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Pyeloplasty

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https://www.readbyqxmd.com/read/28061550/the-watertightness-of-the-anastomosis-after-laparoscopic-or-robot-assisted-pyeloplasty-is-a-drainage-necessary
#1
Annika Ruehle, Emilio Arbelaez, Agostino Mattei, Hansjörg Danuser
OBJECTIVE: To determine whether or not temporary drainage is necessary immediately following laparoscopic (lap) and robot-assisted (rob) pyeloplasty (PP). METHODS: Of 99 patients undergoing lap PP (n=23) or rob PP (n=76) for treatment of ureteropelvic junction obstruction (UPJO), 52 had no drainage, 47 were given an "easy flow" drain (EFD). The volume of leaking urine (in ml) was defined as the volume of drainage fluid (in ml) x creatinine concentration in drainage fluid (in μmol/ml) / median urine creatinine concentration (in μmol/ml)...
January 6, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28039051/pediatric-robot-assisted-redo-pyeloplasty-with-buccal-mucosa-graft-a-novel-technique
#2
Jennifer J Ahn, Michael E Shapiro, Jonathan S Ellison, Thomas S Lendvay
OBJECTIVE: To report a novel approach of pediatric robot-assisted redo pyeloplasty with buccal mucosa graft (BMG). METHODS: An IRB-approved retrospective review of all patients undergoing robot-assisted redo pyeloplasty with BMG at our institution was performed. OPERATIVE DETAILS: For all patients, the following ports were used: one 8.5mm camera, two 8mm robotic, and one 5mm assistant. Initial dissection was performed laparoscopically and robotically, and the ureter was incised longitudinally along the anterior surface...
December 27, 2016: Urology
https://www.readbyqxmd.com/read/28008756/cost-effectiveness-and-robot-assisted-urologic-surgery-does-it-make-dollars-and-sense
#3
Ryan W Dobbs, Brenden P Magnan, Nikita Abhyankar, Ashok K Hemal, Ben Challacombe, Jim Hu, Prokar Dasgupta, Francesco Porpiglia, Simone Crivellaro
INTRODUCTION: The introduction of the robotic surgical platform has led to distinct changes in practice patterns and the utilization of minimally invasive surgery in urology. While use of the robotic system is associated with improvements in perioperative outcomes such as estimated blood loss and hospital stay, there are significant fixed and variable costs with the purchase, maintenance and use of the robotics system that has led many authors to investigate the cost effectiveness of robotic urologic surgery...
December 22, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/27964829/the-role-of-voiding-cystourethrography-in-asymptomatic-unilateral-isolated-ureteropelvic-junction-obstruction-a-retrospective-study
#4
Mohammed S ElSheemy, Waleed Ghoneima, Mohammad Abdelwahhab, Waseem Aboulela, Kareem Daw, Ahmed M Shouman, Ahmed I Shoukry, Mohamed El Ghoneimy, Hany A Morsi, Hesham Badawy
INTRODUCTION: The presence of concomitant vesicoureteric reflux (VUR) and ureteropelvic junction obstruction (UPJO) is uncommon. Nevertheless, the reported VUR coexisting with asymptomatic unilateral isolated hydronephrosis (AUIH) requiring pyeloplasty for correction of UPJO was of low grade and mostly resolved during conservative follow-up. Therefore, VCUG may be not indicated in these children except if voiding symptoms, urinary tract infection (UTI), dilated ureters, or bladder and ureteric abnormalities are suspected...
November 24, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27939966/prediction-of-clinical-outcomes-in-prenatal-hydronephrosis-importance-of-gravity-assisted-drainage
#5
Rachael D Sussman, Emily S Blum, Bruce M Sprague, Massoud Majd, H Gil Rushton, Hans G Pohl
PURPOSE: In infants with SFU (Society for Fetal Urology) grade 3-4 congenital hydronephrosis, (99m)Tc-mercaptoacetyltriglycine diuretic renography assesses differential function and drainage half-time. We routinely also include the percent of radiotracer drained after 30 minutes of diuresis as well as after 15 minutes with the patient in the upright position. We investigated whether any 1 or more of these parameters on initial diuretic renography predicts persistent or worsening drainage parameters...
