Urology video journal最新文献

{"title":"Transvesicoscopic Robotic-Assisted excision of giant ureterocele and bladder neck reconstruction: A novel approach in pediatric and young adult patients","authors":"J.A. García Andrade ,&nbsp;J.E. Arboleda- Bustán ,&nbsp;J. Chirinos ,&nbsp;F. Alarcón ,&nbsp;Escobar Gabriela","doi":"10.1016/j.urolvj.2025.100347","DOIUrl":"10.1016/j.urolvj.2025.100347","url":null,"abstract":"<div><h3>Introduction and Objective</h3><div>Complex ureteroceles in children and young adults, particularly those previously treated in infancy, often present later with voiding dysfunction, high-pressure bladder, and upper tract deterioration. We present a video-based case series demonstrating a novel transvesicoscopic robotic approach for complete ureterocele resection and bladder floor reconstruction.</div></div><div><h3>Methods</h3><div>We describe four patients (ages 14–20) with recurrent urinary tract infections, high-grade hydronephrosis, and bladder outlet dysfunction after initial ureterocele treatment in infancy. All underwent robotic-assisted transvesical excision of ureterocele remnants and bladder neck reconstruction. One case included ureteral reimplantation and Mitrofanoff revision.</div></div><div><h3>Results</h3><div>All procedures were completed robotically with operative times ranging from 210 to 300 min. Postoperative recovery was uneventful with minimal blood loss, early discharge (day 3), and catheter removal between days 6 and 18. Follow-up at 8 weeks to 2 years showed restoration of voiding function, stabilization of renal function, and resolution of urinary symptoms.</div></div><div><h3>Conclusions</h3><div>Transvesicoscopic robotic-assisted reconstruction offers a safe, precise, and minimally invasive alternative to treat complex ureterocele sequelae in adolescents and young adults. This technique enables direct access to the bladder floor with excellent visualization and reconstructive control, surpassing limitations of conventional laparoscopy or open surgery.</div></div>","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"27 ","pages":"Article 100347"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144572684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenging scenarios in HoLEP","authors":"Alejandro Bautista-Pérez-Gavilán,&nbsp;Cyrus Chehroudi,&nbsp;Elsayed Desouky,&nbsp;Jamal Alamiri,&nbsp;Smita De","doi":"10.1016/j.urolvj.2025.100349","DOIUrl":"10.1016/j.urolvj.2025.100349","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction and objectives&lt;/h3&gt;&lt;div&gt;Holmium laser enucleation of the prostate (HoLEP) is a gold standard treatment for benign prostatic hyperplasia (BPH). It provides robust symptom relief and low re-operative rates while being size independent. There are several challenging scenarios that can be encountered by surgeons that require a systematic approach to complete the procedure. We highlight our approach to difficult scenarios during HoLEP including: “beach ball” morcellation, prostatic urethral lift implants, equipment malfunction, and poor visibility.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Vascular prostates are prone to intraoperative bleeding, which can lead to impaired visibility during enucleation. Surgeons should ensure good inflow and outflow as clots can form in the resectoscope. Deliberate hemostasis, working close to tissue, continued dissection, and potentially using alternative approaches allow the surgeon to reach the capsular plane and control prostatic vessels near their origin. The need to use bipolar cautery for hemostasis during HoLEP is rare but should be considered when other strategies are not successful.&lt;/div&gt;&lt;div&gt;It is crucial to recognize capsular perforations early to minimize complications. Most perforations can be managed by overcorrecting the plane of enucleation and using loop diuretics. These cases should be finished efficiently, as prolonged operative times can increase risk for volume overload. In rare scenarios, the case may need to be terminated or converted due to increased fluid absorption by the patient or loss of visibility.&lt;/div&gt;&lt;div&gt;Enucleated prostate adenoma is morcellated in the final step of HoLEP. Occasionally, very dense adenoma tissue will not morcellate creating “beach balls.” The first step to mitigating this issue is to slow down the morcellator speed. If this fails, the adenoma can be brought into the fossa where it is less likely to disengage from the morcellator blade. Next, grooves can be cut into the adenoma using the laser to improve tissue engagement. Finally, a bipolar loop may be used to break down the adenoma into smaller pieces that can be irrigated out. Small “beach balls” can also be removed using an atraumatic tipless percutaneous stone basket.