Urology video journal最新文献

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Step-by-step guide to flexible and navigable suction ureteric access sheath (FANS) 灵活可导航的输尿管吸入套(FANS)的分步指南
Urology video journal Pub Date : 2023-10-01 DOI: 10.1016/j.urolvj.2023.100250
Vineet Gauhar , Chloe Shu-Hui Ong , Olivier Traxer , Ben Hall Chew , Nariman Gadzhiev , Jeremy Yuen-Chun Teoh , Saeed Bin Hamri , Chin Tiong Heng , Daniele Castellani , Bhaskar Kumar Somani , Deepak Ragoori
{"title":"Step-by-step guide to flexible and navigable suction ureteric access sheath (FANS)","authors":"Vineet Gauhar ,&nbsp;Chloe Shu-Hui Ong ,&nbsp;Olivier Traxer ,&nbsp;Ben Hall Chew ,&nbsp;Nariman Gadzhiev ,&nbsp;Jeremy Yuen-Chun Teoh ,&nbsp;Saeed Bin Hamri ,&nbsp;Chin Tiong Heng ,&nbsp;Daniele Castellani ,&nbsp;Bhaskar Kumar Somani ,&nbsp;Deepak Ragoori","doi":"10.1016/j.urolvj.2023.100250","DOIUrl":"https://doi.org/10.1016/j.urolvj.2023.100250","url":null,"abstract":"<div><h3>Objective</h3><p>Retrograde intrarenal surgery (RIRS) is a well-established treatment option for renal calculi. Stone dusting has drastically improved with the advent of high-power LASERs, but the challenge remains in clearing the fine dust and fragments which may become niduses for future stone recurrence. The aim of this article is to demonstrate the use of the Flexible And Navigable ureteric access Sheath (FANS), a novel invention which improves the aspiration of stone dust and fragments, and assess its safety and outcomes.</p></div><div><h3>Patients and Surgical Procedure</h3><p>In this video, Clearpetra 12/14 Fr FANS was used with a TFL LASER for RIRS of the renal pelvic calculus. Data regarding intra-operative outcomes, immediate post-operative (within 24 h) and 3-month stone-free rate (SFR), and post-operative complications, was collected. Retrospective analysis was carried out on 45 patients who underwent RIRS between September 2022 and March 2023 across 3 centres.</p></div><div><h3>Results</h3><p>RIRS was successful in all patients (median operating time=65 min). Immediate CT scan within 24 h showed no evidence of pelvicalyceal injury or perinephric fluid collection. 71.1% (<em>n</em> = 32) had 100% SFR immediately post-operation, and this improved to 93.3% (<em>n</em> = 42) at 3-month follow-up. 11 of these 45 patients have been followed up for 6 months – all have 100% SFR and no complications. 35.6% (<em>n</em> = 16) had transient fever which resolved with antibiotics; none had sepsis. A double J stent was placed in 62.6% (<em>n</em> = 28), while 26.6% (<em>n</em> = 12) had an overnight ureteric catheter only.</p></div><div><h3>Conclusion</h3><p>FANS improves single-session SFR and reduces the need for a ureteric stent or catheter. It is safe with minimal complications, reduces the need for ancillary treatment and post-operative follow-up, therefore resulting in cost savings for the hospital and patient.</p></div>","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"20 ","pages":"Article 100250"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590089723000440/pdfft?md5=ee22f0575c9872b954df459662423286&pid=1-s2.0-S2590089723000440-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91641421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A novel apparatus to assess intraoperative intrarenal pelvic pressure and associated clinical outcomes 一种评估术中肾内盆腔压力及相关临床结果的新型仪器
Urology video journal Pub Date : 2023-10-01 DOI: 10.1016/j.urolvj.2023.100246
Alex J. Xu , Kirtishri Mishra , Nabeel Shakir , Lee Cheng Zhao