December 7, 2016: Journal of Urology
https://www.readbyqxmd.com/read/27936909/variation-in-the-use-of-open-pyeloplasty-minimally-invasive-pyeloplasty-and-endopyelotomy-for-the-treatment-of-ureteropelvic-junction-obstruction-in-adults
#6
Bruce L Jacobs, Julie C Lai, Rachana Seelam, Janet M Hanley, J Stuart Wolf, Brent K Hollenbeck, John M Hollingsworth, Andrew W Dick, Claude M Setodji, Christopher S Saigal
BACKGROUND AND PURPOSE: Ureteropelvic junction obstruction is a common condition that can be treated with open pyeloplasty, minimally invasive pyeloplasty, and endopyelotomy. While all these treatments are effective, the extent to which they are used is unclear. We sought to examine the dissemination of these treatments. PATIENTS AND METHODS: Using the MarketScan(®) database, we identified adults 18 to 64 years old who underwent treatment for ureteropelvic junction obstruction between 2002 and 2010...
January 5, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/27927021/cost-analysis-of-treatments-for-ureteropelvic-junction-obstruction
#7
Bruce L Jacobs, Rachana Seelam, Julie C Lai, Janet M Hanley, J Stuart Wolf, Brent K Hollenbeck, John M Hollingsworth, Andrew W Dick, Claude M Setodji, Christopher S Saigal
BACKGROUND AND PURPOSE: Ureteropelvic junction obstruction is a common urologic condition that accounts for approximately $12 million in inpatient spending annually. Few studies have assessed the costs related to treatment. We sought to examine the cost of care for patients treated for ureteropelvic junction obstruction. PATIENTS AND METHODS: We used the MarketScan(®) database to identify adults from 18 to 64 years old treated with minimally invasive pyeloplasty, open pyeloplasty, and endopyelotomy for ureteropelvic junction obstruction between 2002 and 2010...
January 5, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/27922703/robotkirurgi-p%C3%A3-bred-front-%C3%A2-utan-evidensbaserad-grund-tekniken-anv%C3%A3-nds-allt-mer-trots-att-den-%C3%A3-r-dyr-och-att-vetenskapliga-bevis-f%C3%A3-r-patientnytta-saknas
#8
Henrik Sjövall, Josefine Persson
Robot-assisted surgery on a broad front - without evidence for being cost-effective Robot-assisted surgery is currently heavily marketed. The HTA centre in Region Västra Götaland has produced five HTA reports regarding use of robot-assisted surgery in different clinical situations (prostatic cancer, benign gynaecological surgery, pediatric pyeloplasty and fundoplication, and rectal cancer), finding weak evidence for a patient value. The current report by Per Carlsson et al confirms that robot-assisted surgery indeed leads to increased costs that are not balanced by augmented patient value, i...
November 29, 2016: Läkartidningen
https://www.readbyqxmd.com/read/27914584/outcome-of-poorly-functioning-kidneys-secondary-to-pujo-preserved-by-pyeloplast
#9
Yasir Ahmad Lone, Ram Samujh, Anish Bhattacharya, Ravi Prakash Kanojia
AIMS: To study the intermediate term to long-term functional status of kidneys with split renal function(SRF) <15% secondary to PUJO which are preserved by pyeloplasty and to find out whether these kidneys can recover or eventually need nephrectomy. METHODS: 24 patients with SRF<15% and undergoing pyeloplasty with or without prior percutaneous nephrostomy (PCN) were studied. Those with associated VUR, B/L disease and redo pyeloplasties were excluded. Follow up USG and EC scan were done at 3, 9 and 18months and yearly thereafter to document functional status after surgery...
November 26, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27900220/use-of-fibrin-glue-as-a-sealant-at-the-anastomotic-line-in-laparoscopic-pyeloplasty-a-randomised-controlled-trial
#10
Ahmed Farouk, Ahmed Tawfick, Mohamed Kotb, Alaa Abdellmaksoud, Ahmed Safaan, Mohamed Yassin, Hassan Shaker
OBJECTIVE: To assess the effectiveness of fibrin glue as a sealant at the anastomotic line of a stentless laparoscopic pyeloplasty (LPP) repair instead of JJ stent insertion. PATIENTS AND METHODS: In all, 46 patients with pelvi-ureteric junction obstruction scheduled for LPP were randomised into two groups each containing 23 patients. Group A underwent stented repair, while group B had a stentless repair together with sealing of the anastomotic line with fibrin glue...
