Distal Corporoplasty for Distal Cylinders Extrusion after Penile Prosthesis Implantation

2016 ◽  
Vol 84 (1) ◽  
pp. 38-39 ◽  
Author(s):  
Maurizio Carrino ◽  
Francesco Chiancone ◽  
Gaetano Battaglia ◽  
Luigi Pucci ◽  
Paolo Fedelini
Keyword(s):  
Postoperative Complications ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Penile Prosthesis ◽  
Prosthetic Material ◽  
Safe Procedure ◽  
Potential Complication ◽  
Prosthesis Implantation ◽  
Mean Values

Introduction Distal extrusion of cylinders is a potential complication of the penile prosthesis implantation. Several methods have been proposed for repairing a distal penile erosion. We present our preliminary experience in “Distal corporoplasty” technique. Methods We enrolled 18 consecutive patients whose underwent a distal corporoplasty with simultaneous reimplantation of an “AMS 700 inflatable penile prosthesis (LGX)” from January 2013 to November 2015 at our hospital. All procedures were performed by a single surgical team. Intraoperative and postoperative complications have been classified and reported according to Satava6 and Clavien-Dindo (CD) system.7 Mean values with standard deviations (±SD) were computed and reported for all items. Results Mean age of the patients was 53.61 (±11.90) years. Mean body max index (BMI) was 24.22 (±2.51). Mean operative time was 85.2 (±13.1) minutes. Blood losses were minimal. No intraoperative complications are reported according to Satava classification. Four out of 18 patients (22.22%) experienced postoperative complications according to CD system. All patients had sexual intercourse for the first time postsurgery after a mean of 59.11 ± 2.08 days. Mean follow-up was 22.11 (±9.95). Discussions Distal extrusion of cylinders is a potential complication of the penile prosthesis implantation. Distal corporoplasty was first described by Mulcahy. He reported a series of 14 patients with a follow-up of about 2 years with optimal functional outcomes. Moreover, distal corporoplasty resulted in shorter operative time, better function, less pain, and fewer recurrences than Gortex windsock repair.10 In our experience, distal corporoplasty is a simple and safe procedure in the treatment of distal cylinders extrusion when the prosthetic material is not exposed to the exterior.

Phacoemulsification on Previously Vitrectomized Eyes: Results of a 10-Year Period

2007 ◽  
Vol 17 (4) ◽  
pp. 601-604 ◽  
Author(s):  
Z. Szijártó ◽  
B. Haszonits ◽  
Z. Biró ◽  
B. Kovács
Keyword(s):  
Postoperative Complications ◽  
Intraoperative Complications ◽  
Posterior Capsule Opacification ◽  
Posterior Capsule ◽  
Safe Procedure ◽  
Intraocular Pressure Elevation ◽  
Posterior Capsule Rupture ◽  
Pars Plana ◽  
Visual Results

Purpose To provide an overview of intraoperative and postoperative complications during phacoemulsification cataract surgery and to evaluate the visual results in patients having pars plana vitrectomy (PPV) with 10 years of follow-up. Methods Retrospective evaluation of intraoperative and postoperative complications and postoperative visual results in 134 consecutive patients who underwent phacoemulsification after PPV. Of 11,498 eyes treated with phacoemulsification, 143 (1.2%) had previous PPV during the 10-year period (January 1, 1995-December 31, 2004). A total of 134 eyes were included in this study. Results The phacoemulsification procedure seemed to be difficult where there was a deep or fluctuating anterior chamber (93%) and primary posterior capsule opacification (19%). The most frequent intraoperative complications were posterior capsule rupture (9%) and incomplete capsular rhexis (5%). Postoperative intraocular pressure elevation (7%), retinal detachment (6%), and posterior capsule opacification (8%) occurred most frequently during the mean follow-up period of 18.2 months (1.5–110 months). Best-corrected visual acuity (BCVA) increased two or more Snellen E lines in 55% of the cases or became better than or equal to 0.5 in 10% of the cases. Conclusions Despite the well-known difficulties encountered in vitrectomized eyes such as zonular damage, increased mobility of the lens-iris diaphragm, and altered intraocular fluid dynamics, phacoemulsification proved to be a safe procedure in the hands of experienced surgeons.

