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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...
January 15, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Melinda Wolboldt, Barbara Saltzman, Patrick Tenbrink, Khaled Shahrour, Samay Jain
INTRODUCTION: With healthcare reform, cost and patient satisfaction will directly affect hospital reimbursement. We present data on same day discharge (SDD) for patients who underwent robot assisted laparoscopic radical prostatectomy (RALP). METHODS: Patient data were gathered in an IRB approved database. In April 2015, surgeon (SJ) began SDD. The SDD protocol for RALP includes multimodal anesthesia/analgesia and extended recovery. Interim analysis revealed that government insurance (CMS) refused hospital reimbursement for SDD...
October 19, 2016: Journal of Endourology
Karan Wadhwa, Giulio Patruno, Andrew Patterson, Tristan Barrett, Chandni Dalia, Brendan C Koo, Ferdia A Gallagher, Eva Serrao, Anne Warren, Vincent Gnanapragasam, Nimish Shah, Andrew Doble, Christof Kastner
BACKGROUND: To assess if transperineal prostate (TP) biopsy affects the outcome of robotic-assisted laparoscopic prostatectomy (RALP), with particular reference to peri-operative complications, oncological results and functional outcomes in the early post operative setting. METHODS: We identified 61 men who had undergone RALP after TP biopsies, from June 2012 to June 2014 and a control group of 120 men who had undergone RALP after conventional TRUS biopsy in the same period...
September 29, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Nozomu Kishimoto, Tetsuya Takao, Gaku Yamamichi, Takuya Okusa, Ayumu Taniguchi, Koichi Tsutahara, Go Tanigawa, Seiji Yamaguchi
PURPOSE: To evaluate the influence of prior abdominal surgery on the outcomes after robotic-assisted laparoscopic radical prostatectomy (RALP). MATERIALS AND METHODS: We retrospectively analyzed patients with prostate cancer who underwent RALP between June 2012 and February 2015 at our institution. Patients with prior abdominal surgery were compared with those without prior surgery while considering the mean total operating, console, and port-insertion times; mean estimated blood loss; positive surgical margin rate; mean duration of catheterization; and rate of complications...
September 1, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Jun H Song, Joshua R Kaplan, Daniel Abbott, Eric Gewirtz, Ellen Hauck, Daniel D Eun
Obturator nerve injury is a known injury after robot-assisted laparoscopic radical prostatectomy (RALP) and patients often present with motor and sensory deficits in the immediate postoperative period. We describe a 65-year-old male who presented with motor deficits, indicative of obturator neurapraxia after RALP upon waking from anesthesia. Work-up revealed an expansile hematoma possibly compressing the obturator nerve. After evacuation of the hematoma, the patient had immediate improvement of his neurologic deficits...
2016: J Endourol Case Rep
Ashima Singal, Christopher M Gonzalez, Daniel Oberlin, Justin S Han
Vesicourethral anastomotic (VUA) disruption with bladder displacement into the abdominal cavity following robot-assisted laparoscopic prostatectomy (RALP) is an exceedingly rare complication. There have been no cited case reports after robotic surgery but case reports after open radical prostatectomy have been noted. Other complications related to VUA include bleeding with or without pelvic hematoma, bladder neck contracture, or severe stress urinary incontinence. Following radical prostatectomy, studies estimate the rate of VUA leakage to be 1...
2016: J Endourol Case Rep
Aya Doe, Motoi Kumagai, Yuichiro Tamura, Akira Sakai, Kenji Suzuki
PURPOSE: Steep Trendelenburg position and pneumoperitoneum during robotic-assisted laparoscopic prostatectomy (RALP) increase intracranial pressure (ICP) and may alter cerebral blood flow (CBF) and oxygenation. Volatile anesthetics and propofol have different effects on ICP, CBF, and cerebral metabolic rate and may have different impact on cerebral oxygenation during RALP. In this study, we measured jugular venous bulb oxygenation (SjO2) and regional oxygen saturation (SctO2) in patients undergoing RALP to evaluate cerebral oxygenation and compared the effects of sevoflurane and propofol...
August 26, 2016: Journal of Anesthesia
Glen D R Santok, Ali Abdel Raheem, Lawrence H C Kim, Kidon Chang, Trenton G H Lum, Byung H Chung, Young D Choi, Koon H Rha
OBJECTIVE: To investigate the effect of preoperative prostate volume (PV) on the perioperative, continence and early oncological outcomes among patients treated with Retzius-sparing robot-assisted laparoscopic radical prostatectomy (RS-RALP). PATIENTS AND METHODS: This is a retrospective analysis of 294 patients with organ-confined prostate cancer treated with RS-RALP in a high-volume centre from November 2012 to February 2015. Patients were divided into three groups based on their transrectal ultrasonography estimated PV as follows: group 1, <40 mL (231 patients); group 2, 40-60 mL (47); group 3, >60 mL (16)...