{"title":"A novel apparatus to assess intraoperative intrarenal pelvic pressure and associated clinical outcomes","authors":"Alex J. Xu ,&nbsp;Kirtishri Mishra ,&nbsp;Nabeel Shakir ,&nbsp;Lee Cheng Zhao","doi":"10.1016/j.urolvj.2023.100246","DOIUrl":"https://doi.org/10.1016/j.urolvj.2023.100246","url":null,"abstract":"<div><h3>Objective</h3><p>To design a simple, novel, economical apparatus which effectively provides reliable, real-time measurements of intrarenal pelvic pressure (IRPP) intraoperatively and to demonstrate clinical utility.</p></div><div><h3>Patients and Surgical Procedure</h3><p>Patients undergoing robotic ureteral reconstruction from 10/2020 to 7/2021 for whom intraoperative IRPP measurement was conducted were included.</p><p>Baseline opening pressure was noted with the pelvis completely drained. The kidney was intermittently drained when IRPP exceeded a certain threshold, returning the pressure to baseline. Relief of obstruction was defined as return of IRPP to physiologic value without further increases for the remainder of surgery.</p><p>Demographic, intraoperative, and post-operative variables were collected and IRPP measurements extracted. Post-operative success was defined as resolution of obstruction by clinical symptoms and imaging.</p></div><div><h3>Results</h3><p>Eleven patients met criteria including 4 (36.4%) men and 7 (63.6%) women. Median age and BMI was 61 years (range 14–23) and 26 kg/m<sup>2</sup> (range 17.2–42), respectively. Six patients (54.5%) had undergone prior interventions.</p><p>Ureteral reconstructive procedures included bilateral refluxing reimplants (2), unilateral reimplant with Boari flap (3), non-transecting reimplant (2), unilateral ileal ureter (1), bilateral ileal ureter (1), buccal ureteroplasty (1), and ureteroureterostomy (1). Median peak IRPP was 52 mmHg (range 27–59) and median nadir IRPP was 14 mmHg (range 1–24), with median decrease of 36 mmHg (range 26–84).</p><p>At median follow-up of 120 days, all patients had successful repairs.</p></div><div><h3>Conclusions</h3><p>Intraoperative measurement of IRPP can be utilized in patients with percutaneous nephrostomy tubes using readily available equipment. This measurement has the potential to ensure that ureteral obstruction is completely relieved and to prevent development of supraphysiologic IRPP during surgery.</p></div>","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"20 ","pages":"Article 100246"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49733406","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}
引用次数: 0
Minimally invasive monsplasty 微创单体成形术
Urology video journal Pub Date : 2023-10-01 DOI: 10.1016/j.urolvj.2023.100245
Amiya Alexander, Sarah Armitage, Aron Liaw
{"title":"Minimally invasive monsplasty","authors":"Amiya Alexander,&nbsp;Sarah Armitage,&nbsp;Aron Liaw","doi":"10.1016/j.urolvj.2023.100245","DOIUrl":"https://doi.org/10.1016/j.urolvj.2023.100245","url":null,"abstract":"<div><p>In this video, we present our technique for a minimally invasive monsplasty using a sling. This is a variation of Shaeer's technique, previously published on by Dr Shaeer. He has demonstrated excellent success with this and we have adapted it with a commercial sling and a midline incision.</p><p>Buried penis repair can be a very difficult surgery with significant morbidity. In patients with a relatively soft suprapubic fat pad, we attempt to unbury the penis with a relatively simple and minimally invasive surgery.</p><p>While this technique does not provide as robust a repair as a traditional buried penis repair, it is significantly less morbid and can produce good functional results with much shorter operative time and quicker recovery. Most patients are discharged same day and experience minimal pain. We believe this technique is best suited for patients with a soft, small to moderate fat pad, and who may be poor candidates for a larger surgery.</p></div>","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"20 ","pages":"Article 100245"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590089723000397/pdfft?md5=53636ca3bd6e28a8a068553dff1de110&pid=1-s2.0-S2590089723000397-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92026667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Modified Mini-Jupette sling for climacturia during IPP placement 在IPP放置期间为Climacturia修改的迷你jupette Sling
Urology video journal Pub Date : 2023-10-01 DOI: 10.1016/j.urolvj.2023.100240
Jayson Kemble, Elizabeth Olive, Eileen Byrne, Jonathan Nicholas Warner, Sevann Helo, Matthew Ziegelmann, Tobias Kohler
