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https://www.readbyqxmd.com/read/29343662/cost-benefit-performance-simulation-of-robot-assisted-thoracic-surgery-as-required-for-financiall-viability-under-the-2016-revised-reimbursement-paradigm-of-the-japanese-national-health-insurance-system
#1
Naohiro Kajiwara, Yasufumi Kato, Masaru Hagiwara, Masatoshi Kakihana, Tatsuo Ohira, Norihiko Kawate, Norihiko Ikeda
PURPOSE: To discuss the cost-benefit performance (CBP) and establish a medical fee system for robotic-assisted thoracic surgery (RATS) under the Japanese National Health Insurance System (JNHIS), which is a system not yet firmly established. METHODS: All management steps for RATS are identical, such as preoperative and postoperative management. This study examines the CBP based on medical fees of RATS under the JNHIS introduced in 2016. RESULTS: Robotic-assisted laparoscopic prostatectomy (RALP) and robotic-assisted partial nephrectomy (RAPN) now receive insurance reimbursement under the category of use of support devices for endoscopic surgery ($5420 and $3485, respectively)...
January 17, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29334304/switching-from-laparoscopic-radical-prostatectomy-to-robot-assisted-laparoscopic-prostatectomy-comparing-oncological-outcomes-and-complications
#2
Ida Johnson, Fredrik Ottosson, Lien My Diep, Rolf Eigil Berg, Jon-Roar Hoff, Nicolai Wessel, Lars Magne Eri, Viktor Berge
OBJECTIVES: To compare oncological outcomes and complication rates based on the Clavien classification between laparoscopic radical prostatectomies (LRP) and robot-assisted laparoscopic radical prostatectomies (RALP). MATERIAL AND METHODS: In a prospective quality registry clinical data were consecutively entered for 544 LRP and 1081 RALP patients operated from 2003 to the end of 2012. Complications within 90 days postoperatively were assessed according to the Clavien classification and compared between LRP and RALP patients...
January 15, 2018: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/29279663/nerve-bundle-hydrodissection-and-sexual-function-after-robot-prostatectomy
#3
Hannah Wenger, Aria Razmaria, Scott Eggener, Jay D Raman
Background and Objectives: Loss of erectile function is common after prostatectomy, and surgeons have long sought techniques that reduce this adverse outcome. This study was conducted to assess erectile function after robot-assisted laparoscopic prostatectomy, with and without hydrodissection (HD) of the neurovascular bundles (NVBs). Methods: Using a database of 335 consecutive RALP procedures conducted by 2 surgeons, we identified all nerve-sparing surgeries performed by HD or standard dissection (SD)...
October 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/29234260/can-anterior-prostatic-fat-harbor-prostate-cancer-metastasis-a-prospective-cohort-study
#4
Mohannad Hosny, Bhavan Rai, Feras Aljaafari, Samita Agarwal, Thomas McNicholas, Gregory Boustead, Thimothy Lane, James Adshead, Nikhil Vasdev
Objectives: Traditionally anterior prostatic fat (APF) hasn't been included in pelvic lymph node (LN) dissection templates following radical prostatectomy. In this study we evaluate the incidence of lymphoid tissue in the APF and the incidence of LN metastasis in APF in patients who have undergone robotic-assisted laparoscopic radical prostatectomy (RALP). Methods: A prospective database of RALP has been maintained between January 2010 and September 2015. APF is routinely excised and sent separately for histopathological evaluation to identify lymphoid tissue and metastatic prostate cancer...
November 2017: Current Urology
https://www.readbyqxmd.com/read/29212368/impact-of-variations-in-prostatic-apex-shape-on-apical-margin-positive-rate-after-radical-prostatectomy-robot-assisted-laparoscopic-radical-prostatectomy-versus-open-radical-prostatectomy
#5
Young Dong Yu, Minseung Lee, Sung Kyu Hong, Seok-Soo Byun, Sang Eun Lee, Sangchul Lee
AIM: To evaluate the effects of prostatic apex shape variations on positive apical margin rate (PAM) after radical prostatectomy (RP) by undertaking a comparative study of robot-assisted laparoscopic radical prostatectomy (RALP) versus open radical prostatectomy (ORP). METHODS: A total 3,324 cases of RP (1,004 ORP and, 2,320 RALP) from January 2004 to March 2017 were retrospectively reviewed. All patients underwent preoperative magnetic resonance imaging (MRI) and the cohorts were stratified into 4 categories according to prostatic apical shape at the mid-sagittal plane...