August 18, 2016: BJU International
Jung Ki Jo, Jong Jin Oh, Sangchul Lee, Seong Jin Jeong, Sung Kyu Hong, Seok-Soo Byun, Sang Eun Lee
PURPOSE: To identify the perioperative and oncological impact of different intervals between biopsy and robot-assisted laparoscopic radical prostatectomy (RALP) for localized prostate cancer. METHODS: All consecutive patients with localized prostate cancer who underwent RALP with primary curative intent in January 2008-July 2014 in a large tertiary hospital were enrolled in this retrospective cohort study. The patients were divided into groups according to whether the biopsy-RALP interval was ≤2, ≤4, ≤6, or >6 weeks...
August 1, 2016: World Journal of Urology
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
Jung Ki Jo, Sung Kyu Hong, Seok Soo Byun, Homayoun Zargar, Riccardo Autorino, Sang Eun Lee
PURPOSE: To assess the impact of intravesical prostatic protrusion (IPP) on the outcomes of robot-assisted laparoscopic prostatectomy (RALP). MATERIALS AND METHODS: The medical records of 1094 men who underwent RALP from January 2007 to March 2013 were analyzed using our database to identify 641 additional men without IPP (non-IPP group). We excluded 259 patients who presented insufficient data and 14 patients who did not have an MRI image. We compared the following parameters: preoperative transrectal ultrasound, prostate specific antigen (PSA), clinicopathologic characteristics, intraoperative characteristics, postoperative oncologic characteristics, minor and major postoperative complications, and continence until postoperative 1 year...
September 2016: Yonsei Medical Journal
Matthew N Simmons, Michelle Fitts, Timothy Krigbaum, Andrew D Neeb
OBJECTIVE: To evaluate outcomes for 144 robotic-assisted laparoscopic prostatectomies (RALP) conducted upon introduction of a robotic surgery program in a community hospital. METHODS: Patient data was reviewed for 144 patients who underwent RALP from January 2013 through February 2015. Complications, oncologic and functional outcomes were assessed. Student's t-test and ANOVA were used to compare differences among study groups. RESULTS: Median age was 64 (IQR 60-68), and median PSA was 5...
July 7, 2016: 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
Akash Bijlani, April E Hebert, Mike Davitian, Holly May, Mark Speers, Robert Leung, Nihal E Mohamed, Henry S Sacks, Ashutosh Tewari
BACKGROUND: The economic value of robotic-assisted laparoscopic prostatectomy (RALP) in the United States is still not well understood because of limited view analyses. OBJECTIVES: The objective of this study was to examine the costs and benefits of RALP versus retropubic radical prostatectomy from an expanded view, including hospital, payer, and societal perspectives. METHODS: We performed a model-based cost comparison using clinical outcomes obtained from a systematic review of the published literature...
June 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Daniel Ramirez, Vishnu Ganesan, Ryan J Nelson, Georges-Pascal Haber
OBJECTIVE: To describe our technique for performing robotic-assisted laparoscopic prostatectomy (RALP) and pelvic lymph node dissection using only 3 robotic instruments to reduce disposable costs associated with the robotic surgical platform. METHODS: The financial impact of robotic surgery is real. Whereas the initial capital investment of the robotic platform (including the cost of the device itself and the maintenance contract) is largely fixed, the cost of disposable instrumentation can vary depending on utilization...
September 2016: Urology
Roger Li, Brian Hu
Ectopic ureter and ureterocele are rare congenital anomalies. As such, are seldom encountered incidentally during urologic surgery. We present a case illustrating an unforeseen encounter of an ectopic ureter with an associated ureterocele during a robotic assisted laparoscopic prostatectomy (RALP) and the surgical technique used to adapt to the anatomical variation.
September 2016: Urology Case Reports
Jihad H Kaouk, Oktay Akca, Homayoun Zargar, Peter Caputo, Daniel Ramirez, Hiury Andrade, Selami Albayrak, Humberto Laydner, Kenneth Angermeier
OBJECTIVE: To minimize technical challenges of radical perineal prostatectomy (RPP), we conceived and applied the robotic approach to this technique in an aim to improve surgical applicability of RPP. Radical prostatectomy via the perineal route, avoiding the intra-abdominal cavity, has been shown to be oncologically safe, with excellent functional outcomes and a short hospital stay. We report our initial results with this novel approach. MATERIALS AND METHODS: We performed the procedure in 4 patients...
August 2016: Urology
Jesús Moreno Sierra, M Ciappara Paniagua, M I Galante Romo, J L Senovilla Pérez, E Redondo González, M I Galindo Herrero, N Novo Gómez, J Blázquez Izquierdo
INTRODUCTION: Radical prostatectomy is a more skillful procedure in kidney graft recipients. Robotic surgery can provide a useful minimally invasive tool. OBJECTIVES: The study aims to evaluate the robotic-assisted laparoscopic prostatectomy (RALP) in kidney transplant recipients, describing intra/postoperative complications, renal and oncological outcomes. METHODS: This is a retrospective study conducted in a single institution of 84 RALP...
May 24, 2016: Urologia Internationalis
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