women undergoing laparoscopic prolapse surgery is expected to rise.
Abstract: Introduction: Pelvic organ prolapse (POP) affects 130,000 women annually, and this number is likely to rise as our population increases in age. Approximately 11% of women will undergo a su...
2 citations
TL;DR: A patient whose prostatectomy was complicated by unrecognized rectal injury and pelvic abscess was presented for management of the resulting rectovesical fistula, and underwent successful repair using minimally invasive techniques.
Abstract: Introduction and Objectives: Rectovesical fistulas are a rare but devastating complication of radical prostatectomy. Management can be challenging due to deep location in the pelvis and recent surgery. We present a case of a patient whose prostatectomy was complicated by unrecognized rectal injury and pelvic abscess. After diverting colostomy, he was referred for management of the resulting rectovesical fistula. The patient failed primary closure with a sliding rectal advancement flap. Methods: In this video, we demonstrate robotic repair of a rectovesical fistula. The fistula tract was first dissected posterior to the bladder. Due to the location of the fistula, a transvesical approach was also required to identify the distal end of the fistula. Once the fistula was completely separated from the bladder, it was primarily closed. An omental flap was then mobilized and secured over the fistula site. Results: The patient underwent successful repair using minimally invasive techniques, preventing th...
2 citations
TL;DR: Paragangliomas of the organ of Zuckerkandl are rare extra-adrenal pheochromocytomas, and according to a recent systematic review,1 only 135 cases have been reported so far.
Abstract: Background: Paragangliomas of the organ of Zuckerkandl (PZ) are rare extra-adrenal pheochromocytomas, and according to a recent systematic review,1 only 135 cases have been reported so far...
2 citations
TL;DR: Robot-assisted laparoscopic techniques are being adopted by urologists for reconstruction of the upper urinary tract with mixed results in women and men.
Abstract: Introduction and Objective: Robot-assisted laparoscopic techniques are being adopted by urologists for reconstruction of the upper urinary tract. Specifically, this technique is being incr...
2 citations
TL;DR: Colovesical fistula is a rare, but well-recognized complication of abdominopelvic surgery, diverticular disease, and pelvic radiation therapy and management is often challenging.
Abstract: Introduction: Colovesical fistula is a rare, but well-recognized complication of abdominopelvic surgery, diverticular disease, and pelvic radiation therapy. Management is often challenging...
1 citations
TL;DR: Inguinal lymphadenectomy is the treatment of choice for patients with penile cancer and inguinal lymph node metastases and the performance of robotic bilateral ingui...
Abstract: Introduction: Inguinal lymphadenectomy is the treatment of choice for patients with penile cancer and inguinal lymph node metastases. We describe the performance of robotic bilateral ingui...
1 citations
TL;DR: The flap valve technique for creating a continent urinary diversion was popularized by Paul Mitrofanoff and several tissues may be used to create the catheterizable vesicocutane.
Abstract: Introduction: The flap valve technique for creating a continent urinary diversion was popularized by Paul Mitrofanoff. Several tissues may be used to create the catheterizable vesicocutane...
1 citations
TL;DR: Robot-assisted laparoscopic prostatectomy (RALP) with suprapubic tube (SPT), compared to urethral catheter (UC) drainage, has been proposed to improve patient's quality of life.
Abstract: Introduction and Objective: Robot-assisted laparoscopic prostatectomy (RALP) with suprapubic tube (SPT), compared to urethral catheter (UC) drainage, has been proposed to improve patient's...
TL;DR: Robot-assisted laparoscopic excision of retrovesicular Cysts, including prostatic utricle cysts, has been described with success given excellent three-dimensional visualizati...
Abstract: Introduction: Robot-assisted laparoscopic excision of retrovesicular cysts, including prostatic utricle cysts, has been described with success given excellent three-dimensional visualizati...
TL;DR: An educative video is presented that shows the performance of a conventional right laparoscopic radical nephrectomy since its surgical planning, usual and crucial step considerations, warnings, possible complications, and their managements.
Abstract: Introduction: Whereas laparoscopic nephrectomy was initially used primarily for small tumors only, this has decreased in favor of nephron-sparing surgery. Meanwhile, laparoscopic nephrectomy is now offered for selected patients with large tumors up to stage T3 and for cytoreductive nephrectomies. Objectives: We present an educative video that shows the performance of a conventional right laparoscopic radical nephrectomy since its surgical planning, usual and crucial step considerations, warnings, possible complications, and their managements. With the big experience of the authors in this topic, we share tips and tricks about this usual procedure. Methods: We collected multiple videos from the author's personal video collections all around the world that exemplified each right laparoscopic radical nephrectomy step and its possible complication with the respective management and prevention. We summarized all the videos and designed special step illustrations and made a unique one for an academic v...
