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https://www.readbyqxmd.com/read/29777349/robot-assisted-laparoscopic-pyeloplasty-a-single-centre-experience
#1
Thomas Charles Wood, Nicholas Raison, Oussama El-Hage, Kamran Ahmed, Declan Cahill, Benjamin J Challacombe, Muhammad Shamim Khan, Prokar Dasgupta
BACKGROUND: Ureteropelvic junction obstruction (UPJO) is characterised by an obstruction compromising the passage of urine from the renal pelvis into the ureter, and can be corrected by Robot-Assisted Laparoscopic Pyeloplasty (RALP). We aimed to evaluate the surgical outcomes of RALP, and examine the rates of true pain resolution following the procedure. METHODS: We retrospectively explored the records of all patients who underwent RALP between April 2005 and January 2017...
May 17, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29776869/outcomes-of-externalized-pyeloureteral-versus-internal-ureteral-stent-in-pediatric-robotic-assisted-laparoscopic-pyeloplasty
#2
D I Chu, D Shrivastava, J P Van Batavia, D K Bowen, C C Tong, C J Long, D A Weiss, A R Shukla, A K Srinivasan
INTRODUCTION: After pyeloplasty, urinary drainage options include internal double-J (DJ) ureteral stents or externalized pyeloureteral (EPU) stents, which can avoid bladder symptoms and additional anesthetic exposure from stent removal. Comparative outcome studies, however, are lacking following primary pediatric robotic-assisted laparoscopic pyeloplasty (RALP). OBJECTIVE: To compare operative success, operative time, hospitalization, and postoperative complications of EPU versus DJ stents following RALP...
May 7, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29775449/-dodatkowa-t%C3%A4-tnica-nerkowa-przyczyn%C3%A4-skrajnego-wodonercza-u-5-letniego-ch%C3%A5-opca
#3
Grażyna Krzemień, Jarosław Sołtyski, Agnieszka Szmigielska, Stanisław Warchoł, Teresa Dudek-Warchoł, Aleksandra Jakimów-Kostrzewa
Hydronephrosis in children is most often due to an intrinsic ureteropelvic junction obstruction or by compression on ureter by accessory renal artery coming from the aorta to the lower pole of the kidney. AIM: The aim of study was to present a case with a late onset of hydronephrosis caused by accessory renal artery. CASE REPORT: 5-year old boy with a mild pyelectasia during first 10 months of age was admitted to hospital because of abdominal pain and vomiting. Abdominal ultrasound revealed a marked dilatation of the right pelvicalyceal system with renal pelvis measuring 23 mm in anterior-posterior (ap) diameter, enlargement of calyces to 10 mm and narrowed cortex to 5 mm...
April 23, 2018: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29775448/pyonephrosis-as-the-first-symptom-of-congenital-hydronephrosis-in-a-6-year-old-girl
#4
Teresa Dudek-Warchoł, Stanisław Warchoł, Przemysław Bombiński, Krzysztof Toth, Agnieszka Szmigielska, Garżyna Krzemień
Pyonephrosis in the course of hydronephrosis usually provides to total or near-total loss of renal function. In adults pyonephrosis usually results from urolithiasis. In children usually congenital urinary tract anomalies are present as contributing factors. CASE REPORT: 6-year old girl was admitted to the hospital because of 2-day history of high fever, abdominal pain, progressive deterioration of general condition and ultrasonographically (US) detected left hydronephrosis. US on admission showed grossly dilated left renal collecting system together with extensive echogenic debris and laboratory tests highly elevated inflammatory markers...
April 23, 2018: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29774814/robotic-pyeloplasty
#5
Andrew Bergersen, Raju Thomas, Benjamin R Lee
Historically, the gold standard for management of ureteropelvic junction obstruction (UPJO) has been open pyeloplasty. However, continued technological and surgical advances have ultimately led to the robotic approach. Continued advances in minimally invasive surgery have led to shorter hospital stays and hastened recovery. Here we present our step by step guide and video to robotic-assisted laparoscopic pyeloplasty.