Erectile Dysfunction: Surgical Treatment (Vascular and Prosthetic Surgery)

2019 ◽  
Author(s):  
M Ryan Farrell ◽  
Laurence A Levine ◽  
George A Abdelsayed
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Intraoperative Complications ◽  
Penile Prosthesis ◽  
Pelvic Trauma ◽  
Effective Treatment Option ◽  
Prosthesis Implantation ◽  
Inflatable Penile Prosthesis ◽  
Arterial Insufficiency ◽  
Prosthetic Surgery

Surgical treatment oferectile dysfunction (ED) can be considered in men who either fail or elect to avoid further nonoperative modalities. For patients with an organic etiology of ED, a penile prosthesis can be placed. There are multiple approaches available for penile prosthesis implantation including penoscrotal, infrapubic, and subcoronal. Furthermore, the location of reservoir placement should be considered, either within the space of Retzius or at an ectopic submuscular location according to patient factors. Potential intraoperative and postoperative complications of penile prosthesis implantation are also reviewed. Alternatively, for young and otherwise healthy men with ED secondary to focal arterial insufficiency often in the setting of pelvic trauma, penile microarterial bypass surgery is an effective treatment option. This review contains 6 figures, 2 tables, and 48 references.  Key words:erectile dysfunction, inflatable penile prosthesis, malleable penile prosthesis, surgical technique, intraoperative complications, postoperative complications, arterial revascularization

scholarly journals Laparoscopic Risk-Reducing Salpingo-Oophorectomy: The Brigham and Women's Experience

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Melina Shoni ◽  
Taymaa May ◽  
Allison F. Vitonis ◽  
Anjelica Garza ◽  
Michael G. Muto ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Admission Rate ◽  
Safe Procedure ◽  
Short Term ◽  
Surgical Morbidity ◽  
Hospital Admission Rate ◽  
Estimated Blood Loss ◽  
Risk Reducing

Objective. To establish short-term surgical outcomes of three-port laparoscopic risk-reducing salpingo-oophorectomy (RRSO) in women with hereditary breast-ovarian cancer syndrome (HBOC). Methods. The medical records of all HBOC women that underwent laparoscopic RRSO between January 2001 and December 2010 were retrospectively reviewed. Demographic data, operative details, and short-term surgical outcomes were obtained and subjected to SAS. Statistical univariate and multivariate analyses were performed. Results. 358 patients met study criteria with 277 (77.4%) carrying a documented BRCA mutation. The predominant technique utilized three ports (two 5 mm and one 10/12 mm), a 5 mm laparoscope and a 5 mm Ligasure pulsatile bipolar device. Mean operative time was 58.3 minutes (SD 22.6, 26.0–197.0), significantly affected by BMI greater than 30 (P<0.0001) and status of adhesions (P=0.001). Estimated blood loss (EBL) was negligible in 96.9% of cases. Seven patients required conversion to laparotomy. No major intraoperative complications were recorded. One-night hospital admission rate was less than 2.0% while postoperative complication rate was 3.1%. Malignancy was revealed in 14 patients (3.9%). Conclusion. In HBOC population, three-port laparoscopic RRSO is a simple, reproducible, and safe procedure with low conversion rate, short operative time, minimal EBL, low surgical morbidity, and rapid postoperative recovery.

A modified ileal conduit technique in patients undergoing radical cystectomy: Single-centre experience

2021 ◽  
pp. 205141582110414
Author(s):  
Francesco Chiancone ◽  
Francesco Persico ◽  
Marco Fabiano ◽  
Maurizio Fedelini ◽  
Clemente Meccariello ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Radical Cystectomy ◽  
Ileal Conduit ◽  
Intraoperative Complications ◽  
Perioperative Outcomes ◽  
Multivariate Logistic Regression Model ◽  
Increased Risk

Objective: We aimed to evaluate perioperative outcomes and complications of a modified technique of ileal conduit diversion. Methods: Forty-seven cases of radical cystectomy with modified ileal conduit diversion were performed at our institution from January 2015 to January 2020. After radical cystectomy, a segment of ileum was used to pack the conduit and was placed below the digestive anastomosis. Then, the mesentery window of the ileo-ileal anastomosis was sutured. The ureters were anastomosed on their native side on single loop ureteral stents. All procedures were performed by a single surgical team. Intra- and postoperative complications were classified and reported according to the Satava and Clavien–Dindo grading systems. Results: The mean age of population was 66.40±10.14 years, and 76.6% were male. Concomitant diabetes was found in 31.9% of patients. About three quarters of patients had T2G3 bladder cancer. Mean blood loss was 449.36±246.50 ml, and hospitalization was 10.32±5 days. With a mean follow-up of 17.36±12.63 months, the recurrence rate was 17%, and 14.9% of patients died of bladder cancer. Out of the 47 patients, three (4.3%) experienced intraoperative complications, while 15 (31.9%) had postoperative complications. Of these, only three patients experienced Clavien–Dindo complications ⩾grade 3. Multivariate logistic regression model showed that diabetes ( p=0.023) and higher blood loss ( p=0.010) were significantly associated with an increased risk of postoperative complications. We reported one case of ureterointestinal anastomosis stenosis on the left side and none on the right side. Despite our results being promising, larger randomized trials with longer follow-up are needed to explore further the feasibility of this technique on a larger scale. Conclusion: We describe a safe and simple surgical technique with a similar postoperative complications rate and a lower incidence of ureteroileal anastomosis stenosis compared to the standard technique. Level of evidence 4.

