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To describe the evolution of robotic partial nephrectomy (PN) technique and to analyze the surgical outcomes in a large single institution experience. Retrospective review of our institutional review board–approved, prospectively maintained, minimally invasive PN database yielded 252 robotic partial nephrectomy (RPN) procedures from June 2007 to October 2010. Our initial experience, adopted from...
We report an unusual case of a periurethral cystic mass in a 43-year-old man who presented with perineal pain, dysuria, painful ejaculation, and post-ejaculatory lower urinary tract symptoms. Computed tomography and magnetic resonance imaging demonstrated a multiocular periurethral cystic structure. On surgical exploration of the urethra, a cystic lesion was identified and removed. The mass was classified...
To evaluate the safety and feasibility of robotic partial nephrectomy for patients with complex renal masses.We reviewed the data for 164 consecutive patients who had undergone transperitoneal robotic partial nephrectomy at a tertiary care center from February 2007 to June 2010. Of the 112 patients who had available imaging studies to review, 67 were identified and classified as having a moderately...
To describe novel robotic laparoendoscopic single-site surgery (R-LESS) instruments, and present the initial laboratory experience in urology.The VeSPA surgical instruments (Intuitive Surgical, Sunnyvale, CA) were designed to be used with the DaVinci Si surgical system. A multichannel port and curved cannulae were inserted through a single 3.5-cm umbilical incision. The port allowed 1 scope, 2 robotic...
We describe a case of retrocaval ureter treated with laparoendoscopic single-site surgery (LESS).A 26-year-old female was referred to our institution with a history of intermittent right-sided flank pain. Radiological imaging demonstrated hydronephrosis, suggesting the presence of a retrocaval ureter. A LESS repair was planned.Retrograde pyelogram confirmed a classic appearance for retrocaval ureter...
To report the first series of laparoendoscopic single-site surgery for radical cystectomy and bilateral pelvic lymph node dissection. The development of laparoendoscopic single-site surgery and its application to urothelial malignancy has not been previously evaluated.A novel, single multichannel port and flexible laparoscopic instruments and laparoscope were used for all procedures. The eligible...
To present comparative outcomes among matched patients who underwent robotic partial nephrectomy (RPN) or laparoscopic partial nephrectomy (LPN) by a single surgeon at a single institution.Between March 2002 and August 2009, a retrospective review of 261 consecutive patients who underwent LPN (n = 186) or RPN (n = 75) by a single surgeon was performed. Patients were matched for age, gender, body mass...
To compare the incidence of positive surgical margins obtained with robotic-assisted laparoscopic prostatectomy (RALP), during the initiation of a robotics program, with that from a similarly matched cohort of open radical retropubic prostatectomy (RRP) cases as performed by a single surgeon.From December 2005 to March 2008, 63 patients underwent RRP and another 50 underwent RALP by a single urologist...
Decompression of compartment syndrome is known to salvage tissues in numerous organ systems. To demonstrate evidence that testes exposed to prolonged ischemia exhibit compartment syndrome physiology and propose a novel technique in treating this phenomenon.Three boys, aged 11, 14, and 16 years, with prolonged testicular torsion lasting 6-7 hours were taken to the operating room. All testes appeared...
To compare the effectiveness of two local anesthetic techniques in men undergoing no-scalpel vasectomy.Before undergoing no-scalpel vasectomy, 50 men underwent separate forms of anesthesia to each side of their scrotum. One vas deferens was anesthetized with a high-pressure spray of 0.3 mL 2% lidocaine using the MadaJet Medical Injector, and the other vas deferens was anesthetized using the traditional...
Ureteral injury secondary to blunt trauma is rare. Bilateral ureteropelvic disruptions have only been reported eight times previously. A high index of suspicion must guide the appropriate evaluation, and the severity of the disruption will determine the management options. We present the case of a 63-year-old man who had fallen from his roof and subsequently partially disrupted both ureteropelvic...
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