May 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29774813/robotic-laparoendoscopic-single-site-pyeloplasty-and-nephrectomy-chapter
#6
Igor Sorokin, Jeffrey A Cadeddu
Robotic laparoendoscopic single site (RLESS) for upper tract procedures is safe and feasible in the correctly selected patient. An ideal candidate is young, has a low body mass index, and is undergoing surgery for benign indications. For RLESS procedures, we utilize a GelPOINT® access platform for "single-port" placement and ports are configured in a diamond shape. Five millimeter EndoWrist® robotic instruments are placed under direct vision. Range of motion is increased by utilizing the chopstick technique...
May 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29764771/external-stent-in-laparoscopic-pyeloplasty-the-k-wire-technique
#7
A Upasani, A Paul, A Cherian
The majority of surgeons leave internal stents following laparoscopic pyeloplasty, which necessitates a second anaesthetic for removal. A novel technique of placing external nephro-ureteric stents, thus obviating a second procedure for retrieval, is shown in this video bank. As demonstrated in the video, a Kirschner wire (K-wire) is used to thread the stent in place. Although, there are few reports of using externalised stents in laparoscopic pyeloplasty, it is believed that this technique has not been previously described...
April 26, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29754252/laparoscopic-single-incision-triangulated-umbilical-surgery-situs-pyeloplasty-a-description-of-the-first-32-cases
#8
Martin Habicher, Theodoros Tokas, Thomas Rw Herrmann, Udo Nagele
INTRODUCTION AND OBJECTIVES: Transumbilical laparoendoscopic (LESS) procedures reduce access trauma. Laparoendocopic single-incision triangulated umbilical surgery (SITUS) utilizes straight instruments in a triangulated fashion, via three trocars placed through a single umbilical incision. METHODS: Thirty-two consecutive patients underwent an SITUS pyeloplasty. Access is performed by incision of the umbilical fold by 3/4 of its circumference, a 5-mm camera port, and consequently, cranial and caudal 3 or 5 mm working trocars are placed at a distance of 3-6 cm, thus allowing triangulation...
May 12, 2018: World Journal of Urology
https://www.readbyqxmd.com/read/29751025/laparoscopic-yang-monti-ureteral-reconstruction-in-children
#9
Dehong Liu, Huixia Zhou, Xuemei Hao, Hualin Cao, Lifei Ma, Xiaoguang Zhou, Tian Tao, Wei Cheng, Zhichun Feng
OBJECTIVE: To investigate the clinical outcome of surgical treatment for long ureteral defect in children, we evaluated our experience of managing six children with the long defect utilizing laparoscopic ureteral reconstruction technique using Yang-Monti technique. MATERIALS AND METHODS: Six children with long ureteral defect who underwent laparoscopic Yang-Monti ureteral reconstruction between January 2013 and March 2016 were reviewed. The diagnosis and outcomes of long ureteral defects were reviewed based on clinical and imaging data...
May 8, 2018: Urology
https://www.readbyqxmd.com/read/29744478/relative-to-open-surgery-minimally-invasive-renal-and-ureteral-pediatric-surgery-offers-no-improvement-in-30-day-complications-yet-requires-longer-operative-time-data-from-the-national-surgical-quality-improvement-program-pediatrics
#10
Marc Colaco, Austin Hester, William Visser, Alison Rasper, Ryan Terlecki
Purpose: Performance of minimally-invasive surgery (MIS) is increasing relative to open surgery. We sought to compare the contemporary rates of short-term complications of open versus laparoscopic renal and ureteral surgery in pediatric patients. Materials and Methods: A retrospective cross-sectional analysis of the National Surgical Quality Improvement Program Pediatrics database was performed of all cases in 2014 identified using CPT procedure codes for nephrectomy, partial nephrectomy (PN), ureteroneocystostomy (UNC), and pyeloplasty, and reviewed for postoperative complications...
May 2018: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/29738332/anesthetic-care-of-2-siblings-with-neonatal-ichthyosis-and-sclerosing-cholangitis-syndrome-case-reports
#11
Céline Khalifa, Geoffrey Boliaki Botombe, Xavier Stephenne, Francis Veyckemans
We report for the first time the anesthetic management of 2 sisters suffering from neonatal ichthyosis and sclerosing cholangitis syndrome. They both presented with neonatal cholestatic jaundice and ichthyosis. The first was admitted for orthotopic liver transplantation at the age of 1 year, and the second patient underwent open pyeloplasty for a pyeloureteric junction syndrome at the age of 4 years. These 2 case reports highlight that, except for the potential difficulties with securing the catheters, dressings and endotracheal tube to the skin, the anesthetic implications of neonatal ichthyosis and sclerosing cholangitis syndrome are mainly related to the liver disease: cirrhosis and portal hypertension...