December 6, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/29197360/psychometric-properties-of-the-expanded-prostate-cancer-index-composite-26-instrument-in-a-cohort-of-radical-prostatectomy-patients-theoretical-and-practical-examinations
#6
Karol Axcrona, Rasmus Nilsson, Bjørn Brennhovd, Øystein Sørebø, Sophie D Fosså, Alv A Dahl
BACKGROUND: Recently, the Expanded Prostate Cancer Index Composite 26-item version (EPIC-26) was recommended for the assessment of adverse effects after the treatment of prostate cancer without clear reasons. This decision encouraged us to review the questionnaire development from the UCLA Prostate Cancer Index (UCLA-PCI) to the EPIC-16 CP with a focus on psychometric properties. We also reviewed PubMed for papers concerning such properties of the EPIC-26 since 2012 (latest review in 2011)...
December 2, 2017: BMC Urology
https://www.readbyqxmd.com/read/29181778/retzius-space-reconstruction-following-transperitoneal-laparoscopic-robot-assisted-radical-prostatectomy-does-it-have-any-added-value
#7
Yasmin Abu-Ghanem, Zohar Dotan, Jacob Ramon, Dorit E Zilberman
Retzius space sparing (RSS) during laparoscopic robot-assisted radical prostatectomy (RALP) has been offered as an approach that reduces perioperative complications and enables faster gaining of full urinary continence due to bladder anatomy preservation. Retro and transperitoneal techniques have been proposed, whereby RSS has been implemented. We sought to explore whether Retzius space reconstruction (RSR) following transperitoneal RALP will be an advantageous step as well. A prospective registry database of 102 consecutive transperitoneal RALP cases performed by a single surgeon was reviewed...
November 27, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29177945/removing-the-urinary-catheter-on-post-operative-day-2-after-robot-assisted-laparoscopic-radical-prostatectomy-a-feasibility-study-from-a-single-high-volume-referral-centre
#8
Aldo Brassetti, Flavia Proietti, Antonio Cardi, Antonio De Vico, Antonio Iannello, Alberto Pansadoro, Aldo Scapellato, Tommaso Riga, Paolo Emiliozzi, Gianluca D'Elia
The indwelling urinary catheter (UC) is a significant bother for men after radical prostatectomy (RP) and should be removed as soon as possible without jeopardizing the outcome. Our aim was to assess the feasibility and safety of its removal on postoperative day (POD) 2 after robot-assisted laparoscopic RP (RALP). A consecutive series of patients undergoing RALP for localized prostate cancer (PCa) were prospectively enrolled. Inclusion criteria were: no bladder-neck reconstruction, watertight urethrovesical anastomosis at 150 ml filling, ≤ 200 ml of intraoperative bleeding, ≤ 80 ml of fluid from the drain on POD 1, clear urine from the UC on POD 2...
November 25, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29128577/pathological-and-3-tesla-volumetric-mr-predictors-of-biochemical-recurrence-after-robotic-assisted-radical-prostatectomy-correlation-with-whole-mount-histopathology
#9
Nelly Tan, Luyao Shen, Pooria Khoshnoodi, Héctor E Alcalá, Weixia Yu, William Hsu, Robert E Reiter, David Y Lu, Steven S Raman
OBJECTIVE: To identify the clinical and MRI variables predictive of biochemical recurrence (BCR) after robotic assisted radical prostatectomy (RALP) in patients who underwent multi-parametric 3 Tesla prostate MR Imaging. METHODS: An IRB approved, HIPAA compliant, a single arm observational study with 3T mpMRI prior to RALP from December 2009 until March 2016 was performed. Clinical, MRI, pathological information and clinical outcome were compiled. Biochemical recurrence was defined as PSA greater > 0...
November 8, 2017: Journal of Urology
https://www.readbyqxmd.com/read/29127531/impact-of-a-robotic-surgical-system-on-treatment-choice-for-men-with-clinically-organ-confined-prostate-cancer
#10
Takashi Kobayashi, Kent Kanao, Motoo Araki, Naoki Terada, Yasuyuki Kobayashi, Atsuro Sawada, Takahiro Inoue, Shin Ebara, Toyohiko Watanabe, Tomomi Kamba, Makoto Sumitomo, Yasutomo Nasu, Osamu Ogawa
BACKGROUND: Introducing a new surgical technology may affect behaviors and attitudes of patients and surgeons about clinical practice. Robot-assisted laparoscopic radical prostatectomy (RALP) was approved in 2012 in Japan. We investigated whether the introduction of this system affected the treatment of organ-confined prostate cancer (PCa) and the use of radical prostatectomy (RP). METHODS: We conducted a retrospective multicenter study on 718 patients with clinically determined organ-confined PCa treated at one of three Japanese academic institutions in 2011 (n = 338) or 2013 (n = 380)...
