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Robotic pyeloplasty

William E Bennett, Benjamin M Whittam, Konrad M Szymanski, Richard C Rink, Mark P Cain, Aaron E Carroll
The objective of this study is to determine the cost and charge differences between patients undergoing open vs. robotic pyeloplasty. This is a retrospective analysis of the Pediatric Health Information System (PHIS) database in patients undergoing pyeloplasty between 2004 and 2013 conducted in large pediatric children's hospitals in the United States which contribute to PHIS. The participants included all pediatric patients undergoing pyeloplasty at these institutions. We assessed RCC-based cost, charge details, length of stay, and the presence of complications, and compared them between open and robotic cases...
October 20, 2016: Journal of Robotic Surgery
Alexander Roosen, Cagatay Dogan, H Nguyen, Markus Heiland, D Longwitz, Burkhard Ubrig
Purpose Diuretic renography (DRG) is commonly used to diagnose ureteropelvic junction obstruction (UPJO) and to evaluate the success of surgical repair (pyeloplasty). Duration, frequency and interpretation of renographic follow-ups are still under dispute. Methods We retrospectively reviewed 94 consecutive patients diagnosed with UPJO who underwent a minimally invasive, robotically assisted laparoscopic pyeloplasty at our institution between 01/2009 and 09/2015. DRG was carried out preoperatively and again routinely 4-6 weeks postoperatively the day after stent removal (early DRG)...
October 7, 2016: Journal of Endourology
Fuminori Sato, Ken Nakagawa, Akihiro Kawauchi, Akio Matsubara, Takatsugu Okegawa, Tomonori Habuchi, Koji Yoshimura, Akio Hoshi, Hidefumi Kinoshita, Akira Miyajima, Yasuyuki Naitoh, Shogo Inoue, Naoshi Itaya, Shintaro Narita, Kazuya Hanai, Kazutoshi Okubo, Masaaki Yanishi, Tadashi Matsuda, Toshiro Terachi, Hiromitsu Mimata
OBJECTIVE: To report on a multi-institutional series of non-robotic urological laparoendoscopic single-site surgery in Japan. METHODS: Consecutive cases of laparoendoscopic single-site surgery carried out between February 2009 and December 2012 at nine academic institutions were included. We examined the surgical outcomes, including conversion and complications rates. RESULTS: Four hundred and sixty-nine cases were included in the analysis...
October 4, 2016: International Journal of Urology: Official Journal of the Japanese Urological Association
Rishi Nayyar, Siddharth Yadav, Prabhjot Singh, Prem Nath Dogra
INTRODUCTION: It is believed that the outcomes of robotic surgery depends not only on the experience of the console surgeon but also the patient-side assistant. However, objective data supporting it is lacking. The aim of this study was to objectively determine change in operative outcomes with increasing experience of patient-side assistant. MATERIALS AND METHODS: We performed a retrospective analysis of 222 urologic robotic procedures performed by two teams of surgeon-assistant and split the data into two chronological halves according to date of surgery...
July 2016: Indian Journal of Urology: IJU: Journal of the Urological Society of India
Weil Ron Lai, Carrie Aline Stewart, Raju Thomas
Surgical management of ureteropelvic junction obstruction (UPJO) has historically been performed with open pyeloplasty. With the advent of endourology, laparoscopy, and robotics, minimally invasive techniques have been described and accepted as alternatives to open surgery. Each of these approaches has its own advantages and disadvantages, equipment needs, degree of invasiveness, and experience of the treating urologist. Advocates and critics have their own say as to their preferred technique. In this article, we review the chronological evolution of these techniques and discuss their current role in the management of UPJO...
August 22, 2016: Journal of Endourology
Marco Oderda, Giorgio Calleris, Marco Allasia, Ettore Dalmasso, Marco Falcone, Massimo Catti, Emilio Merlini, Paolo Gontero
OBJECTIVE: The aim of this study was to describe the technical aspects of a robotic pyeloplasty in pediatric patients with uretero-pelvic junction obstruction (UPJO) in horseshoe kidney (HSK) through the report of our recent case, and to outline the state of the art of minimally invasive pyeloplasty (MIP) with a systematic review of the literature. METHODS: We describe all the steps of our surgery performed on an 11-year-old patient with left UPJO in HSK in detail...