&lt;/div&gt;&lt;div&gt;Prostatic urethral lift is a minimally invasive therapy for BPH. These implants may be encountered during enucleation and broken down with the laser. They can also jam or damage the blade during morcellation. If this occurs, the implant needs to be cleared from the blade, and if the blade is damaged a new morcellator blade should be used.&lt;/div&gt;&lt;div&gt;Scope breakage may occur during HoLEP. The beak of the resectoscope has been reported to detach in the bladder and can be retrieved using laparoscopic graspers. Excessive torque on the scope and lens during enucleation can lead to bending of the scope or lens. It is critical to have a backup set ready in the event of equipment malfunction.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;di","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"27 ","pages":"Article 100349"},"PeriodicalIF":0.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-port (SP) robotic transvesical bladder diverticulectomy: Description of technique and initial outcomes","authors":"Jaya Sai Chavali,&nbsp;Nicolas Soputro,&nbsp;Roxana Ramos,&nbsp;Adriana Pedraza,&nbsp;Carter Mikesell,&nbsp;Jihad Kaouk","doi":"10.1016/j.urolvj.2025.100348","DOIUrl":"10.1016/j.urolvj.2025.100348","url":null,"abstract":"<div><h3>Introduction</h3><div>We aim to present our robotic transvesical (TV) technique for performing bladder diverticulectomy using the da Vinci single-port (SP) surgical platform.</div></div><div><h3>Methods</h3><div>We performed three cases of SP robotic TV diverticulectomy between 2020–2023. The TV surgical technique described in the video pertained to a 66-year-old male with severe lower urinary tract symptoms (LUTS) secondary to benign prostate hypertrophy (BPH). Given the large posterior bladder diverticulum identified on preoperative magnetic resonance imaging (MRI), diverticulectomy was performed in the same intraoperative setting for SP TV enucleation of the prostate (STEP) through the same bladder incision.</div></div><div><h3>Results</h3><div>All SP TV bladder diverticulectomy cases were completed without any complications, conversion to other approaches, or additional ports. All patients were discharged on the same day (median stay of 4 h), and no postoperative complications were seen. All subjects had an improvement in their postoperative international prostatism symptom scores (IPSS) at a median follow-up of 16 months.</div></div><div><h3>Conclusion</h3><div>SP TV robotic diverticulectomy is a feasible option for the excision of the bladder diverticula. The TV approach offers the benefit of regionalizing the surgery to the bladder, simultaneous treatment of bladder and prostate pathology, and overall shorter foley catheter duration.</div></div>","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"27 ","pages":"Article 100348"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new indwelling urethral catheter (amSafeX) to verify the position of its balloon within the bladder during inflation","authors":"Anil Mandhani ,&nbsp;Sunil Singh ,&nbsp;Jakesh Reddy ,&nbsp;Shrey Jain ,&nbsp;Ramniwas Yadav","doi":"10.1016/j.urolvj.2025.100343","DOIUrl":"10.1016/j.urolvj.2025.100343","url":null,"abstract":"<div><h3>Introduction</h3><div>Inserting a Foley catheter for urethral catheterization can lead to numerous iatrogenic injuries in patients, as it is difficult to ensure that the balloon is in the bladder during inflation. This video demonstrates the safety and effectiveness of a new design of indwelling urethral catheter (amSafeX) that confirms the presence of the balloon in the bladder during inflation.</div></div><div><h3>Design, setting, and participants</h3><div>One hundred male patients who required a catheter for various reasons and 25 female postoperative patients were included in a prospective non-randomized interventional study. They were catheterized using the amSafeX catheter by a nurse or trainee doctor. The catheter features two draining eyes, with an additional eye proximal to the balloon and the usual distal eye blocked with an internal obturator attached to the string coming out of the drainage port. Standard instructions were given to follow the iSIP protocol of urethral catheterization. Data were collected and analyzed for the safety and efficacy of catheterization.