Videourology (New Rochelle, N.Y.)最新文献

{"title":"Robot-Assisted Revision of Bilateral Ureteroenteric Anastomotic Strictures","authors":"Nirupama Ancha, Safiya-Hana Belbina, Sofia Gereta, Aaron Laviana","doi":"10.1089/vid.2023.0031","DOIUrl":"https://doi.org/10.1089/vid.2023.0031","url":null,"abstract":"Background: The incidence of ureteroenteric stricture (UES) after radical cystectomy is approximately 8%.1–4 UES is often managed with long-term indwelling ureteral stents or nephrostomy tubes, both of which can have a negative impact on quality of life and require frequent exchange. In this video, we are the first to describe bilateral robotic-assisted revision of UES in a neobladder with the assistance of Firefly and Indocyanine Green (ICG). Clinical History: A 66-year-old male underwent an open cystoprostatectomy and open neobladder construction in 2016 due to bladder cancer. Seven years later, he presented with back pain and serum creatinine elevated to 3.5 mg/dL. He had no prior history of radiation. Physical Exam: Physical exam was significant for an intact midline incision from previous procedures. Diagnosis: Imaging revealed stable bilateral hydronephrosis from bilateral UES. Intervention: On presentation, the patient was managed with indwelling nephroureteral stents connected to external drainage. The patient strongly preferred definitive revision to avoid continuous nephroureteral stent exchange. As such, we proceeded with a robotic-assisted revision of bilateral ureteroenteric anastomoses in a neobladder. The surgery began with laparoscopic lysis of adhesions from the previous open procedures. ICG was given through the bilateral nephrostomy tubes to facilitate ureteral and neobladder identification and highlight healthy ureteral tissue. The right ureter was mobilized and resected sharply, and the old ureteral stent was exchanged. The right ureter was then spatulated sharply at the anterior roof, and a cystostomy was made into the afferent limb. A running anastomosis was performed with 4-0 polydioxanone suture and reinforced with 4-0 vicryl suture. The same technique was repeated on the left ureter. Due to the shortened length of the left ureter, it was reimplanted into the top of the afferent chimney, the portion of the neobladder having the most mobility. Bilateral nephrostomy tubes were removed intraoperatively. Follow-Up/Outcomes: The patient's postoperative course was uncomplicated. His serum creatinine normalized to 2.0 mg/dL. He was discharged home on postoperative day 5 with a foley catheter which was removed 10 days later. Both ureteral stents were removed cystoscopically and at 6 months postoperatively, he remains drain and stent free with a stable creatinine of 2.0 mg/dL. His hydronephrosis has also resolved. Overall, bilateral ureteroenteric anastomotic strictures are a significant complication of radical cystectomy and urinary diversion that are rarely documented. In this video, we are the first to validate the usefulness of a conventional robot-assisted system for simultaneous repair of bilateral UES in a neobladder. No competing financial interests exist. Runtime of video: 5 mins 4 secs","PeriodicalId":92974,"journal":{"name":"Videourology (New Rochelle, N.Y.)","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134918124","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":"The Vortex Effect in Minimally Invasive Percutaneous Nephrolithotomy","authors":"Willian E. Ito, Dillon J. Prokop, Crystal Valadon, Bristol B. Whiles, Donald A. Neff, David A. Duchene, Wilson R. Molina","doi":"10.1089/vid.2023.0035","DOIUrl":"https://doi.org/10.1089/vid.2023.0035","url":null,"abstract":"Introduction: Minimally invasive percutaneous (MIP) nephrolithotomy was initially discredited with assumptions of difficult stone fragment retrieval because of the equipment's smaller size. However, in 2008 Nagele et al. described a hydrodynamic phenomenon that allowed stone retrieval without the aid of endoscopic tools.1–3 This study aims to describe the physical principles of the “vortex effect” to better understand its applicability in MIP procedures. Methods: Two acrylic phantom models were built based on the cross-sectional area (CSA) ratio of an MIP nephroscope and access sheaths (15/16F and 21/22F MIP-M™, Karl Storz®). The nephroscope–phantom was 10 mm in diameter. The access sheaths had diameters of 14 mm (CSA ratio: 0.69) and 20 mm (CSA ratio: 0.30). The models were adapted to generate hydrolysis, and hydrogen bubbles enhanced flow observation on a green laser background. After calibration, the