August 2, 2016: Urologia
Kentaro Mizuno, Yoshiyuki Kojima, Satoshi Kurokawa, Hideyuki Kamisawa, Hidenori Nishio, Yoshinobu Moritoki, Akihiro Nakane, Tetsuji Maruyama, Atsushi Okada, Noriyasu Kawai, Keiichi Tozawa, Kenjiro Kohri, Takahiro Yasui, Yutaro Hayashi
Robotic-assisted procedures are gaining traction as a viable form of minimally invasive surgery in the field of reconstructive surgery. In this article, the aim is to present our initial experience and clinical outcomes of robot-assisted laparoscopic pyeloplasty (RAL-P). We performed RAL-P in 22 patients for the management of ureteropelvic junction obstruction between December 2012 and August 2015. The da Vinci® S surgical system was utilized for all cases. All procedures were performed via a transperitoneal approach...
August 6, 2016: Journal of Robotic Surgery
Girdhar S Bora, DurgaPrasad Bendapudi, Ravimohan S Mavuduru, Santosh Kumar, Sudheer K Devana, Shrawan K Singh, Arup K Mandal
Traditionally, bilateral UPJO in adults was managed by the staged approach during the open surgery era, because of need for two separate incisions and change of patient positioning. In addition, there was a feared risk of post-operative bilateral renal obstruction. Even with advent minimal invasive laparoscopic surgery, simultaneous pyeloplasty did not pick up due to difficult suturing. However, robot-assisted surgery, with its distinct advantageous, had made it feasible. In this case series, we demonstrate safety and feasibility of bilateral simultaneous pyeloplasty over short term...
July 30, 2016: Journal of Robotic Surgery
Nicolò Maria Buffi, Giovanni Lughezzani, Rodolfo Hurle, Massimo Lazzeri, Gianluigi Taverna, Giorgio Bozzini, Riccardo Bertolo, Enrico Checcucci, Francesco Porpiglia, Nicola Fossati, Giorgio Gandaglia, Alessandro Larcher, Nazareno Suardi, Francesco Montorsi, Giuliana Lista, Giorgio Guazzoni, Alexandre Mottrie
BACKGROUND: Minimally invasive treatment of benign ureteral strictures is still challenging because of its technical complexity. In this context, robot-assisted surgery may overcome the limits of the laparoscopic approach. OBJECTIVE: To evaluate outcomes for robotic ureteral repair in a multi-institutional cohort of patients treated for ureteropelvic junction obstruction and ureteral stricture (US) at four tertiary referral centres. DESIGN, SETTING, AND PARTICIPANTS: This retrospective study reports data for 183 patients treated with standard robot-assisted pyeloplasty (PYP) and robotic uretero-ureterostomy (UUY) at four high-volume centres from January 2006 to September 2014...
July 26, 2016: European Urology
Michael V Hollis, Patricia S Cho, Richard N Yu
The laparoscopic approach to the pyeloplasty procedure has proven to be safe and effective in the pediatric population. Multiple studies have revealed outcomes comparable to the open approach. However, a major drawback to laparoscopy is the technical challenge of precise suturing in the small working space in children. The advantages of robotic surgery when compared to conventional laparoscopy have been well established and include motion scaling, enhanced magnification, 3-dimensional stereoscopic vision, and improved instrument dexterity...
December 2015: American Journal of Robotic Surgery
T D Davis, A S Burns, S T Corbett, C A Peters
INTRODUCTION: Reoperative pyeloplasty for recurrent ureteropelvic junction obstruction (UPJO) can be technically challenging and is associated with greater morbidity and lower success rates than an initial repair. Robotic-assisted laparoscopic pyeloplasty (RALP) previously has been demonstrated to be a safe and effective approach for management of recurrent UPJO; however, the length of follow-up has been limited. The objective of this study was to confirm the safety and efficacy of RALP for UPJO in children following failed previous pyeloplasty and provide clinical benchmarks for intermediate length follow-up in this patient population...
June 29, 2016: Journal of Pediatric Urology
Ashay Patel, Mark W Pickhardt, Nathan Littlejohn, Ismael Zamilpa, Mallikarjuna Rettiganti, Chunqiao Luo, Stephen Canon
INTRODUCTION: Robotic-assisted laparoscopic pyeloplasty (RALP) is increasingly becoming the standard procedure for management of ureteropelvic junction obstruction (UPJO) in the pediatric population, but few studies have shown a clear advantage over the more technically demanding laparoscopic pyeloplasty (LP) in children. The objective was to study the patients treated with RALP or LP at our institution and the associated outcomes for each minimally invasive approach for the correction of UPJO...
