Laparoscopic ureteropyeloanastomosis in iatrogenic trauma of the upper pole ureter in a duplex kidney

2018 ◽

Vol 1 (2) ◽

pp. 7

Author(s):

Jun Ho Lee

Keyword(s):

Lumbar Disc ◽

Lumbar Discectomy ◽

Radiographic Evaluation ◽

Operative Indication ◽

Endoscopic Techniques ◽

Bone Removal ◽

Iatrogenic Trauma ◽

Minimal Damage ◽

Surgical Modality ◽

Endoscopic Lumbar Discectomy

Background: Percutaneous endoscopic lumbar discectomy (PELD) is one of the most sophisticated operative procedures for the treatment of lumbar disc herniation (LDH). Endoscopic techniques are now becoming standard in many areas due to expanded technical possibilities of full-endoscopic transforaminal or interlaminar resection of herniated lumbar discs as well as stenosis. However conventional percutaneous endoscopic interlaminar discectomy (PEID) disc operations may sometimes result in subsequent untoward complications due to unnoticed iatrogenic trauma to neural structures, which is mostly related to an anatomical limitation during endoscope insertion.Methods: An appropriate operative indication of the PEID without bone removal or laminectomy can be used to treat LDH cases with an enough interlaminar space (at least ≥ 20 mm by bi-facetal distance) from the reported evidences. Otherwise, there might be several indications for requirement of bone removal; a narrow interlaminar space, disappearance of the concave shape of the upper vertebral laminae, high-grade migration of LDH, recurrent LDH, obesity, or an immobile nerve root.Conclusion: The significance of PEID lies also in its minimal damage to surrounding structures such as muscle, bone, and ligaments. A discrete radiographic evaluation from the patient preoperatively is mandatory before choosing a proper endoscopic surgical modality for the sake of optimal clinical outcome after PEID.

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Technical standardization of ICG near-infrared fluorescence (NIRF) laparoscopic partial nephrectomy for duplex kidney in pediatric patients

World Journal of Urology ◽

10.1007/s00345-021-03759-6 ◽

2021 ◽

Author(s):

Ciro Esposito ◽

Giuseppe Autorino ◽

Vincenzo Coppola ◽

Giorgia Esposito ◽

Mariano Paternoster ◽

...

Keyword(s):

Partial Nephrectomy ◽

Near Infrared ◽

Standard Technique ◽

Laparoscopic Partial Nephrectomy ◽

Loss Of Function ◽

Duplex Kidney ◽

Near Infrared Fluorescence ◽

Laparoscopic Equipment ◽

Clear Identification ◽

Operative Ultrasound

Abstract Purpose This study aimed to standardize the operative technique of indocyanine green (ICG) near-infrared fluorescence (NIRF) laparoscopic partial nephrectomy (LPN) and compare it with the standard technique. Methods In the last 4 years, we performed 22 LPN (14 right-sided, 8 left-sided) in children with non-functioning moiety of duplex kidney. Patients included 12 girls and 10 boys with a median age of 3.9 years (range 1–10). Patients were grouped according to the use of ICG-NIRF: G1 included 12 patients operated using ICG-NIRF and G2 included 10 patients receiving the standard technique. We standardized the technique of injection of ICG in three different steps. Results The median operative time was significantly lower in G1 [87 min (range 68–110)] compared with G2 [140 min (range 70–220)] (p = 0.001). One intra-operative complication occurred in G2. At post-operative ultrasound (US), the residual moiety was normal in all patients. An asymptomatic renal cyst related to the site of surgery was visualized at US in 8/22 (36%), with a significantly higher incidence in G2 (6/10, 60%) compared with G1 (2/12, 16.6%) (p = 0.001). Renogram demonstrated no loss of function of residual moiety. No allergic reactions to ICG occurred. Conclusion ICG-NIRF LPN is technically easier, quicker, and safer compared with the standard technique. The main advantages of using ICG-NIRF during LPN are the clear identification of normal ureter, vasculature of non-functioning pole, and demarcation line between the avascular and the perfused pole. The main limitation of ICG technology remains the need for specific laparoscopic equipment that is not always available.