November 11, 2017: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29124889/the-neurovascular-structure-adjacent-frozen-section-examination-neurosafe-approach-to-nerve-sparing-in-robot-assisted-laparoscopic-radical-prostatectomy-in-a-british-setting-a%C3%A2-prospective-observational-comparative-study
#11
George Mirmilstein, Bhavan Prasad Rai, Olayinka Gbolahan, Vinaya Srirangam, Ashish Narula, Samita Agarwal, Tim M Lane, Nikhil Vasdev, James Adshead
OBJECTIVES: To evaluate the neurovascular structure-adjacent frozen-section examination (NeuroSAFE) technique in a British setting in men undergoing robot-assisted laparoscopic radical prostatectomy (RALP) . PATIENTS AND METHODS: We retrospectively analysed our prospectively maintained database of patients who underwent RALP between November 2008 and February 2017. We examined preoperative pathological and functional parameters, intraoperative nerve sparing (NS), postoperative histology, as well as functional and oncological follow-up...
November 10, 2017: BJU International
https://www.readbyqxmd.com/read/29039893/open-radical-prostatectomy-reproducing-robot-assisted-radical-prostatectomy-involving-antegrade-nerve-sparing-and-continuous-anastomosis
#12
Se Yun Kwon, Jun Nyung Lee, Yun-Sok Ha, Seock Hwan Choi, Tae-Hwan Kim, Tae Gyun Kwon
PURPOSE: To present modified RRP using the same method as RALP and compare its surgical outcomes with RALP. MATERIALS AND METHODS: Demographics, perioperative and functional outcomes of the 322 patients that underwent RRP (N=99) or RALP (N=223) at our institution from January 2011 through June 2013 were evaluated retrospectively. Postoperative incontinence and erectile dysfunction are involved functional outcomes. During the modified procedure, the bladder neck was dissected first as for RALP...
October 17, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29032238/psa-density-is-a-good-predictor-of-upstaging-and-upgrading-according-to-the-new-grading-system-the-keys-we-are-seeking-may-be-already-in-our-pocket
#13
Aldo Brassetti, Riccardo Lombardo, Paolo Emiliozzi, Antonio Cardi, De Vico Antonio, Iannello Antonio, Scapellato Aldo, Riga Tommaso, Pansadoro Alberto, D'Elia Gianluca
OBJECTIVES: To analyse the performance of Prostate specific antigen density (PSAD) as a predictor of upstaging and Prognostic Grade Group (PGG) upgrading. METHODS: we retrospectively evaluated data on men with prostate PCa treated with robotic radical prostatectomy (RALP) at our center in 2014-2015. Preoperative PSAD was calculated. Bioptic and pathologic PGGs were also considered in the analysis. We defined upgrading any increase in PGG after RALP; upstaging was the pathological diagnosis of a pT≥3a PCa clinically unsuspected...
October 12, 2017: Urology
https://www.readbyqxmd.com/read/28979094/ocular-parameters-before-and-after-steep-trendelenburg-positioning-for-robotic-assisted-laparoscopic-radical-prostatectomy
#14
Kyoichi Mizumoto, Masahiko Gosho, Masayoshi Iwaki, Masahiro Zako
PURPOSE: Intraocular pressure (IOP) increases in patients in a steep Trendelenburg position during robotic-assisted laparoscopic radical prostatectomy (RALP). We hypothesized that a steep Trendelenburg position during RALP, an unusual systemic condition involving a transiently increased IOP, may induce ocular pathology that can be detected by detailed evaluations long after the surgery. This study aims to explore ocular structural and functional parameters in patients before and in the long term after the surgery...