TL;DR: Urologic complications from hysterectomy such as vesicovaginal fistula (VVF) and ureteral injury are known to occur at a rate of ∼1%.
Abstract: Introduction: Urologic complications from hysterectomy such as vesicovaginal fistula (VVF) and ureteral injury are known to occur at a rate of ∼1%. When a hysterectomy is indicated for ute...
TL;DR: Transitional cell cancer is the fourth most frequent carcinoma, but the upper urinary tract is affected in only 5% to 10% and an affection of the renal pelvis is observed twice as much as that of the abdomen.
Abstract: Introduction: Transitional cell cancer is the fourth most frequent carcinoma. The upper urinary tract is affected in only 5% to 10%. An affection of the renal pelvis is observed twice as o...
TL;DR: An automated laser fragmentation testing system was developed, where laser fibers moving at constant velocity over the surface of artificial stones create a fissure, whose width, depth, and volume were analyzed.
Abstract: Introduction and Objective: Urologists have diverging opinions and beliefs concerning the ideal laser lithotripter setting. We decided to confirm or reject common beliefs by evaluating laser lithotripsy efficiency and retropulsion using innovative testing methods free from any human interaction bias. Methods: An automated laser fragmentation testing system was developed, where laser fibers moving at constant velocity over the surface of artificial stones create a fissure, whose width, depth, and volume were analyzed. Lithotripter settings included different pulse energies (0.2–1.2 J), frequencies (5–40 Hz), power levels (4–20 W), and laser fiber diameters (200 and 550 μm), including high-frequency versus low-frequency experiments. Other artificial stones were put in direct contact with a laser fiber tip, through which a single laser pulse was fired at various pulse energies (0.2–3.5 J), using small and large laser fibers. All experiences were recorded with high-speed video, the distance the stone...
TL;DR: Several methods of dorsal venous complex (DVC) ligation have been described during a robot-assisted radical prostatectomy, including suture and stapler ligation.
Abstract: Introduction: Several methods of dorsal venous complex (DVC) ligation have been described during a robot-assisted radical prostatectomy. These include suture and stapler ligation. In this ...
TL;DR: A new modified technique for transperitoneal laparoscopic nephrectomy that includes a direct upper kidney pole access and early ligation of renal pedicle and no significant differences were detected regarding mean patient age, intraoperative blood loss, and duration of hospital stay.
Abstract: Introduction: We are presenting in this video our new modified technique for transperitoneal laparoscopic nephrectomy. We aimed to compare its results with the classical ascending transper...
TL;DR: Open dismembered pyeloplasty is a gold standard for managing ureteropelvic junction (UPJ) obstruction resulting in a success rate >90% and is considered to salvage the kidney when there are no other options.
Abstract: Introduction: Open dismembered pyeloplasty is a gold standard for managing ureteropelvic junction (UPJ) obstruction resulting in a success rate >90%.1 The conventional open surgery for failed pyeloplasty is very challenging because of the fibrosis and scarring at the previous surgical site. The current options for managing the failed pyeloplasty are endopyelotomy or redo pyeloplasty, which can be an open, laparoscopic or robot-assisted approach.2 The ureterocalicostomy is considered to salvage the kidney when there are no other options. The redo pyeloplasty is equally difficult with both the open and laparoscopic approach. We present a video demonstration of laparoscopic redo pyeloplasty. The port positions are depicted in the illustration. After achieving the pneumoperitoneum, the colon was reflected along the line of toldt. The affected renal unit and dilated renal pelvis were exposed after incising Gerota's fascia. The normal ureter was identified and dissection was continued proximally toward...
TL;DR: A standardized approach to the bladder neck was applied to robot-assisted radical prostatectomy performed with the Da Vinci Surgical System and helps in maintaining the features of the tissue, thus distinguishing the muscular tissue of the detrusor from the glandular tissue ofThe prostate.
Abstract: Introduction: Dissection of the bladder neck represents one of the most challenging steps of robot-assisted radical prostatectomy, particularly in the presence of difficult anatomic conditions. These can be natural, such as the presence of a median lobe, or due to previous surgery, as in the case of previous surgery for benign prostatic hyperplasia. Materials and Methods: A standardized approach to the bladder neck was applied to robot-assisted radical prostatectomy performed with the Da Vinci Surgical System. Results: A 30° camera is used during the bladder neck dissection. The line of dissection of the anterior bladder neck can be identified operating traction with the fourth arm, with a symmetric pressure of the robotic arms or pulling the catheter. The use of a low monopolar energy helps in maintaining the features of the tissue, thus distinguishing the muscular tissue of the detrusor from the glandular tissue of the prostate. The approach to the posterior bladder neck is based on two opposit...
TL;DR: The aim of this video is to show the importance of knowing the prognosis before and after pelvic organ prolapse preoperatively on the basis of prior history and once the patient is discharged from hospital.