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Interpolated Flaps

Facial Plastic Surgery ◽

10.1055/s-0037-1598170 ◽

2017 ◽

Vol 33 (01) ◽

pp. 034-042 ◽

Cited By ~ 1

Author(s):

Kaveh Karimnejad ◽

Ian Maher ◽

Paul Gruber ◽

Scott Walen ◽

Samkon Gado

Keyword(s):

Blood Supply ◽

Psychological Injury ◽

Nasal Reconstruction ◽

Central Feature ◽

Human Face ◽

Forehead Flap ◽

Future Directions ◽

Donor Tissue ◽

Indian Medical ◽

Iatrogenic Trauma

AbstractNasal reconstruction has been articulated in the literature since 700 B.C. when the earliest iteration of the forehead flap was described in the Indian medical treatise, the Sushruta Samhita. Since then it has evolved into the interpolated flap which has served as a powerful tool for facial reconstruction. The interpolated flap is constructed from nonadjacent donor tissue that has an inherent blood supply. It requires a multistaged approach and is best suited for reconstruction of large or deep defects of the nose. There are three types of interpolated flaps used for nasal reconstruction: the forehead, melolabial, and nasofacial interpolation flaps. The nose is the central feature of the human face and its placement is both aesthetic and functional. Any defects owing to accidental or iatrogenic trauma can cause physiologic and psychological injury to patients. This article aims to review the aforementioned flaps and give indications, contraindications, procedure details, and future directions of these flaps.

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Videolaparoscopic lower pole heminephrectomy for treatment of a duplex kidney

Journal of Pediatric Urology ◽

10.1016/j.jpurol.2018.11.009 ◽

2019 ◽

Vol 15 (2) ◽

pp. 193-194

Author(s):

G. Lang-Motta ◽

E. Llorens de Knecht ◽

J.M. Gaya Sopena ◽

Y. Quiróz Madarriaga ◽

A. Bujons Tur

Keyword(s):

Lower Pole ◽

Duplex Kidney

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Massive Spontaneous Hemothorax as a Complication of Apixaban Treatment

Case Reports in Pulmonology ◽

10.1155/2018/8735036 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

M. Abu Hishmeh ◽

P. Srivastava ◽

Q. Lougheide ◽

M. Srinivasan ◽

S. Murthy

Keyword(s):

Pleural Effusion ◽

Health Care Providers ◽

Rare Complication ◽

Pigtail Catheter ◽

Care Providers ◽

Nonvalvular Atrial Fibrillation ◽

Vein Thrombosis ◽

Spontaneous Hemothorax ◽

First Case ◽

Iatrogenic Trauma

Introduction. Hemothorax is usually related to chest or iatrogenic trauma from procedures such as central lines and thoracentesis. Spontaneous hemothorax is defined as pleural fluid hematocrit greater than 50% of serum hematocrit in absence of natural or iatrogenic trauma affecting the lung or pleural space. Coagulopathy secondary to anticoagulant use has been associated with spontaneous hemothorax. We present a case of spontaneous hemothorax in a patient taking apixaban for venous thromboembolism disease. To our knowledge, this is the first case report of apixaban as a cause of spontaneous hemothorax. Case Presentation. A 56-year-old woman with end-stage renal disease (ESRD) was diagnosed with upper extremity deep vein thrombosis (DVT) one month prior to presentation and was started on apixaban presented with dyspnea and left-sided pleuritic chest pain for two weeks. She was found to have left-sided large pleural effusion which was diagnosed as hemothorax. Other etiologies for spontaneous hemothorax were excluded and drainage by 12-French pigtail catheter achieved total resolution of hemothorax in three days. Discussion. Apixaban is a DOAC used to prevent stroke or thromboembolic events in patients with nonvalvular atrial fibrillation and to prevent recurrent venous thromboembolic disease. Events such as gastrointestinal, intracranial, and soft tissue bleeding have been well-documented. However, bleeding manifestation as hemothorax is seldom reported. Our patient presented with isolated left-sided large pleural effusion which was diagnosed as spontaneous hemothorax. 12-Fr pigtail catheter drainage was effective in the management of our patient and provided total resolution in three days. Conclusion. Spontaneous hemothorax is a rare complication of anticoagulant therapy and might not exhibit the usual radiological signs of traumatic hemothorax. Health care providers should have high index of suspicion for spontaneous hemothorax when evaluating new pleural effusion in patients receiving DOACs therapy. Drainage by small bore pigtail catheter might be as effective as larger chest tubes.

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