Initial outcomes of robotic assisted laparoscopic upper urinary tract reconstruction – report of the first 7 cases

2018 ◽  
Vol 8 (2) ◽  
Author(s):  
Anh Toàn Đỗ ◽  
◽  
Keyword(s):  
Urinary Tract ◽  
Operation Time ◽  
Upper Urinary Tract ◽  
Stone Extraction ◽  
Short Term ◽  
Robotic Assisted ◽  
Urinary Tract Reconstruction ◽  
The Mean ◽  
Radiographic Improvement ◽  
Robotic Assisted Laparoscopy

Tóm tắt Đặt vấn đề: Đánh giá kết quả ban đầu phẫu thuật nội soi ổ bụng với Rô bốt hỗ trợ tạo hình đường tiết niệu trên tại Bệnh viện Bình Dân.Phương pháp nghiên cứu: Số liệu thu thập từ 07 trường hợp (TH) được phẫu thuật nội soi ổ bụng với Rô bốt hỗ trợ tạo hình đường niệu trên, gồm các trường hợp tạo hình khúc nối bể thận – niệu quản có hoặc không lấy sỏi bể thận, phẫu thuật cắt nối niệu quản tận- tận và cắm lại niệu quản vào bàng quang. Các TH này được tiến hành tại Bệnh viện Bình Dân, từ 11/ 2016 đến 3/2017. Kết quả chính bao gồm khả năng cải thiện triệu chứng lâm sàng cũng như trên hình ảnh học và ghi nhận tỷ lệ tai biến - biến chứng xảy ra. Kết quả: Tất cả 07 TH đều phẫu thuật thành công, dù thời gian mổ tương đối dài, trung bình là 222,8 phút (150 – 330 phút), không có trường hợp nào xảy ra tai biến - biến chứng. Sau rút thông JJ niệu quản 01 tháng, chưa ghi nhận trường hợp nào bị tái phát. Kết luận: Qua 07 TH đầu tiên được phẫu thuật nội soi ổ bụng tạo hình đường tiết niệu trên với hỗ trợ Rô bốt cho thấy tuy thời gian mổ khá dài nhưng khả thi và an toàn, có thể thay thế mổ mở trong một số trường hợp phức tạp. Tuy nhiên, cần thực hiện với số lượng lớn hơn và theo dõi thêm để có thể đánh giá kết quả lâu dài của phương pháp này trong điều kiện thực tế hiện nay. Abstract Introduction: To evaluate the initial outcomes of robotic assisted laparoscopic (RAL) upper urinary tract (UUT) reconstruction at Binh Dan hospital. Material and Methods: 07 patients underwent RAL UUT reconstruction including pyeloplasty with or without stone extraction, uretero-ureterostomy and ureteric reconstruction at Binh Dan hospital from November 2016 to March 2017. Primary outcomes were symptomatic and radiographic improvement of obstruction and complication rate. Results: All 07 cases of RAL UUT reconstruction had good clinical and radiographic improvement without any significant complication (over grade I of Clavien Dindo classification). The mean operation time was 222,8 minutes (150 – 330 minutes). Conclusion: Robotic-assisted laparoscopic UUT could be performed safely with good short-term results and be considered a reasonable alternative to the open procedure for robotic experienced surgeons in some complicated cases. Keyword: Upper urinary tract reconstruction, robotic assisted laparoscopy.

Tubeless outpatient robotic upper urinary tract reconstruction in the pediatric population: short-term assessment of safety

2017 ◽  
Vol 12 (2) ◽  
pp. 257-260 ◽  
Author(s):  
Eric J. Fichtenbaum ◽  
Andrew C. Strine ◽  
Charles W. Concodora ◽  
Marion Schulte ◽  
Paul H. Noh
Keyword(s):  
Urinary Tract ◽  
Pediatric Population ◽  
Upper Urinary Tract ◽  
Short Term ◽  
Urinary Tract Reconstruction

386 OUTCOMES OF ROBOTIC-ASSISTED LAPAROSCOPIC UPPER URINARY TRACT RECONSTRUCTION: 214 CONSECUTIVE PATIENTS

2013 ◽  
Vol 189 (4S) ◽  
Author(s):  
Tracy Marien ◽  
Matthew Bilbily ◽  
Gaurav Rao ◽  
Ojas Shah ◽  
Michael Stifelman
Keyword(s):  
Urinary Tract ◽  
Upper Urinary Tract ◽  
Robotic Assisted ◽  
Urinary Tract Reconstruction