</div></div><div><h3>Result</h3><div>From Jan 2022 to Oct 2022, none of the 125 patients had any adverse events during catheterization, and the obturator could be removed easily in all procedures. There were no incidents of peri‑catheter leakage or urethral injury recorded during catheterization. The median duration of catheterization was 5 (3–12) days.</div></div><div><h3>Conclusion</h3><div>The innovative design of amSafeX indwelling urethral catheter ensured that the bulb was always present in the bladder during inflation. This may eliminate the risk of urethral injury.</div></div>","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"27 ","pages":"Article 100343"},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted appendiceal interposition for long segment ureteric stricture: A case report","authors":"G.S. Bora,&nbsp;R.S. Mavuduru,&nbsp;S. Sathaye","doi":"10.1016/j.urolvj.2025.100342","DOIUrl":"10.1016/j.urolvj.2025.100342","url":null,"abstract":"<div><div>Long segment upper ureteric stricture management is surgically challenging. Appendix has unique advantages for bridging the gap in right sided ureteric strictures. we present a case and our technique of right sided long segment ureteric stricture managed with robot assisted appendiceal interposition.</div></div>","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"27 ","pages":"Article 100342"},"PeriodicalIF":0.0,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144313195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-port (SP) robotic transvesical radical prostatectomy in patients with prior kidney transplantation: Technique description and early results","authors":"Jaya Sai Chavali ,&nbsp;Ethan Ferguson ,&nbsp;Nicolas Soputro ,&nbsp;Roxana Ramos ,&nbsp;Mohamed Eltemamy ,&nbsp;Jihad Kaouk","doi":"10.1016/j.urolvj.2025.100340","DOIUrl":"10.1016/j.urolvj.2025.100340","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Transvesical radical prostatectomy allows for direct access to the bladder and prostate that completely avoids the peritoneal cavity and allows for minimal disturbance to the extraperitoneal space or the iliac fossa. We sought to evaluate the safety and effectiveness of a single-port transvesical approach in the treatment of patients with prior kidney transplantation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Single port transvesical radical prostatectomy was performed on two patients with prior kidney transplantation, including one patient with two prior kidney transplants. Flexible cystoscopy was used for assistance in accessing the bladder intraoperatively in the patient with two prior transplants to avoid injury to either transplant ureteral orifice.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Both patients had similar preoperative pathology, operative times, estimated blood loss (EBL), and hospital stay. There were no intraoperative or postoperative complications in either patient. While both patients showed high-risk pathology, surgical margins were negative in both cases and the latest postoperative PSA at 6 weeks was undetectable. Both patients had good recovery of continence after surgery, with 0 and 1 pads per day at a 6-week follow-up.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Single port transvesical radical prostatectomy is safe and feasible in patients with prior renal transplantation. No biochemical recurrence was recorded on the latest follow-up.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To demonstrate the safety and technique of Transvesical (TV) Single-Port (SP) robot-assisted radical prostatectomy (RARP) in patients with prior kidney transplantation (KT).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Patients and surgical procedure&lt;/h3&gt;&lt;div&gt;Between 2022 and 2023, we performed SP TV RARP on two patients with prior KT who were diagnosed with clinically significant prostate cancer. The technique was demonstrated in a 62-year-old male patient with two prior KT. Flexible cystoscopy was used to evaluate the bladder intraoperatively to avoid injury to the transplant and native ureteral orifices.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Both procedures were completed without any evidence of perioperative complications. Patients 1 and 2 who underwent SP TV RARP had overall similar operative times i.e. 193 and 173 min respectively, and estimated blood loss (EBL), i.e. 100 ml and 50 ml respectively. They were discharged within 24 h of hospital stay. There were no intraoperative or postoperative complications in the cohort.