{"title":"Modified Mini-Jupette sling for climacturia during IPP placement","authors":"Jayson Kemble,&nbsp;Elizabeth Olive,&nbsp;Eileen Byrne,&nbsp;Jonathan Nicholas Warner,&nbsp;Sevann Helo,&nbsp;Matthew Ziegelmann,&nbsp;Tobias Kohler","doi":"10.1016/j.urolvj.2023.100240","DOIUrl":"10.1016/j.urolvj.2023.100240","url":null,"abstract":"<div><h3>Objective</h3><p>Climacturia, the inadvertent leak of urine during orgasm, is a well-known complication following radical prostatectomy and can cause significant patient/partner bother. The Mini-Jupette sling treats climacturia during placement of an inflatable penile prosthesis (IPP) but requires an extended corporotomy with a complex closure. Our modified Mini-Jupette technique utilizes a standard corporotomy and places the sling inferior as opposed to integrated into the corporotomy. Additionally, we perform an intraoperative drip test for urethral occlusion, which eliminates the need for guessing on sling tension. Corset sutures can then be utilized intraoperatively or in future revision surgeries in the event of sling loosening or recurrent climacturia.</p></div><div><h3>Patients and surgical procedure</h3><p>An IPP surgical candidate with climacturia was identified. Intraoperative video of the Mini-Jupette technique was recorded using an overhead camera. The Mini-Jupette sling is placed with four vertical Ethibond (00) sutures placed inferior to the corporotomy stay sutures. The drip test is set up by retracting the catheter to the distal urethra and connecting it to a bedside irrigation system set 60 cm above the patient. Stoppage of fluid flow during IPP inflation indicates that the sling is appropriately occluding the urethra.</p></div><div><h3>Results</h3><p>Successful demonstration of a modified Mini-Jupette technique and intraoperative drip test without complications.</p></div><div><h3>Conclusions</h3><p>Our modified Mini-Jupette and intraoperative drip test provide a reasonable alternative to the standard Mini-Jupette technique.</p></div>","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"20 ","pages":"Article 100240"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47369693","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}
引用次数: 0
Manuscript- revision vaginoplasty with robotic assistance for obliterated neovagina 手稿-在机器人辅助下的阴道成形术的修正
Urology video journal Pub Date : 2023-10-01 DOI: 10.1016/j.urolvj.2023.100241
Alexandr Pinkhasov, Gennady Bratslavsky, Prashant Upadhyaya, Dmitriy Nikolavsky
{"title":"Manuscript- revision vaginoplasty with robotic assistance for obliterated neovagina","authors":"Alexandr Pinkhasov,&nbsp;Gennady Bratslavsky,&nbsp;Prashant Upadhyaya,&nbsp;Dmitriy Nikolavsky","doi":"10.1016/j.urolvj.2023.100241","DOIUrl":"10.1016/j.urolvj.2023.100241","url":null,"abstract":"","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"20 ","pages":"Article 100241"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41757104","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}
引用次数: 0
IPP reservoir fixation techniques: THALIA and low transfascial IPP储层固定技术:THALIA和低腹水
Urology video journal Pub Date : 2023-10-01 DOI: 10.1016/j.urolvj.2023.100248
Jayson Kemble , Lexiaochuan Wen , Eileen Byrne , Mohit Khera , Jonathan Nicholas Warner , Sevann Helo , Matthew Ziegelmann , Tobias Köhler
{"title":"IPP reservoir fixation techniques: THALIA and low transfascial","authors":"Jayson Kemble ,&nbsp;Lexiaochuan Wen ,&nbsp;Eileen Byrne ,&nbsp;Mohit Khera ,&nbsp;Jonathan Nicholas Warner ,&nbsp;Sevann Helo ,&nbsp;Matthew Ziegelmann ,&nbsp;Tobias Köhler","doi":"10.1016/j.urolvj.2023.100248","DOIUrl":"https://doi.org/10.1016/j.urolvj.2023.100248","url":null,"abstract":"<div><h3>Objective</h3><p>Inflatable penile prosthesis reservoir herniation or migration may occur with space of Retzius or submuscular placement. The dangers of high submuscular placement include bowel or bladder perforation (from blind instrument passage) and or bowel herniation (from unintentional peritoneal placement and stretching of small opening with reservoir filling). Even under direct vision submuscular placement, reservoirs can ultimately reside into the scrotum, retroperitoneum, and lateral abdominal wall. The Tubing, Hitch And Lasso, Intussusception Anchor (THALIA) and the low Transfascial Fixation (TFF) techniques were recently developed to prevent reservoir migration with placement either submuscularly or in the space of Retzius, but video of these techniques has not been previously published. The aim of this study is to visually demonstrate the proper surgical technique of THALIA and TFF during IPP reservoir placement.