experimental flow rate was set to 12.0 mL/sec. Three 30-second trials assessing the flow were performed with each model. Computational fluid dynamic simulations were completed to determine the speed and pressure profiles. Results: In both models, as the incoming fluid from the nephroscope–phantom attempted to move toward the collecting system, a stagnation point (SP) was demonstrated. No fluid entered the collecting system phantom. Utilizing the 14 mm sheath, we observed a random generation of several vortices and a pressure gradient (PG) of 114.4 Pa between the nephroscope's tip and SP. When the 20 mm sheath was examined, a significantly smaller PG (19.4 Pa) and no noticeable vortices were noted. Conclusions: The speed of the fluid and equipment geometry regulate the PG and the vortices field, which are responsible for the production of the vortex effect. Considering the same flow rate, a higher ratio between the CSA of the nephroscope and access sheath results in improved efficacy of the vortex. Patient Consent Statement: This is a bench study. No patients were involved in this study. Consent statements are not applicable to this type of study. W.R.M. reports a relationship with Olympus Surgical Technologies America that includes consulting or advisory, funding grants, and speaking and lecture fees. W.R.M. reports a relationship with Boston Scientific Corp that includes consulting or advisory, funding grants, and speaking and lecture fees. W.R.M. reports a relationship with Fortec that includes consulting or advisory, funding grants, and speaking and lecture fees. W.R.M. reports a relationship with IPG that includes consulting or advisory, funding grants, and speaking and lecture fees. D.A.N. reports a relationship with Boston Scientific Corp that includes consulting or advisory, funding grants, and speaking and lecture fees. D.A.D. reports a relationship with Lumenis Inc Americas that includes consulting or advisory, funding grants, and speaking and lecture fees. All other authors have no disclosures to inform. Runtime of video: 8 mins 00 secs ","PeriodicalId":92974,"journal":{"name":"Videourology (New Rochelle, N.Y.)","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135248643","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":"Donor-Gifted Allograft Staghorn Calculus Managed via Percutaneous Nephrolithotomy","authors":"Maria Veronica Rodriguez, Octavio Herrera, Brett Friedman, Mario Moya, Gaudencio Olgin","doi":"10.1089/vid.2023.0041","DOIUrl":"https://doi.org/10.1089/vid.2023.0041","url":null,"abstract":"Donor-gifted lithiasis presents in <1%. Presentation is asymptomatic given allograft denervation, but it can be associated with infections, hydronephrosis, or creatinine (Cr) elevations. Ultrasonography (US) offers the possibility to detect calculi that can be managed during transplantation. However, its use has remained controversial due to the infrequent occurrence of these events, making the benefits of imaging cadaveric kidneys unclear. Historically, the management can be achieved through medical expulsion therapy or any percutaneous procedures. For those stones <1.5 cm, extracorporeal shock wave lithotripsy is commonly used. Retrograde ureteroscopy is challenging since access to the reimplanted ureter is at the dome. For large stones, percutaneous nephrolithotomy (PCNL) is preferred to achieve high stone-free rates. In the past, open or percutaneous procedures were avoided due to high morbidity along with risks of immunosuppression, like poor wound healing.1 However, multiple series have demonstrated favorable long-term outcomes in patients undergoing PCNL.2,3 Late diagnosis can lead to graft rejection. The downfall of long-term observation in a denervated kidney is the potential for obstruction, silent hydronephrosis, and pyelonephritis/sepsis in an immunocompromised patient. There are concerns regarding PCNL's safety in immunosuppressed, as the surgery itself results in a grade 4 renal laceration, albeit controlled and targeted. Heterotopic allograft positioning in the iliac fossa creates challenges in obtaining a direct calyceal puncture, increasing risk for vascular injuries. Additionally, immunosuppressives generate an inflammatory capsule surrounding the allograft, which may limit pyelocaliceal dilation and nephroscope manipulation.4,5 This is a rare presentation of a 53-year-old with a donor-gifted allograft staghorn calculus managed with PCNL. History included polycystic kidney that resulted in renal failure, hemodialysis was for 6 years prior to transplant. Postoperatively, a staghorn