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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
#1
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
#2
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
#3
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
#4
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.
November 11, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27889223/laparoscopic-pyeloplasty-initial-experience-with-3d-vision-laparoscopy-and-articulating-shears
#5
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...
October 24, 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
#6
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
#7
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
#8
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...
November 14, 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
#9
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
#10
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
#11
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
#12
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
INTRODUCTION: Failure after pyeloplasty for Ureteropelvic Junction Obstruction (UPJO) in children may occur in up to 10% of cases. Treatment 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 here report on the largest series of reoperative laparoscopic UPJO repair in children and compared it to primary laparoscopic pyeloplasty...
October 24, 2016: Journal of Urology
https://www.readbyqxmd.com/read/27785727/establishing-a-pediatric-robotic-surgery-program-in-canada
#13
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
https://www.readbyqxmd.com/read/27784168/hospital-based-analysis-of-trends-and-outcomes-for-patients-undergoing-pyelolithotomy
#14
Charles U Nottingham, Andrew J Cohen, Vignesh T Packiam, Joseph J Pariser, Glenn S Gerber
OBJECTIVE: To determine trends in pyelolithotomy, evaluate risk factors for complications, and evaluate the difference in outcomes and charges between open and minimally invasive (MI) techniques. PATIENTS AND METHODS: We used the Nationwide Inpatient Sample to identify patients with a diagnosis of having nephrolithiasis undergoing pyelolithotomy from 2008 to 2012. Total charges were inflation-adjusted to U.S. dollars in 2012. Patient demographics, hospital characteristics, and outcomes were reported and compared between open and MI groups after survey weighting...
November 17, 2016: Journal of Endourology
https://www.readbyqxmd.com/read/27778495/laparoscopic-pyeloplasty-in-children-with-horseshoe-kidney
#15
Paulo Renato Marcelo Moscardi, Roberto Iglesias Lopes, Marcos Figueiredo Mello, Cristovao Machado Barbosa, Bruno Nicolino Cezarino, Lorena Marçalo Oliveira, Francisco Tibor Dénes, Miguel Srougi
INTRODUCTION: Horseshoe kidney occurs in 1 per 400-800 live births and are more frequently observed in males (M:F 2:1). Ureteropelvic junction obstruction (UPJO) is commonly associated with horseshoe kidneys. The variable blood supply, presence of the isthmus and high insertion of the ureter contribute to this problem. CASE REPORT: An asymptomatic 6 year-old boy presented with antenatal hydronephrosis. Ultrasonography and CT scan demonstrated left UPJO associated with a horseshoe kidney...
October 20, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/27775281/-efficacy-of-the-retroperitoneal-assisted-laparoscopic-pyeloplasty-versus-the-mini-posterior-lumbotomy-approach
#16
P Bragagnini Rodríguez, B Stors Sastre, R Fernández Atuan, R Delgado Alvira, M A Rihuete Heras, J Gracia Romero
OBJECTIVE: To evaluate the results of the retroperitoneal-assisted laparoscopic pyeloplasty (RALP) versus the mini posterior lumbotomy pyeloplasty (MPLP). MATERIAL AND METHODS: A retrospective study of 77 patients diagnosed with ureteropelvic junction obstruction between 2007 and 2013 was made, analyzing the surgical technique, complications and results. The anteroposterior pelvic diameter of the kidney, the thickness of the renal parenchyma, the renal function and the morphology of the renogram curve were also evaluated and compared...
April 15, 2015: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/27771423/short-term-complications-after-pyeloplasty-in-children-with-lower-urinary-tract-anomalies
#17
Rafal Chrzan, Wojciech Panek, Caroline F Kuijper, Peter Dik, Aart J Klijn, Keetje L de Mooij, Tom P de Jong
OBJECTIVE: To investigate whether children with lower urinary tract (LUT) anomalies are at greater risk for postoperative complications after laparoscopic pyeloplasty stented with a double-J catheter (JJC). MATERIALS AND METHODS: Prospectively collected data of laparoscopic pyeloplasty (LP) performed between 2006 and 2015 were analyzed. Inclusion criteria are (1) toilet-trained child and (2) unilateral dismembered pyeloplasty stented with a JJC done by the same surgeon...
October 19, 2016: Urology
https://www.readbyqxmd.com/read/27766551/validated-cost-comparison-of-open-vs-robotic-pyeloplasty-in-american-children-s-hospitals
#18
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
https://www.readbyqxmd.com/read/27765696/laparoscopic-versus-open-pyeloplasty-in-children-results-of-a-randomized-prospective-controlled-trial
#19
John M Gatti, Sable Amstutz, Paul R Bowlin, Heidi A Stephany, J Patrick Murphy
PURPOSE: Open dismembered pyeloplasty is the preferred repair for ureteropelvic junction (UPJ) obstruction. Minimally invasive techniques have been applied to the original open approach, but no clear advantage has been shown to these technological advances. We evaluate outcomes between transperitoneal laparoscopic (LP) and open pyeloplasty (OP) in children. METHODS: All children aged 1 to 18 years with UPJ obstruction requiring operative repair were offered enrollment in the study...
October 17, 2016: Journal of Urology
https://www.readbyqxmd.com/read/27765591/functional-and-morphological-outcomes-of-pyeloplasty-at-different-ages-in-prenatally-diagnosed-sfu-grade-3-4-upjo-is-it-safe-to-wait
#20
Dapeng Jiang, Bingqiang Tang, Maosheng Xu, Houwei Lin, Longhu Jin, Lei He, Guofeng Xu, Xiaoliang Fang, Hongquan Geng
OBJECTIVE: To evaluate changes in functional and morphological outcomes in children with prenatally diagnosed SFU grade 3-4 UPJO who underwent pyeloplasty at different ages. We also examined the effect of surgical wait time on recovery of renal function. MATERIALS AND METHODS: All patients (age, 0-12 months) with prenatally diagnosed SFU grade 3-4 UPJO who underwent pyeloplasty in a single center between January 2013 and December 2015 were reviewed. 133 children were enrolled in this study...
October 17, 2016: Urology
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