</p></div><div><h3>Patients and Surgical Procedure</h3><p>Two IPP surgical candidates at high risk of complications should reservoir migration occur were identified. Video of THALIA and TFF techniques performed during IPP surgery was recorded using an in-light overhead camera and a GoPro aseptically positioned on the lead surgeon. The THALIA technique adheres the reservoir tubing to the pubic bone by use of a 2–0 Ethibond suture and an extra tubing collar. The TFF technique fixates the reservoir tubing by perforating the external inguinal ring and running the tubing through the ring.</p></div><div><h3>Results</h3><p>Successful demonstration of THALIA and TFF techniques during IPP placement without complications.</p></div><div><h3>Conclusions</h3><p>THALIA and TFF techniques are feasible options to aid prevention of penile implant reservoir herniation.</p></div>","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"20 ","pages":"Article 100248"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49711283","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}
引用次数: 0
A simple and step-wise dissection of the dorsal nerve of the clitoris 对阴蒂背神经进行简单的分步解剖
Urology video journal Pub Date : 2023-10-01 DOI: 10.1016/j.urolvj.2023.100253
Monica Llado-Farrulla , Geolani W. Dy , Blair R. Peters
{"title":"A simple and step-wise dissection of the dorsal nerve of the clitoris","authors":"Monica Llado-Farrulla ,&nbsp;Geolani W. Dy ,&nbsp;Blair R. Peters","doi":"10.1016/j.urolvj.2023.100253","DOIUrl":"https://doi.org/10.1016/j.urolvj.2023.100253","url":null,"abstract":"<div><h3>Objective</h3><p>Dissection of the dorsal nerves of the clitoris (DNC) is an important step in most gender-affirming phalloplasty techniques. Understanding DNC anatomy also facilitates safe vulvar and clitoral surgery. However, the surgical anatomy of the DNC has only recently been thoroughly described in the literature, and dissection of the DNC has not traditionally been a routine part of genitourinary surgical education.<sup>1,2</sup> With procedures involving the DNC (e.g. gender-affirming phalloplasty) increasing in frequency, surgical resources are needed to better illustrate and teach this critical dissection. In this video, we demonstrate a safe, efficient and reliable approach to dissection of the DNC.</p></div><div><h3>Patients and surgical procedure</h3><p>This video is a demonstration of an approach to dissection of the dorsal nerve of the clitoris in a gender-affirming phalloplasty procedure.</p></div><div><h3>Results</h3><p>The DNC is a critical structure for erogenous and sexual function and its dissection should always be approached cautiously to avoid injury. The DNC is formed from branches of the pudendal nerve and travels below the inferior public ramus along the posterior edge of the clitoral crus <span>[3]</span>. Inferior to the pubic symphysis, at the angle of the clitoral body, the dorsal clitoral nerves enter the deep component of the suspensory ligament of the clitoris.<sup>1,2</sup> At the base of the clitoral body the dorsal nerves are superiorly suspended away from the clitoris before they descend inferiorly along the clitoral body. At this level, the DNC are large, approximately 2–3.2 mm, traveling at 10-11 and 1-2 o'clock positions along the clitoral body. We approach the DNC at this level by releasing the suspensory ligament of the clitoris and dissecting through the clitoral fascia.