Outcomes of robotic-assisted laparoscopic upper urinary tract reconstruction: 250 consecutive patients

2015 ◽  
Vol 116 (4) ◽  
pp. 604-611 ◽  
Author(s):  
Tracy Marien ◽  
Marc A. Bjurlin ◽  
Blake Wynia ◽  
Matthew Bilbily ◽  
Gaurav Rao ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Upper Urinary Tract ◽  
Robotic Assisted ◽  
Urinary Tract Reconstruction

Pyeloureteral dynamics in the intact and chronically obstructed multicalyceal kidney

1981 ◽  
Vol 241 (5) ◽  
pp. R398-R411 ◽  
Author(s):  
C. E. Constantinou ◽  
J. C. Djurhuus
Keyword(s):  
Urinary Tract ◽  
Ureteral Obstruction ◽  
Intravenous Infusion ◽  
Upper Urinary Tract ◽  
Urine Flow ◽  
Hierarchical Organization ◽  
Bolus Volume ◽  
Pelvic Contractions ◽  
The Mean ◽  
Pelvic Pressure

The transport of urine in the upper urinary tract of the multicalyceal kidney was studied in healthy and chronically obstructed pigs in terms of renal pelvic pressure, rate of and coordination of ureteral contractions, and bolus volume. The variations of these parameters to diuresis was examined by incremental elevation of urine output effected by intravenous infusion of mannitol. In 16 healthy animals the mean variation in urine flow was 0.01-3.20 ml/min, the change in peristaltic rate ranged from 0.763 to 5.125 min-1, and bolus volume from 0.003 to 2.083 ml.. In 14 chronically obstructed kidneys, for a mean variation in urine flow of 0.006-5.4 ml/min, peristaltic rate ranged from 0.237 to 6.095 min-1 and bolus volume from 0.00 to 1.80 ml. Discoordinated contractions, bursts of peristalsis, and incompletely transmitted pelvic contractions were characteristic of a chronically obstructed system. These observations are compared with the unobstructed unicalyceal and multicalyceal kidney. The disrupting impact of chronic ureteral obstruction on the hierarchical organization of the pyeloureteral pacemaker system is discussed.

scholarly journals The effect and long-term outcome of Partial Anterior Myometrial Resection and Reconstruction under tourniquet and/or prophylactic abdominal aorta balloon occlusion on the patients with placenta percreta 

2020 ◽  
Author(s):  
Huidan Zhao ◽  
Chen Chen ◽  
Ya Tao ◽  
Zhuan Liu ◽  
Cai Liu ◽  
...  
Keyword(s):  
Blood Loss ◽  
Abdominal Aorta ◽  
Operation Time ◽  
Balloon Occlusion ◽  
Placenta Percreta ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
The Mean

Abstract Background Patients with placenta accreta spectrum (PAS) disorders often experience overwhelming hemorrhage during cesarean. Placenta percreta is the most serious subtype. In this paper, we propose a new procedure in order to control intraoperative bleeding. We aimed to evaluate the effect and long-term outcome of Partial Anterior Myometrial Resection and Reconstruction under tourniquet and/or prophylactic abdominal aorta balloon occlusion on patients with placenta percreta. Methods In a retrospective study, data from patients with placenta percreta who delivered by cesarean section between January 1, 2017 and December 31, 2019 were analyzed. Short-term and long-term outcomes were followed up by outpatient clinic and by phone. The quantity of estimated blood loss (EBL), operation time, urine tube time, hospital stay and short-term and long-term complications including fever, thrombosis, hematoma, breast feeding and menstruation problems, lower limb complaints, intrauterine adhesion and so on, were analyzed. Results For all cases, the mean EBL in the surgery was 1399 ± 948 mL, the mean operation time was 107 ± 35minutes, and the mean perioperative hospital stay was 9.6 ± 5.0 days. All the patients had a preserved uterus. Menstrual quantity decreased in 12 patients. Menstrual period prolonged in 11 cases. Uncomfortable abdomen symptoms happened in 9 cases after the surgery. Four cases got thrombosis and 3 got hematoma. Lower extremity discomfort was found in 6 patients. Conclusion Combined with prophylactic abdominal aorta balloon occlusion and/or tourniquet, Partial Anterior Myometrial Resection and Reconstruction is highly effective in reducing the intraoperative blood loss and hysterectomy in placenta percreta. But we should pay great attention to short-term and long-term complications, especially to the complications associated with aorta balloon occlusion.