June 2016: Canadian Journal of Urology
M S Silay, A F Spinoit, S Undre, V Fiala, Z Tandogdu, T Garmanova, A Guttilla, A A Sancaktutar, B Haid, M Waldert, A Goyal, E C Serefoglu, E Baldassarre, G Manzoni, A Radford, R Subramaniam, A Cherian, P Hoebeke, M Jacobs, B Rocco, R Yuriy, Fabio Zattoni, R Kocvara, C J Koh
INTRODUCTION: Minimally invasive pyeloplasty (MIP) for ureteropelvic junction (UPJ) obstruction in children has gained popularity over the past decade as an alternative to open surgery. The present study aimed to identify the factors affecting complication rates of MIP in children, and to compare the outcomes of laparoscopic (LP) and robotic-assisted laparoscopic pyeloplasty (RALP). MATERIALS AND METHODS: The perioperative data of 783 pediatric patients (<18 years old) from 15 academic centers who underwent either LP or RALP with an Anderson Hynes dismembered pyeloplasty technique were retrospectively evaluated...
August 2016: Journal of Pediatric Urology
Diana K Bowen, Bruce W Lindgren, Earl Y Cheng, Edward M Gong
We sought to determine if the learning curve in pediatric robotic-assisted laparoscopic pyeloplasty (RALP) for an experienced open surgeon (OS) converting to robotics would be affected by proctoring from an experienced robotic surgeon (RS), and/or the experience of training within the framework of an established robotics program. We reviewed pediatric RALP cases by three surgeons at our institution, including the OS, RS, and a new fellowship-trained surgeon (FTS). We compared the first eight independent RALPs for the OS with the most recent ten RALPs for the RS...
June 24, 2016: Journal of Robotic Surgery
Young Beom Jeong, Oh Seok Ko, Hyung Sub Park, Jai Seong Cha, Seung Chol Park, Hyung Jin Kim, Jong Kwan Park, Yu Seob Shin
We present a case of ureteropelvic junction obstruction (UPJO) and renal cell carcinoma (RCC) in a solitary functioning kidney (SFK), managed by robot-assisted dismembered pyeloplasty with partial nephrectomy in a single stage. To our best knowledge, we report the first case of UPJO with RCC in a congenital SFK.
March 2016: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
Aaron M Potretzke, Anand Mohapatra, Jeffrey A Larson, Brian M Benway
No abstract text is available yet for this article.
May 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Jeffrey Law, Neal Rowe, Jason Archambault, Sofia Nastis, Alp Sener, Patrick P Luke
INTRODUCTION: We compared the outcomes of single-incision, robot-assisted laparoscopic pyeloplasty vs. multiple-incision pyeloplasty using the da Vinci robotic system. METHODS: We reviewed all consecutive robotic pyeloplasties by a single surgeon from January 2011 to August 2015. A total of 30 procedures were performed (16 single:14 multi-port). Two different single-port devices were compared: the GelPort (Applied Medical, Rancho Santa Margarita, CA) and the Intuitive single-site access port (Intuitive Surgical, Sunnyvale, CA)...
March 2016: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
Julia B Finkelstein, Jason P Van Batavia, Pasquale Casale
With increased experience, many laparoscopic procedures have evolved from mandatory same-day admission to the outpatient setting. Given the shorter operative time and length of stay, the potential to perform robotic surgery as an outpatient procedure exists. We sought to describe our initial experience with performing robotic-assisted laparoscopic pyeloplasty (RP) on children in an outpatient setting. We retrospectively reviewed a prospectively collected database of all patients undergoing RP from July 2012 to May 2014 by a single surgeon...
September 2016: Journal of Robotic Surgery
Igor Sorokin, Rebecca L O'Malley, Brian K McCandless, Ronald P Kaufman
INTRODUCTION: Intracorporeal suturing is considered to be the most challenging aspect of laparoscopic and robotic surgery. To overcome this problem, barbed self-retaining sutures have been effectively employed in various minimally invasive endourologic surgeries. However, the use of this suture has been recently cautioned for pyeloplasty due to a high failure rate. Our objective was to report our experience using barbed suture during robotic pyeloplasty. METHODS: We retrospectively identified 13 consecutive patients who underwent robotic pyeloplasty with a barbed monofilament (4-0 V-Loc™) suture for the ureteropelvic anastomosis from 2011 to 2014...
June 2016: Journal of Endourology
Philip A Fontenot, Ted R Capoccia, Bradley Wilson, Andrew Arthur, David A Duchene
OBJECTIVES: To review the objective and subjective success rates of robotic-assisted laparoscopic pyeloplasty in symptomatic patients with radiographic findings suggestive of uretero-pelvic junction obstruction (UPJO), but equivocal renal scans (diuretic T1/2 <20 minutes). METHODS: We reviewed 77 patients with symptomatic UPJO, who underwent robotic-assisted laparoscopic pyeloplasty between August 2006 and March 2013. We grouped patients by renal scan findings into 1 of 2 groups, obstructed (diuretic T1/2 ≥20 minutes) or equivocal (diuretic T1/2 <20 minutes)...
July 2016: Urology
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