December 2016: Arab Journal of Urology
https://www.readbyqxmd.com/read/27894745/cevl-interactive-promoting-effective-teamwork-to-perform-robot-assisted-laparoscopic-pyeloplasty-in-pediatric-urology
#11
EDITORIAL
Belinda Li, Max Maizels, Dennis Liu, Edward Ming-Luan Gong, Bruce W Lindgren, Neha Malhotra, Diana Bowen, Sean Corbett
No abstract text is available yet for this article.
December 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27889223/laparoscopic-pyeloplasty-initial-experience-with-3d-vision-laparoscopy-and-articulating-shears
#12
Hiba Abou-Haidar, Talal Al-Qaoud, Roman Jednak, Alex Brzezinski, Mohamed El-Sherbiny, John-Paul Capolicchio
INTRODUCTION: Laparoscopic reconstructive surgery is associated with a steep learning curve related to the use of two-dimensional (2D) vision and rigid instruments. With the advent of robotic surgery, three-dimensional (3D) vision, and articulated instruments, this learning curve has been facilitated. We present a hybrid alternative to robotic surgery, using laparoscopy with 3D vision and articulated shears. OBJECTIVE: To compare outcomes of children undergoing pyeloplasty using 3D laparoscopy with articulated instruments with those undergoing the same surgery using standard laparoscopy with 2D vision and rigid instruments...
December 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27867849/laparoscopic-transposition-of-lower-pole-crossing-vessels-vascular-hitch-in-children-with-pelviureteric-junction-obstruction
#13
Ciro Esposito, Cosimo Bleve, Maria Escolino, Paolo Caione, Simona Gerocarni Nappo, Alessandra Farina, Maria Grazia Caprio, Mariapina Cerulo, Angela La Manna, Salvatore Fabio Chiarenza
BACKGROUND: Congenital hydronephrosis due to intrinsic or extrinsic uretero-pelvic-junction (UPJ) obstruction (UPJO) is a common problem in childhood UPJO may be caused by intrinsic disorganization or by extrinsic compression from crossing vessels (CV); extrinsic causes usually present symptomatically in older children. This report the large Italian experience in the treatment of children with extrinsic-UPJO by CV. METHODS: We analyzed the data of 51 children (17 girls and 34 boys, median age 10, 7 years) affected by extrinsic-UPJO were treated in three Italian institutions with laparoscopic transposition of CV (Hellström Vascular Hitch modified by Chapman)...
October 2016: Translational pediatrics
https://www.readbyqxmd.com/read/27867848/pyeloplasty-techniques-using-minimally-invasive-surgery-mis-in-pediatric-patients
#14
REVIEW
Francesco Turrà, Maria Escolino, Alessandra Farina, Alessandro Settimi, Ciro Esposito, François Varlet
Hydronephrosis is the most common presentation of ureteropelvic junction (UPJ) obstruction. We reviewed literature, collecting data from Medline, to evaluate the current status of minimally invasive surgery (MIS) approach to pyeloplasty. Since the first pyeloplasty was described in 1939, several techniques has been applied to correct UPJ obstruction, but Anderson-Hynes dismembered pyeloplasty is established as the gold standard, to date also in MIS technique. According to literature several studies underline the safety and effectiveness of this approach for both trans- and retro-peritoneal routes, with a success rate between 81-100% and an operative time between 90-228 min...
October 2016: Translational pediatrics
https://www.readbyqxmd.com/read/27856354/robotic-assisted-surgery-and-treatment-of-urolithiasis
#15
REVIEW
Khurram Mutahir Siddiqui, David Mois Albala
Advancement in surgical management of urolithiasis has revolved around improvements in technology. Urologists have been at the forefront on embracing new technology and passing on the benefits to the patients. Da Vinci(®) robotic system has contributed significantly in improving the outcomes of minimally invasive procedures especially those requiring complex resections and reconstruction. Endourological and percutaneous techniques have established superiority in management of urolithiasis and majority of the patients are ideal candidates for such procedures...