scholarly journals Open Nephroureterectomy Compared to Laparoscopic in Upper Urinary Tract Urothelial Carcinoma: A Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Guihong Liu ◽  
Zeqin Yao ◽  
Guoqiang Chen ◽  
Yalang Li ◽  
Bing Liang
Keyword(s):  
Urinary Tract ◽  
Blood Loss ◽  
Urothelial Carcinoma ◽  
Meta Analysis ◽  
Operation Time ◽  
Upper Urinary Tract ◽  
Efficacy And Safety ◽  
Lower Blood ◽  
Urinary Tract Urothelial Carcinoma ◽  
Laparoscopic Nephroureterectomy

Background: In this meta-analysis, we will focus on evaluating the effects of open nephroureterectomy compared with laparoscopic nephroureterectomy on postoperative results in upper urinary tract urothelial carcinoma subjects.Methods: A systematic literature search up to January 2021 was performed, and 36 studies included 23,013 subjects with upper urinary tract urothelial carcinoma at the start of the study; of them, 8,178 were laparoscopic nephroureterectomy, and 14,835 of them were open nephroureterectomy. They were reporting relationships between the efficacy and safety of open nephroureterectomy compared with laparoscopic nephroureterectomy in the treatment of upper urinary tract urothelial carcinoma. We calculated the odds ratio (OR) or the mean difference (MD) with 95% CIs to evaluate the efficacy and safety of open nephroureterectomy compared with laparoscopic nephroureterectomy in the treatment of upper urinary tract urothelial carcinoma using the dichotomous or continuous method with a random or fixed-effect model.Results: Laparoscopic nephroureterectomy in subjects with upper urinary tract urothelial carcinoma was significantly related to longer operation time (MD, 43.90; 95% CI, 20.91–66.90, p < 0.001), shorter hospital stay (MD, −1.71; 95% CI, −2.42 to −1.00, p < 0.001), lower blood loss (MD, −133.82; 95% CI, −220.92 to −46.73, p = 0.003), lower transfusion need (OR, 0.56; 95% CI, 0.47–0.67, p < 0.001), and lower overall complication (OR, 0.79; 95% CI, 0.70–0.90, p < 0.001) compared with open nephroureterectomy.However, no significant difference was found between laparoscopic nephroureterectomy and open nephroureterectomy in subjects with upper urinary tract urothelial carcinoma in 2–5 years recurrence-free survival (OR, 0.90; 95% CI, 0.69–1.18, p = 0.46), 2–5 years cancer-specific survival (OR, 0.94; 95% CI, 0.69–1.28, p = 0.68), and 2–5 years overall survival (OR, 1.31; 95% CI, 0.91–1.87, p = 0.15).Conclusion: Laparoscopic nephroureterectomy in subjects with upper urinary tract urothelial carcinoma may have a longer operation time, shorter hospital stay, and lower blood loss, transfusion need, and overall complication compared to open nephroureterectomy. Further studies are required to validate these findings.

V2-05 ROBOTIC UPPER URINARY TRACT RECONSTRUCTION USING NEAR INFRARED FLUORESCENCE IMAGING

2014 ◽  
Vol 191 (4S) ◽  
Author(s):  
Susan Marshall ◽  
Marc Bjurlin ◽  
Tyler Mcclintock ◽  
Tracy Marien ◽  
Michael Borofsky ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Fluorescence Imaging ◽  
Near Infrared ◽  
Upper Urinary Tract ◽  
Near Infrared Fluorescence ◽  
Urinary Tract Reconstruction ◽  
Near Infrared Fluorescence Imaging

scholarly journals Treatment of upper urinary tract stones with flexible ureteroscopy in children