&lt;/div&gt;&lt;div&gt;The final pathology showed high-risk Gleason Grade (GG) 4 prostate cancer, surgical margins were negative in both cases. The latest postoperative prostate-specific antigen (PSA) at 6 weeks was undetectable. Both patients had good recovery of continence after surgery, with 0 and 1 pads per day at a 6-week follow-up.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;SP TV RARP is safe and feasible in patients with prior KT. No biochemica","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"26 ","pages":"Article 100340"},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low anterior access single port robotic pyeloplasty in a pediatric patient","authors":"Austin Thompson ,&nbsp;Kassandra Zaila Ardines ,&nbsp;Shelby Harper ,&nbsp;Nicolas Soputro ,&nbsp;Jihad H. Kaouk ,&nbsp;John K. Weaver ,&nbsp;Jessica H. Hannick","doi":"10.1016/j.urolvj.2025.100341","DOIUrl":"10.1016/j.urolvj.2025.100341","url":null,"abstract":"<div><h3>Introduction and Objective</h3><div>Single port robotic surgery may be associated with less pain, faster recovery, and improved cosmesis. Herein we demonstrate that the lower anterior access (LAA) approach to single port robotic pyeloplasty is a safe surgical alternative in conjunction with principles of enhanced recovery after surgery (ERAS) to optimize the management of ureteropelvic junction obstruction (UPJO) in children.</div></div><div><h3>Surgical Procedure</h3><div>Access to the retroperitoneum was gained via a 3.5 cm incision two finger breadths above the superior pubic ramus. A purpose built single port access kit was inserted into the incision after blunt finger dissection. A retroperitoneal robotic dismembered pyeloplasty was performed across a JJ ureteral stent. The patient received an ultrasound-guided transversus abdominis plane block at the conclusion of surgery.</div></div><div><h3>Results</h3><div>Total console time was 95 min. No intraoperative narcotics were given and a total of 3.7 mg oral morphine equivalents was given post-operatively. The patient was discharged the evening of surgery. His left flank pain and hydronephrosis had resolved at follow-up with no complications to date and a single easily concealed scar.</div></div><div><h3>Conclusion</h3><div>The LAA approach to single-port robotic pyeloplasty is a safe alternative that should be offered to pediatric patients with ureteropelvic junction obstruction. This approach may further reduce lengths of stay and the need for opioids while optimizing surgical cosmesis. It may also represent a safer alternative for patients with a history of abdominal surgery.</div></div>","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"26 ","pages":"Article 100341"},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic transperitoneal bilateral adrenalectomy for pheochromocytoma: step by step video demonstration","authors":"Kevin Arulraj,&nbsp;Rajeev Kumar","doi":"10.1016/j.urolvj.2025.100344","DOIUrl":"10.1016/j.urolvj.2025.100344","url":null,"abstract":"<div><h3>Introduction</h3><div>Ten percent of all pheochromocytomas are bilateral and require bilateral adrenalectomy. Laparoscopy bilateral simultaneous surgery can be safely performed in most patients. We describe a step-by-step approach to these surgeries.</div></div><div><h3>Patient and surgical procedure</h3><div>A 19-year-old female presented with progressive vision loss in both eyes for 3 years and was diagnosed to have bilateral retinal hemangiomas. On further evaluation, she was detected to have bilateral adrenal masses. She had no history of adrenergic symptoms and her plasma normetanephrines were elevated. Contrast enhanced tomography of the abdomen showed a 5 cm lesion in the right adrenal gland and two nodules on the left. DOTANOC scan showed uptake in bilateral adrenal glands and a diagnosis of VHL syndrome with bilateral pheochromocytoma was made. She was planned for synchronous bilateral laparoscopic adrenalectomy. Right adrenalectomy was performed first in the left lateral decubitus position. The peritoneum over the cranial and medial borders of the tumor was incised and the tumor was separated from the liver to minimize respiratory movements and inadvertent traction on the liver parenchyma. Medial dissection was performed to ligate and divide the adrenal vessels. Dissection was continued and the gland was separated from the kidney. The patient was turned into the right lateral decubitus position for left adrenalectomy. The splenic flexure was mobilized, and the splenic attachments were divided to maximize exposure. Medial dissection was performed to identify the renal and adrenal veins. The adrenal vein was ligated, and the gland was isolated by dividing its attachments to the kidney. Specimen were extracted through a single incision.