December 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27843217/robot-assisted-pyeloplasty-for-pelvi-ureteric-junction-obstruction-of-lower-moiety-in-partial-duplex-system-a-technical-challenge
#16
Girdhar S Bora, Kalpesh Parmar, Ravimohan S Mavuduru
Management of pelvi-ureteric junction obstruction (PUJO) in a duplex system is technically challenging as dissection at the pelvis may jeopardize the vascularity of the normal moiety ureter. Anastomosing the pelvis to the one single ureter will have a risk of future development of stricture which then will risk both the moieties. Robotic assistance enables appropriate tissue dissection; minimal handling of normal ureter and precision in suturing, overcoming the potential challenges involved in the minimally invasive management of such complex cases...
October 2016: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/27834569/influence-of-scars-on-body-image-consciousness-with-respect-to-gender-following-laparoendoscopic-single-site-versus-conventional-laparoscopic-surgery
#17
Masaaki Yanishi, Hidefumi Kinoshita, Takao Mishima, Hisanori Taniguchi, Kenji Yoshida, Yoshihiro Komai, Kaneki Yasuda, Masato Watanabe, Motohiko Sugi, Tadashi Matsuda
OBJECTIVE: The aim of this study was to evaluate and compare the cosmetic outcomes of laparoscopic single-site surgery (LESS) and conventional laparoscopy (CL) in the treatment of ureteropelvic junction obstruction (UPJO) and urachal remnant removal. LESS is thought to produce better cosmetic results than CL; however, patients' perception of their scars has not been assessed. This study compared the subjective body image and cosmesis ratings of patients who had undergone LESS or CL for UPJO and urachal remnant removal...
November 11, 2016: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/27829833/unusual-presentation-of-duplex-kidneys-ureteropelvic-junction-obstruction
#18
Cemile Başdaş, Süleyman Çelebi, Seyithan Özaydın, Birgül Karaaslan, Elmas Reyhan Alim, Ünal Güvenç, Serdar Sander
Aim. Ureteropelvic junction obstruction (UPJO) is rarely associated with a duplex collecting system. We review this unusual anomaly in terms of presentation, diagnostic evaluation, and surgical management. Method. We retrospectively reviewed the medical records of patients diagnosed with a duplex system with UPJO. Result. Sixteen patients (6 girls, 10 boys) with 18 moieties were treated surgically and four patients were treated conservatively. The median age at surgery was two years (range, 2 months to 7 years)...
2016: Advances in Urology
https://www.readbyqxmd.com/read/27789217/reoperative-laparoscopic-ureteropelvic-junction-obstruction-repair-in-children-safety-and-efficacy-of-the-technique
#19
Paulo Renato Marcelo Moscardi, João Arthur Brunhara Alves Barbosa, Hiury Silva Andrade, Marcos Figueiredo Mello, Bruno Nicolino Cezarino, Lorena Marçalo Oliveira, Miguel Srougi, Francisco Tibor Dénes, Roberto Iglesias Lopes
PURPOSE: Failure after pyeloplasty for ureteropelvic junction obstruction in children may occur in up to 10% of cases. Therapeutic options include Double-J® stent placement, endoscopic treatment and reoperation. Laparoscopic and robotic reoperative modalities seem safe and efficacious, although pediatric series are limited in the literature. We report the largest known series of reoperative laparoscopic ureteropelvic junction obstruction repair in children and compare this approach to primary laparoscopic pyeloplasty...
October 24, 2016: Journal of Urology
https://www.readbyqxmd.com/read/27785727/establishing-a-pediatric-robotic-surgery-program-in-canada
#20
Andreana Bütter, Neil Merritt, Sumit Dave
Despite the introduction of robotic surgery in 2000, few pediatric surgeons outside the United States have embraced this technology. We discuss our experience with establishing the first Canadian pediatric robotic surgery program. After simulator training, live animal surgery and observation of robotically assisted cases at an outside institution, we performed our first pediatric da Vinci(®) surgery in July 2013. A prospective database was established to assess outcomes. Forty one children have undergone robotically assisted surgery for the following 42 procedures: (a) pyeloplasty (17), (b) ureteral reimplantations (12), (c) uretero-uretostomy (1), (d) cholecystectomies (10), (e) interval appendectomy (1) and (f) distal pancreatectomy (1)...
October 26, 2016: Journal of Robotic Surgery
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