May 7, 2018: A&A practice
https://www.readbyqxmd.com/read/29725594/transperitoneal-mini-laparoscopic-pyeloplasty-in-flank-position-a-safe-method-for-infants-and-young-adults
#12
Beatriz Bañuelos Marco, Tom Florian Fuller, Frank Friedersdorff, Ricardo González, Anja Lingnau
Introduction and Objectives: Open dismembered pyeloplasty has been the gold standard treatment for ureteropelvic junction obstruction in children. Laparoscopic pyeloplasty (LP) is becoming a standard procedure, but its acceptance is slow. We report our method for minilaparoscopy (MLP) in children using a tansperitoneal approach with the patient in the lateral flank decubitus which we found technically advantageous. Materials and Methods: Retrospective review of the records of 52 children and adolescents up to 18 years of age who underwent transperitoneal MLP at our institution during March 2012-October 2017 A 5 mm trocar is placed for the camera at the site of the umblicus by open technique, two 3 mm trocars placed in the upper and lower quadrants of the abdomen...
2018: Frontiers in Surgery
https://www.readbyqxmd.com/read/29668355/a-prospective-comparative-study-of-continuous-and-interrupted-suturing-in-laparoscopic-pyeloplasty-in-3d-era
#13
Manickam Ramalingam, Senthil Kallappan, Sivasankaran Nachimuthu
INTRODUCTION: Laparoscopic pyeloplasty is becoming the gold standard procedure for pelviureteric junction obstruction. The outcome of pyeloplasty depends on precise pyeloureteral anastomosis. Though in open pyeloplasty interrupted or continuous suture are practiced, in most of the laparoscopic or laparoscopy-assisted robotic pyeloplasty continuous suturing is practiced. After acquiring a 3-dimensional (3D) camera, we prospectively analyzed the suturing time, complication rate, and success rate between interrupted and continuous suturing in laparoscopic pyeloplasty...
April 18, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29610048/is-the-renal-pyramidal-thickness-a-good-predictor-for-pyeloplasty-in-postnatal-hydronephrosis
#14
Amr Hodhod, John-Paul Capolicchio, Roman Jednak, Hadeel Eid, Abd El-Alim El-Doray, Mohamed El-Sherbiny
OBJECTIVES: We evaluated the feasibility and value of renal pyramidal thickness (PT) as a predictor of pyeloplasty in high-grade postnatal hydronephrosis. PATIENTS AND METHODS: We retrospectively reviewed the charts of patients who presented with postnatal hydronephrosis from 2008 to 2013. Included cases had grade 3 or 4 hydronephrosis. We included only units diagnosed as ureteropelvic junction obstruction. Gender, laterality, hydronephrosis side, renogram data, and follow-up data were recorded...
March 20, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29530407/has-the-robot-caught-up-national-trends-in-utilization-perioperative-outcomes-and-cost-for-open-laparoscopic-and-robotic-pediatric-pyeloplasty-in-the-united-states-from-2003-to-2015
#15
Briony K Varda, Ye Wang, Benjamin I Chung, Richard S Lee, Michael P Kurtz, Caleb P Nelson, Steven L Chang
INTRODUCTION: Since 2010, there have been few new data comparing perioperative outcomes and cost between open (OP) and robotic pyeloplasty (RP). In a post-adoption era, the value of RP may be converging with that of OP. OBJECTIVE: To 1) characterize national trends in pyeloplasty utilization through 2015, 2) compare adjusted outcomes and median costs between OP and RP, and 3) determine the primary cost drivers for each procedure. STUDY DESIGN: We performed a retrospective cohort study using the Premier database, which provides a nationally representative sample of U...