</div></div><div><h3>Results</h3><div>The surgical time was 110 min with minimal blood loss. She was started on lifelong steroid supplementation. Post operative period was uneventful and follow up showed no recurrence at one year.</div></div><div><h3>Conclusion</h3><div>Bilateral simultaneous laparoscopic adrenalectomy can be safely performed for pheochromocytomas.</div></div>","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"26 ","pages":"Article 100344"},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic-assisted ileal ureter reconstruction: step-by-step guide","authors":"F. Eskenazi ,&nbsp;A. Ardiles ,&nbsp;L. Fumero ,&nbsp;N. Otaño ,&nbsp;L. Galvis ,&nbsp;O. Rodriguez ,&nbsp;R. Sotelo","doi":"10.1016/j.urolvj.2025.100339","DOIUrl":"10.1016/j.urolvj.2025.100339","url":null,"abstract":"<div><div>Urolithiasis is one of the most common causes of urology consultation. Management for ureteral stones &lt;10 mm can include observation and alpha-blockers. If unsuccessful, stones &gt;10 mm, or complicated (obstructed or infected), definitive treatment may involve ureteroscopy, shock-wave lithotripsy, percutaneous nephrolithotripsy, or open or minimally invasive approaches. Selection will depend primarily on the location and size of the stone. Stones &lt; 20 mm are best managed through ureteroscopy, which achieves a high stone-free rate in a single procedure, although not except for complications, which can occur in up to 25 % of cases. These include iatrogenic displacement of a ureteral calculus into the wall of the ureter, bleeding, perforation, stricture, and avulsion. In this video, we present a case of ureteral avulsion managed with robotic-assisted ileal ureter reconstruction, describing the step-by-step technique for a successful outcome.</div></div>","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"27 ","pages":"Article 100339"},"PeriodicalIF":0.0,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tips and tricks for retroperitoneal Single Port Robot Assisted Partial Nephrectomy","authors":"Luca Lambertini ,&nbsp;Greta Pettenuzzo ,&nbsp;David Yu ,&nbsp;Matteo Pacini ,&nbsp;Giulio Avesani ,&nbsp;Luca Morgantini ,&nbsp;Jhon Smith ,&nbsp;Hakan Bahadir Haberal ,&nbsp;Juan Ramon Anguliano Torres ,&nbsp;Simone Crivellaro","doi":"10.1016/j.urolvj.2025.100335","DOIUrl":"10.1016/j.urolvj.2025.100335","url":null,"abstract":"<div><h3>Objective</h3><div>To provide a comprehensive step by step description of the retroperitoneal Single Port Robot Assisted Partial Nephrectomy (SP RAPN) focusing on the troubleshooting and on the tips and tricks to successfully achieve optimal oncological and functional outcomes.</div></div><div><h3>Patients and procedures</h3><div>All patients with preoperative imaging-based evidence of renal mass amenable to partial nephrectomy were treated with retroperitoneal SP-RAPN, regardless of the tumor location. In case of infiltrative tumor growth pattern, the nephron sparing surgical management was excluded. The main surgical steps during RAPN were: (1) perform supine retroperitoneal access (Low Anterior Access) (2) identification of the Quadratus Lomborum and of the Psoas muscle (supine retroperitoneal landmarks) (3) dissection of the renal pedicle and identification of the tumor location (4) perform an anatomic pure enucleative strategy reaching the tumor pseudocapsule (5) perform anatomical renorraphy. The troubleshooting analyzed the most common intraoperative issues potentially occurring during retroperitoneal SP RAPN. Particularly we sought to analyze (1) management of peritoneal breach (2) limited working space due to the presence of abundant perinephric fat (3) management of large renal masses (4) intraoperative bleeding.</div></div><div><h3>Conclusion</h3><div>The retroperitoneal approach for Single Port Robot Assisted Partial Nephrectomy is safe and potentially provides several perioperative benefits, also when it deals with large renal masses or anterior tumors. In this setting, a proper troubleshooting can expand its feasibility through the current surgical practice.</div></div>","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"26 ","pages":"Article 100335"},"PeriodicalIF":0.0,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}