</p></div><div><h3>Conclusions</h3><p>Dissection of the dorsal nerve of the clitoris (DNC) is a critical step in many gender-affirming phalloplasty procedures. A thorough understanding of its surgical anatomy is also necessary for safe vulvar surgery. In this video, we demonstrate a safe, efficient and reliable approach to dissection of the DNC.</p></div>","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"20 ","pages":"Article 100253"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590089723000476/pdfft?md5=6cbb4ec548b17f134a454b8f8aa57243&pid=1-s2.0-S2590089723000476-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91641423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Plaque incision and grafting with penile prosthesis placement via non-degloving approach for complex biplanar Peyronie's disease and erectile dysfunction 非脱套入路斑块切开阴茎假体植入术治疗复杂双平面Peyronie病和勃起功能障碍
Urology video journal Pub Date : 2023-10-01 DOI: 10.1016/j.urolvj.2023.100251
Jonathan Clavell-Hernández
{"title":"Plaque incision and grafting with penile prosthesis placement via non-degloving approach for complex biplanar Peyronie's disease and erectile dysfunction","authors":"Jonathan Clavell-Hernández","doi":"10.1016/j.urolvj.2023.100251","DOIUrl":"https://doi.org/10.1016/j.urolvj.2023.100251","url":null,"abstract":"<div><h3>Objective</h3><p>Surgery remains the gold standard treatment option for men with complex Peyronie's disease (PD). Historically, most surgical procedures for this condition have been performed through a circumcision with penile degloving. When combined with penile prosthesis (PP) placement, circumcision with degloving could serve as a potential risk for glans ischemia. A ventral non-degloving approach has been previously described for patients undergoing complex reconstruction at the time of inflatable PP placement. This video aims to show the efficacy and safety of the non-degloving approach for a man undergoing plaque incision and grafting with PP placement for the management of complex biplanar PD and erectile dysfunction.</p></div><div><h3>Patients and Surgical Procedure</h3><p>This approach is offered for men with complex PD and ED requiring complex reconstruction at the time of PP placement . A ventral incision is made from the frenulum down to the penoscrotal junction. Paraurethral incisions are made to elevate the neurovascular bundle away from the tunica albuginea while maintaining the continuity of the skin and Dartos fascia to the glans penis at all times. Plaque incision is made for curvature correction, the PP is placed and a graft is placed to cover the defects. Fascial layers and skin are then closed.</p></div><div><h3>Results</h3><p>Correction of the deformity is achieved. Between October 2018 to May 2023, a total of 110 patients underwent PP placement with correction of PD of which 79 underwent PP with plaque incision/excision with grafting via the ventral non-degloving approach. As with other cases involving PP placement, potential complications associated to this procedure include edema, infection (n = 2), herniation of the prosthetic cylinder (n = 2), glans ischemia (n = 0), recurrence of curvature (n = 0), device malposition (n = 0) and device malfunction (n = 1). There were no cases of phimosis reported in our series and a total of 2 cases of paraphimosis were reported which were easily reduced by the patient without requiring additional medical or surgical intervention. Our preferred patch of use is Tachosil® (Baxter); or Evarrest® (Ethicon) if Tachosil is not available. Tutoplast® cadaveric pericardium (Coloplast Corp) is preferred in cases in which the defect is larger than 3 cm in length. Average time of the procedure is 150 min.</p></div><div><h3>Conclusion</h3><p>The non-degloving approach remains a feasible option for men undergoing plaque incision and grafting at the time of PP placement. This approach theoretically may decrease the risk of glans ischemia while maintaining adequate surgical exposure and cosmesis that may increase patient satisfaction.</p></div>","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"20 ","pages":"Article 100251"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590089723000452/pdfft?md5=d1950d96663f340aea4610516fcd440b&pid=1-s2.0-S2590089723000452-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92026666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