Abstract: Introduction and Aim of the Study: Injury to the ureter is the most common urologic complication of pelvic surgery, with an incidence ranging from 1% to 10%. The aim of this video is to sh...
TL;DR: The sphincter irrigation test was routinely performed before the start and at the end of the resections, and at any time needed during the resection to sharpen the surgeon's perception of the normal structures in this region, which enables contractile elements to be spared from resection.
Abstract: Introduction: This video illustrates our technique for bipolar transurethral resection of the prostate (TURP)1 and the sphincter irrigation test. Materials and Methods: A retrospective stu...
TL;DR: Laparoscopic pyelolithotomy for left renal calculus was performed through transperitoneal approach using four ports in lateral decubitus and inverted V-shaped pyelotomy was performed.
Abstract: Introduction: Urolithiasis is a common urological problem with significant morbidity for the patients. Currently, open surgery is indicated for failed percutaneous, ureteroscopic procedure and for calculus in anomalous kidney when other methods are not feasible or not available. In these scenarios, when expertise is available, laparoscopic approach has been proved to be more beneficial with regard to postoperative morbidity, recovery, and clearance of the stone.1,2 We are presenting a video demonstration of laparoscopic management of urolithiasis in different circumstances. Laparoscopic pyelolithotomy for left renal calculus was performed through transperitoneal approach using four ports in lateral decubitus. Double-J stent was placed in the lithotomy position. After reflecting colon, upper ureter was identified and traced proximally to reach the renal pelvis. Renal pelvis was exposed completely, and inverted V-shaped pyelotomy was performed. Calculus was identified and delivered, followed by pye...
TL;DR: Laroscopic pyeloplasty is a well-accepted minimally invasive approach for the management of pelviureteric junction obstruction (UPJO) and in patients presenting with UPJ...
Abstract: Introduction: Laparoscopic pyeloplasty (LP) is a well-accepted minimally invasive approach for the management of pelviureteric junction obstruction (UPJO).1 In patients presenting with UPJ...
TL;DR: Vaginal pull-through is the technique of choice for management of severely virilized patients with disorders of sexual development and a high insertion urogenital sinus.
Abstract: Introduction: Vaginal pull-through is the technique of choice for management of severely virilized patients with disorders of sexual development and a high insertion urogenital sinus. Typi...
TL;DR: The 3-year results of pelvic lymph node dissection in laparoscopic radical cystectomy in the center for pelvic organ prolapse dissection are reported.
Abstract: Objective: To report our 3-year results of pelvic lymph node dissection in laparoscopic radical cystectomy in our center. Method: Laparoscopic pelvic lymph node dissection was performed ac...
TL;DR: Robot-assisted radical prostatectomy has been shown to be a valuable therapeutic option for patients with clinically localized prostate cancer and in the era of cost savings and...
Abstract: Introduction: Robot-assisted radical prostatectomy has been shown to be a valuable therapeutic option for patients with clinically localized prostate cancer. In the era of cost savings and...
TL;DR: During dis Membered pyeloplasty, anterior crossing vessels are usually transposed posteriorly before anastomosis, but recent studies on minimally invasive dismembered pye...
Abstract: Introduction: During dismembered pyeloplasty, anterior crossing vessels are usually transposed posteriorly before anastomosis. However, recent studies on minimally invasive dismembered pye...
TL;DR: This work presents a video-enhanced description of a robot-assisted pyeloureterostomy for a symptomatic right lower pole UPJO in an incomplete duplex system and provides initial outcome data.
Abstract: Introduction: Ureteropelvic junction obstruction (UPJO) and duplicated collecting systems, complete or incomplete, are relatively common congenital urologic anomalies, but rarely occur tog...
TL;DR: A robotic partial nephrectomy technique with intracorporeal cooling and extraction with a potential benefit of cold ischemia for preserving renal function and intraoperative tumor assessment is described.
Abstract: Introduction: The ability to ice the kidney and grossly evaluate the excised tumor during open partial nephrectomy has been difficult to replicate in a reliable fashion using a minimally invasive approach. We previously described a robotic partial nephrectomy (RPN) technique with intracorporeal cooling and extraction (I.C.E.) for cold ischemia and intraoperative tumor assessment.1 We present a video of our I.C.E. technique.2 Recent evidence suggests a potential benefit of cold ischemia for preserving renal function.3,4 The total run time for our video is 8 minutes 2 seconds. Materials and Methods: A total of eight patients underwent the I.C.E. modification of RPN by transperitoneal (n=6) and retroperitoneal (n=2) approaches. A GelPOINT® access port (Applied Medical) was used for the camera and assistant ports. After hilar clamping, modified syringes loaded with ice slush were introduced through the GelPOINT and ice slush was applied over the kidney surface. The excised tumor was immediately extra...