and multiple calyceal stones were diagnosed. Computed tomography was essential during planning to avoid inadvertent bowel injury while obtaining abdominal access. Interventional radiology placed two guidewires into the midpole through a 6F × 25 cm Terumo sheath. Intraoperatively, a 0.038″ hydrophilic guidewire was advanced to obtain through and through access given the short skin-to-stone distance and the risk of losing access. A dual lumen was placed over a guidewire following the markers to estimate the skin-to-stone distance and achieve optimal tract dilation. The 30F × 35 cm access sheath was placed, and the 25F nephroscope with a lithotripter was used to fragment stones. The flexible nephroscope with extraction devices were used to achieve a stone-free outcome. One consideration during this procedure is the short skin-to-stone distance in the abdomen compared to the traditional distance when working in the retroperitoneum. It is important to maint","PeriodicalId":92974,"journal":{"name":"Videourology (New Rochelle, N.Y.)","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134995234","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":"Lined Gauze Plug-In Prevention of Stone Migration in Supine Percutaneous Nephrolithotomy","authors":"Deerush Kannan, Praveen G. Sekaran, J. Soni, R. Paul, Pratik Taur, Nitesh Jain","doi":"10.1089/vid.2023.0024","DOIUrl":"https://doi.org/10.1089/vid.2023.0024","url":null,"abstract":"","PeriodicalId":92974,"journal":{"name":"Videourology (New Rochelle, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42617897","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 Heminephrectomy in Crossed Fused Renal Ectopia with Complex Cyst","authors":"Moacir Cavalcante de Albuquerque Neto, Thomé Décio Pinheiro Barros Júnior, Nayrton Kalys Cruz dos Anjos, Heron Oliveira Schots, Guilherme Bastos Palitot de Brito, Fabio de Oliveira Vilar","doi":"10.1089/vid.2023.0040","DOIUrl":"https://doi.org/10.1089/vid.2023.0040","url":null,"abstract":"","PeriodicalId":92974,"journal":{"name":"Videourology (New Rochelle, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42215747","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 Transabdominal Graft Nephrectomy for Renal Mass in the Transplant Kidney","authors":"Deerush Kannan, Praveen G. Sekaran, Aarthy Panneerselvam, J. Soni, Nitesh Jain","doi":"10.1089/vid.2023.0028","DOIUrl":"https://doi.org/10.1089/vid.2023.0028","url":null,"abstract":"","PeriodicalId":92974,"journal":{"name":"Videourology (New Rochelle, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46371074","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 Transabdominal Single-Position Simultaneous Bilateral Pyeloplasty with Hidden-Incision Trocar Layout: Two Cases Experience","authors":"Chunru Xu, Kunlin Yang, Zhihua Li, Jian Lin, Liqun Zhou, Xuesong Li","doi":"10.1089/vid.2023.0038","DOIUrl":"https://doi.org/10.1089/vid.2023.0038","url":null,"abstract":"","PeriodicalId":92974,"journal":{"name":"Videourology (New Rochelle, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44315677","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":"Extraperitoneal Laparoscopic Simple Prostatectomy for Benign Prostate Hyperplasia","authors":"Amit Sharma, D. Biswal, RT Raghavendra, Pradhuman Yadav","doi":"10.1089/vid.2023.0023","DOIUrl":"https://doi.org/10.1089/vid.2023.0023","url":null,"abstract":"","PeriodicalId":92974,"journal":{"name":"Videourology (New Rochelle, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45874393","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 Excision of a Challenging Case of Left Recurrent Seminal Vesicle Cyst: Surgical Nuances and Management of Intraoperative Complication","authors":"S. Sureka, Ankit Misra, Anil Baid, U. Singh","doi":"10.1089/vid.2022.0078","DOIUrl":"https://doi.org/10.1089/vid.2022.0078","url":null,"abstract":"","PeriodicalId":92974,"journal":{"name":"Videourology (New Rochelle, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46920161","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":"Total Transperineal Biopsy with Ultrasound-MRI Coregistration for Patients with No Rectum Access","authors":"Sara Moreno Sorribas, E. Gómez Gómez, J. Carrasco Valiente, G. Lendínez Cano, J. Valero Rosa, D. López Ruiz, F. A. Anglada Curado","doi":"10.1089/vid.2023.0010","DOIUrl":"https://doi.org/10.1089/vid.2023.0010","url":null,"abstract":"","PeriodicalId":92974,"journal":{"name":"Videourology (New Rochelle, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44235220","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}