3D virtual models plus near-infrared fluorescence guidance for the best selective clamping strategy during robotic partial nephrectomy 三维虚拟模型加近红外荧光引导在机器人部分肾切除术中最佳选择夹紧策略
Urology video journal Pub Date : 2023-10-01 DOI: 10.1016/j.urolvj.2023.100256
Daniele Amparore , Federico Piramide , Paolo Verri , Enrico Checcucci , Sabrina De Cillis , Alberto Piana , Gabriele Volpi , Giovanni Busacca , Mariano Burgio , Marco Colombo , Matteo Manfredi , Cristian Fiori , Francesco Porpiglia
{"title":"3D virtual models plus near-infrared fluorescence guidance for the best selective clamping strategy during robotic partial nephrectomy","authors":"Daniele Amparore ,&nbsp;Federico Piramide ,&nbsp;Paolo Verri ,&nbsp;Enrico Checcucci ,&nbsp;Sabrina De Cillis ,&nbsp;Alberto Piana ,&nbsp;Gabriele Volpi ,&nbsp;Giovanni Busacca ,&nbsp;Mariano Burgio ,&nbsp;Marco Colombo ,&nbsp;Matteo Manfredi ,&nbsp;Cristian Fiori ,&nbsp;Francesco Porpiglia","doi":"10.1016/j.urolvj.2023.100256","DOIUrl":"10.1016/j.urolvj.2023.100256","url":null,"abstract":"<div><h3>Objective</h3><p>Indocyanine green (ICG) and Three-dimensional virtual models (3DVMs) have been developed and introduced in surgical daily practice in the last years to improve preoperative planning and efficacy of selective clamping during nephron sparing surgery. Aim of the study is to evaluate ICG and 3DVMs usefulness in guiding the surgeon's strategy during robot-assisted partial nephrectomy (RAPN).</p></div><div><h3>Materials and methods</h3><p>We retrospectively reviewed our institutional database and analysed all patients harboring organ-confined renal masses underwent RAPN from 2018 to 2023. Specifically, we included all the patients with a 3DVMs available for preoperative planning and intraoperative surgical navigation. In those cases in which a selective clamping was planned and intraoperatively preformed, ICG solution was injected allowing visualization of the kidney's perfusion regions during the surgery. All demographic, intraoperative, postoperative and functional data were extracted and evaluated, comparing the 3DVM-ICG selective clamping with the global clamping Group.</p></div><div><h3>Results</h3><p>Overall, 212 patients were included. 111 (51%) patients underwent 3DVM-ICG selective clamping RAPNs. No differences were recorded in terms of preoperative or perioperative variables between the global and the selective clamping group, except for a lower operative time for the global clamping group (93.5 min vs. 100 min, <em>p</em> = 0.02). Focusing on the functional outcomes, the selective clamping group showed better postoperative outcomes in terms of ΔeGFR at every timepoint considered (postoperative: -10.4% vs. -16.7%, <em>p</em> = 0.003; 3rd month: -9% vs. -14%, <em>p</em> = 0.01; 6th month: -8.9% vs. -13.8%, <em>p</em> = 0.04).</p></div><div><h3>Conclusions</h3><p>ICG and 3DVMs can be considered the most useful and advanced tools to plan an effective selective clamping strategy during RAPN. They can be used in different ways, matching the surgeon's needs from the planning phase to the time of the surgery, leading towards maximum safety and efficacy outcomes.</p></div>","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"20 ","pages":"Article 100256"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590089723000506/pdfft?md5=cdecf9288785bf86a2bf323df158a720&pid=1-s2.0-S2590089723000506-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136127699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Peri-operative considerations for inflatable penile prosthesis: A same-day discharge pathway 充气阴茎假体的围手术期注意事项:当日出院途径
Urology video journal Pub Date : 2023-10-01 DOI: 10.1016/j.urolvj.2023.100252
Sami E. Majdalany, Grace Yaguchi, Mahdi Bazzi, Marcus L. Jamil, Ali A. Dabaja, Amarnath Rambhatla
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