February 22, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29525534/the-evaluation-of-three-comorbidity-indices-in-predicting-postoperative-complications-and-readmissions-in-pediatric-urology
#16
Ruiyang Jiang, Steven Wolf, Muhammad H Alkazemi, Gina-Maria Pomann, J Todd Purves, John S Wiener, Jonathan C Routh
INTRODUCTION: The surgical comorbidity assessment is important for patient risk stratification, counseling, and research. In adults, risk assessment indices, such as the Charlson Co-morbidity Score (CCS) or Van Walraven Index (VWI), are well established. In pediatrics, however, risk assessment indices are scarce. Recently, a pediatric-specific risk assessment index, the Rhee index, was developed to discriminate mortality for pediatric general surgery patients. Currently, there is no validated risk assessment tool in pediatric urology...
February 26, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29518792/predictive-factors-of-contralateral-operation-after-initial-pyeloplasty-in-children-with-antenatally-detected-bilateral-hydronephrosis-due-to-ureteropelvic-junction-obstruction
#17
Dapeng Jiang, Zhoutong Chen, Houwei Lin, Maosheng Xu, Hongquan Geng
OBJECTIVES: This study was performed to analyze the predictive factors of a contralateral operation after initial pyeloplasty in patients with antenatally detected bilateral ureteropelvic junction obstruction. METHODS: Patients with prenatally diagnosed bilateral ureteropelvic junction obstruction who underwent initial pyeloplasty (aged <12 months at initial pyeloplasty) were offered to participate in the study. Patients were recruited from January 2012 to December 2015...
2018: Urologia Internationalis
https://www.readbyqxmd.com/read/29502388/horseshoe-kidney-and-uretero-pelvic-junction-obstruction-in-a-pediatric-patient-laparoscopic-vascular-hitch-a-valid-alternative-to-dismembered-pyeloplasty
#18
Cosimo Bleve, Valeria Bucci, Maria Luisa Conighi, Francesco Battaglino, Lorenzo Costa, Lorella Fasoli, Elisa Zolpi, Salvatore Fabio Chiarenza
Horseshoe kidney (HSK) is a congenital defect of the urinary tract that occurs in 0.25% of the general population. Laparoscopic Vascular Hitch (LVH) according to Hellstrom-Chapman represent an alternative approach in treatment of extrinsic hydronephrosis by crossing vessels (CV) in pediatric age. In our Department from 2006 to 2016, 36 children with extrinsic-Uretero-Pelvic-Junction (UPJ)-Obstruction (UPJO) underwent laparoscopic vessels transposition. Over the last 4years, we have treated three patients with extrinsic hydronephrosis in HSK; two males and one female respectively of 6, 7 and 8years...
December 13, 2017: La Pediatria Medica e Chirurgica: Medical and Surgical Pediatrics
https://www.readbyqxmd.com/read/29501380/risk-factors-for-postobstructive-diuresis-in-pediatric-patients-with-ureteropelvic-junction-obstruction-following-open-pyeloplasty-in-three-high-complexity-institutions
#19
Adriana M Pedraza Bermeo, Ana María Ortiz Zableh, Mariangel Castillo, Jaime Francisco Pérez Niño
INTRODUCTION: Postobstructive diuresis (POD) is a polyuric state in which large quantities of salt and water are eliminated after solving a urinary tract obstruction. These patients are at increased risk of severe dehydration, electrolytic disturbances, hypovolemic shock, and death. Ureteropelvic junction obstruction (UPJO) is the most common etiology of collecting system dilatation in the fetal kidney, and a significant number of patients require pyeloplasty. There are limited data regarding prognostic risk factors for POD in this scenario...
February 20, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29499256/resolution-of-diabetes-insipidus-after-pyeloplasty-a-case-report-and-review-of-the-literature
#20
Christina P Carpenter, Ashley Rawson, David S Hains, Dana W Giel
Nephrogenic diabetes insipidus (NDI), a rare cause of polyuria and polydipsia in children, is usually managed with medications and careful monitoring of water intake. We present a child who was incidentally found to have right hydronephrosis secondary to ureteropelvic junction obstruction, and was subsequently also diagnosed with NDI. After being medically managed, he underwent open right pyeloplasty. His polydipsia abated within 1 month of surgery, and he has done well off of medications since that time. NDI resolution after correction of obstructive uropathy in adults has been reported, but this represents a novel case in pediatrics...
February 28, 2018: Urology
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