2018 ◽  
Vol 13 (3) ◽  
Author(s):  
Jing Xiao ◽  
Xiangyu Wang ◽  
Jun Li ◽  
Miaomiao Wang ◽  
Tiandong Han ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Operation Time ◽  
Upper Urinary Tract ◽  
Laser Lithotripsy ◽  
Holmium Laser ◽  
Flexible Ureteroscopy ◽  
Holmium Laser Lithotripsy ◽  
Stone Free Rate ◽  
Urinary Tract Stones ◽  
Free Rate

Introduction: This single-centre, retrospective study aimed to assess the efficacy and safety of flexible ureteroscopy (FURS) combined with holmium laser lithotripsy in treating children with upper urinary tract stones. Methods: From June 2014 to October 2015, a total of 100 children (74 boys and 26 girls) with upper urinary tract stones were treated using FURS. A 4.7 Fr double-J stent was placed two weeks before operation. Patients were considered stone-free when the absence of residual fragments was observed on imaging studies. The preoperative, operative, and postoperative data of the patients were retrospectively analyzed. Results: A total of 100 pediatric patients with a mean age of 3.51±1.82 years underwent 131 FURS and holmium laser lithotripsy. Mean stone diameter was 1.49±0.92 cm. Average operation time was 30.8 minutes (range 15–60). The laser power was controlled between 18 and 32 W, and the energy maintained between 0.6 and 0.8 J at any time; laser frequency was controlled between 30 and 40 Hz. Complications were observed in 69 (69.0 %) patients and classified according to the Clavien system. Postoperative hematuria (Clavien I) occurred in 64 (64.0 %) patients. Postoperative urinary tract infection with fever (Clavien II) was observed in 8/113 (7.1%) patients. No ureteral perforation and mucosa avulsion occurred. The overall stone-free rate of single operation was 89/100 (89%). Stone diameter and staghorn calculi were significantly associated with stone-free rate. Conclusions: FURS and holmium laser lithotripsy is effective and safe in treating children with upper urinary tract stones.

scholarly journals A randomized prospective study: assessment of transient ureteral stenting by mono-J insertion after primary URS and stone extraction (FaST 3)

Urolithiasis ◽  
2021 ◽  
Author(s):  
Alina Reicherz ◽  
Hannah Westhues ◽  
Lorine Häuser ◽  
Patricia Wenzel ◽  
Joachim Noldus ◽  
...  
Keyword(s):  
Fast Track ◽  
Urinary Calculi ◽  
Operation Time ◽  
Stone Extraction ◽  
Short Term ◽  
Stone Size ◽  
Treatment Groups ◽  
Ureteral Stenting ◽  
Operation Duration ◽  
And Gender

AbstractTo compare the outcome of a short-term insertion of a mono-J catheter for 6 h following ureteroscopic stone removal to a conventional double-J catheter. This single-center academic study (Fast Track Stent study 3) evaluated stenting in 108 patients with urinary calculi after ureterorenoscopy. Patients were prospectively randomized into two study arms before primary ureterorenoscopy: (1) mono-J insertion for 6 h after ureterorenoscopy and (2) double-J insertion for 3–5 days after ureterorenoscopy. Study endpoints were stent-related symptoms assessed by an ureteral stent symptom questionnaire (USSQ) and reintervention rates. Stone sizes and location, age, operation duration, BMI, and gender were recorded. Of 67 patients undergoing ureterorenoscopy, 36 patients were analyzed in the double-J arm and 31 patients in the mono-J arm. Mean operation time was 27.5 ± 1.3 min versus 24.0 ± 1.3 min, and stone size was 5.2 mm versus 4.5 mm for mono-J versus double-J, respectively (p = 0.06 and p = 0.15). FaST 3 was terminated early due to a high reintervention rate of 35.5% for the mono-J group and 16.7% for the double-J group (p = 0.27). One day after ureterorenoscopy, USSQ scores were similar between the study arms (Urinary Index: p = 0.09; Pain Index: p = 0.67). However, after 3–5 weeks, the Pain Index was significantly lower in those patients who had a double-J inserted after ureterorenoscopy (p = 0.04). Short-term insertion of mono-J post-ureterorenoscopy results in similar micturition symptoms and pain one day after ureterorenoscopy compared to double-J insertion. The reintervention rate was non-significant between the treatment groups most likely due to the early termination of the study (p = 0.27). Ethics approval/Trail Registration: No. 18-6435, 2018

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