2017: Clinical Ophthalmology
https://www.readbyqxmd.com/read/28964931/does-site-of-specimen-extraction-affect-incisional-hernia-rate-after-robot-assisted-laparoscopic-radical-prostatectomy
#15
M Seveso, S Melegari, G Bozzini, O De Francesco, A Mandressi, G Taverna
BACKGROUND: Robot assisted laparoscopic radical prostatectomy (RALP) spread in the last decade as a minimally invasive alternative to open radical prostatectomy for men with localized prostate cancer. It is associated with excellent surgical, functional and oncological results with less postoperative pain and shorter convalescence. Anyway, the development of an incisional hernia (IH), may negate known benefits as it can lead not only to bothersome symptoms but also to severe complications, such as bowel obstruction, strangulation and perforation...
November 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28878598/bladder-neck-contracture-following-radical-retropubic-versus-robotic-assisted-laparoscopic-prostatectomy
#16
Benjamin L Spector, Nathan A Brooks, Michael E Strigenz, James A Brown
INTRODUCTION: Radical retropubic prostatectomy (RRP) and robotic-assisted laparoscopic prostatectomy (RALP) are co-standard surgical therapies for localized prostatic adenocarcinoma. These surgical modalities offer similar outcomes; however, lower rate of bladder neck contracture (BNC) is amongst the touted benefits of RALP. The differences between approaches are largely elucidated through multiple-surgeon comparisons, which can be biased by differential experience and practice patterns...
August 2017: Current Urology
https://www.readbyqxmd.com/read/28868504/patient-reported-quality-of-life-recovery-curves-after-robotic-prostatectomy-are-similar-across-body-mass-index-categories
#17
Tullika Garg, Amanda J Young, Korey A Kost, Alyssa M Park, John F Danella, H Lester Kirchner
PURPOSE: To assess the impact of body mass index (BMI) on postoperative recovery curve of urinary and sexual function after robotic-assisted laparoscopic prostatectomy (RALP). We hypothesized that overweight and obese men have different recovery curves than normal weight men. MATERIALS AND METHODS: We reviewed preoperative and postoperative surveys from 691 men who underwent RALP from 2004-2014 in an integrated healthcare delivery system. Survey instruments included: sexual health inventory for men (SHIM), urinary behavior, leakage, and incontinence impact questionnaire (IIQ)...
September 2017: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/28861311/our-experiences-with-robot-assisted-laparoscopic-surgery-in-pediatric-patients-the-first-case-series-from-turkey
#18
Yusuf Kibar, Serdar Yalçın, Engin Kaya, Burak Köprü, Turgay Ebiloğlu, Giray Ergin, Hüseyin Tomruk
OBJECTIVE: Robotic surgery is a leading treatment option for minimally invasive surgery and has an increasing popularity in pediatric population, as well. In this article, we reported our case series of robot-assisted laparoscopic surgery in pediatric population. MATERIAL AND METHODS: We retrospectively reviewed 29 consecutive pediatric patients who underwent robot- assisted procedures between May 2014 and October 2016. Patient demographics, hospitalization time, estimated blood loss, robotic time and total operative and peri-, and post-operative complications were evaluated...
September 2017: Turkish Journal of Urology
https://www.readbyqxmd.com/read/28799065/laparoscopic-inguinal-hernioplasty-after-robot-assisted-laparoscopic-radical-prostatectomy
#19
M Sakon, Y Sekino, M Okada, H Seki, Y Munakata
PURPOSE: To evaluate the efficacy and safety of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair in patients who have undergone robot-assisted laparoscopic radical prostatectomy (RALP). METHODS: From July 2014 to December 2016, TAPP inguinal hernia repair was conducted in 40 consecutive patients who had previously undergone RALP. Their data were retrospectively analyzed as an uncontrolled case series. RESULTS: The mean operation time in patients who had previously undergone RALP was 99...
October 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28798877/previously-undiagnosed-spinal-and-bulbar-muscular-atrophy-as-a-cause-of-airway-obstruction-after-robot-assisted-laparoscopic-prostatectomy
#20
Miyuki Niki, Taihei Tachikawa, Yuka Sano, Hiroki Miyawaki, Aisa Matoi, Yukari Okano, Nobutaka Kariya, Tsuneo Tatara, Munetaka Hirose
BACKGROUND: Preoperative vocal cord paralysis is a risk factor for postoperative respiratory distress following extubation after general anesthesia. We present an unusual case where a geriatric patient developed airway obstruction after robot-assisted laparoscopic prostatectomy. CASE PRESENTATION: A 67-year-old male, who had suffered from left vocal cord paralysis of unknown etiology, was scheduled for robot-assisted laparoscopic prostatectomy (RALP). General anesthesia was performed without any problems...
2017: Case Reports in Anesthesiology
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