1,721,817 research outputs found
Reply to Francesco Montorsi and Giorgio Gandaglia's Letter to the Editor re: Riccardo Autorino, Homayoun Zagar, Mirandolino B. Mariano, et al. Perioperative Outcomes of Robotic and Laparoscopic Simple Prostatectomy: A European'American Multi-institutional Analysis. Eur Urol 2015;68:86-94; Re: Matthew Bultitude, Ben Challacombe. Simple Prostatectomy: A Step Too Far for Laparoscopy? Eur Urol 2015;68:95-6. Eur Urol 2015;68:e7-8
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Laparoendoscopic single-site nephroureterectomy for upper urinary tract urothelial carcinoma: Outcomes of an international multi-institutional study of 101 patients
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Re: Residual Parenchymal Volume, Not Warm Ischemia Time, Predicts Ultimate Renal Functional Outcomes in Patients Undergoing Partial Nephrectomy
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Re: Positive Surgical Margins and Local Recurrence After Simple Enucleation and Standard Partial Nephrectomy for Malignant Renal Tumors: Systematic Review of the Literature and Meta-analysis of Prevalence
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Clampless laparoscopic partial nephrectomy: a step towards a harmless nephron-sparing surgery?
No full textPurpose: To evaluate the results of our technique of clampless laparoscopic partial nephrectomy (LPN) and its impact as an emerging treatment for small renal masses (SMRs). Materials and Methods: We reviewed our prospectively maintained database: data of 117 patients who consecutively underwent LPN at our Institution from January 2009 to December 2011 were studied. Patients were divided into 2 Groups based on operative technique: Group A: clampless-LPN (cl-LPN); Group B: conventional LPN (clamping of renal artery). Demographic and peri-operative data, complications, pre- and post-operative serum creatinine and estimated glomerular filtration rate (eGFR) were registered and compared by Student's t- and Chi-square-tests (p-values < 0.05 considered statistically significant). Results: 41 patients were in Group A and 76 in Group B. Groups were comparable in terms of preoperative data except for tumour's size (2.35 ± 1.10 vs. 3.19 ± 1.57, Group A vs. B, respectively, p = 0.0029). Concerning perioperative data, warm ischemia time (WIT) was 0 min. in all Group A cases; mean WIT in Group B was 20.90 ± 9.27 min. One case (2.4%) in Group A (central tumour) was converted to conventional LPN. Mean eGFR postoperative decrease was higher in Group B (0.17 ± 9.30 vs. 4.38 ± 11.37 mL/min., A vs B, respectively, p = 0.0445). Conclusions: Notwithstanding the limits ofthe study, our results suggest that cl-LPN is a safe and effective technique, which allows surgeon tosurgically treat SRMs even in case of complex location, without injuring kidney by ischemia
Anterior Reconstruction in Radical Prostatectomy
No full textWhen treating localized prostate cancer, excellent oncological outcomes with low rate of complications are nowadays possible with radical prostatectomy (RP). However, functional outcomes in terms of continence and potency recovery are still less enthusiastic. Indeed, in patients who do not early recover continence quality of everyday life is markedly reduced, especially in younger and more active ones. The proportion of continent patients at 1 year after surgery ranges from 70% to 100% in the available. Such disparities in the literature are probably due to either non-homogeneous definition of continence or measurement methods (questionnaires, number of pads, pad test). Several factors have been identified as leading to, including patient characteristics (body mass index, age, prostate volume, and comorbidities), experience of the surgeon, and surgical precision. There are a number of steps and techniques for improving continence after RP: preservation of the bladder neck, nerve-sparing (NS) technique, preservation of the maximum urethral length, preservation of the puboprostatic ligaments and of the endopelvic fascia, reconstruction of the posterior rhabdosphincter, anterior reconstruction, and suture of the arcus tendineus to the bladder neck. The present chapter will try to cover the topic of anterior reconstruction, focusing on the anatomical rationale, the previously reported techniques and the outcomes of such a step
Techniques to Promote Nerve Regeneration After Robot-Assisted Radical Prostatectomy
No full textOver the last two decades, knowledge of the anatomical structures surrounding the prostate has increased, along with the development of the surgical technique of radical prostatectomy. In this field, the robotic system has certainly played a crucial role, thanks to undoubted advantages such as image enlargement, three-dimensional vision, and improved surgeon dexterity due to miniaturized instruments. Over the last two decades, knowledge of the anatomical structures surrounding the prostate has increased along with the development of the surgical technique of radical prostatectomy. In this field, the robotic system has certainly played a crucial role, thanks to undoubted advantages such as image enlargement, three-dimensional vision, and better dexterity of the surgeon thanks to miniaturized instruments. Resection of both nerves eliminates spontaneous erections and suppresses the response to sildenafil. To facilitate nerve regeneration, the interposition of nerve grafts increases the chance of recovery of erectile function, which is probably related to the fact that the graft promotes axonal regeneration. The use of autologous nerve grafts minimizes the risk of rejection. Somatic nerves can be used to replace resected autonomic nerves and are more easily accessible in most cases: the sural nerve is the best example. New perspectives in the development of regeneration techniques focus on the use of substances such as growth factors or neurotrophic factors such as chitosan membrane
Real-time deep learning semantic segmentation during intra-operative surgery for 3D augmented reality assistance
Full text linkThe current study aimed to propose a Deep Learning (DL) and Augmented Reality (AR) based solution for a in-vivo robot-assisted radical prostatectomy (RARP), to improve the precision of a published work from our group. We implemented a two-steps automatic system to align a 3D virtual ad-hoc model of a patient's organ with its 2D endoscopic image, to assist surgeons during the procedure
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