Long-Term Follow-Up After Penile Prosthesis Implantation—Survival and Quality of Life Outcomes

2019 ◽  
Vol 16 (11) ◽  
pp. 1827-1833
Author(s):  
Francesco Chierigo ◽  
Paolo Capogrosso ◽  
Federico Dehò ◽  
Edoardo Pozzi ◽  
Nicolò Schifano ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Penile Prosthesis ◽  
Life Outcomes ◽  
Prosthesis Implantation ◽  
Quality Of Life Outcomes ◽  
Long Term Follow Up

scholarly journals Management of proximal penile prosthetic cylindrical complications: a novel direct crural approach

2020 ◽  
Vol 30 (1) ◽  
Author(s):  
Ahmed S. Zugail ◽  
Maher Abdessater ◽  
Abdulmajeed Althobity ◽  
Johnny Boustany ◽  
Mabel Nuernberg ◽  
...  
Keyword(s):  
Operative Time ◽  
Traditional Approach ◽  
Tunica Albuginea ◽  
Penile Prosthesis ◽  
Proximal Part ◽  
Lithotomy Position ◽  
Longitudinal Incision ◽  
Operative Complications ◽  
Operative Recovery

Abstract Introduction Patients with proximal penile prosthetic cylindrical complications (PPPCC) can be treated with a direct crural technique without using the original traditional approach. In this article we present our novel direct crural approach for management of patients with PPPCC. Materials and methods Between 2014 and 2019, data were retrospectively collected from 13 patients who underwent surgical revision using our novel direct crural approach for PPPCC. The procedure commences with identification of the affected zone. The patient is in a low lithotomy position. A 2-centimeter longitudinal incision is made directly over the affected site. Dissection is carried down through Colles’ fascia, followed by a longitudinal incision through the tunica albuginea at the proximal part of the affected cylinder. Via the incision we can deliver out the cylinder and manage its problem. Results Mean operative time was 40 min. No intra or post-operative complications were reported. All patients (Mean age = 57) were discharged on the same day. Postoperative follow-up found correction of all existing deformities at month 1, 3 and 6. All patients were satisfied and reported less pain and faster recovery than the first procedure. Conclusion Our technique, which can be used for all types of penile prosthesis, is both feasible and safe. It may simplify PPPCC revision by avoiding adhesions below the original incision, without jeopardizing the already implanted materials or the urethra. It may also improve patients’ safety and satisfaction, by reducing iatrogenic injury and post-operative recovery time.

scholarly journals Comparison between LigaSure™ and Harmonic® in Laparoscopic Sleeve Gastrectomy: A Single-Center Experience on 422 Patients

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
N. Velotti ◽  
M. Manigrasso ◽  
K. Di Lauro ◽  
A. Vitiello ◽  
G. Berardi ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Postoperative Complications ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Hospital Costs ◽  
Point Of View ◽  
Morbidly Obese ◽  
Biomedical Sciences ◽  
Single Center Experience ◽  
User Friendly

Background. New laparoscopic devices, such as electrothermal bipolar-activated devices (LigaSure™ (LS)) or ultrasonic systems (Harmonic® scalpel (HS)), have been applied recently to bariatric surgery allowing to reduce blood loss and surgical risks. The aim of this study was to retrospectively compare intraoperative performance of HS and LS, postoperative results, and clinical outcomes in a large cohort of patients undergoing LSG. Methods. Data from 422 morbidly obese patients undergoing LSG in our Bariatric Unit at the Advanced Biomedical Sciences Department of the “Federico II” University of Naples (Italy) between January 2009 and December 2017 were retrospectively analyzed. Subjects were divided into two groups (HS and LS), and operative time, intraoperative complications, and postoperative (within 30 days from surgery) complications were compared. Bleeding from the omentum or from the staple line, use of hemostatic clips, and absorbable hemostat were recorded as intraoperative complications; hemorrhages, abscess formation, gastric leaks, fever, and mortality were considered as postoperative complications. Results. Statistical analysis showed no difference in terms of baseline demographics between the two cohorts. Operative time (48 ± 9 vs 49 ± 6 min, p=0.646) and the rates of intraoperative and postoperative complications did not significantly differ between groups. Conclusion. Harmonic® and LigaSure™ are both useful tools in bariatric surgery, and these two advanced power devices are user-friendly and can facilitate surgeon work; from this point of view, the choice of the energy device should be based on the preference of the surgeon and on the hospital costs policy and availability.

20-Year follow-up after penile prosthesis implantation – functional and quality of life outcomes

2019 ◽  
Vol 18 (1) ◽  
pp. e462
Author(s):  
F. Chierigo ◽  
P. Capogrosso ◽  
F. Dehò ◽  
E. Ventimiglia ◽  
W. Cazzaniga ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Penile Prosthesis ◽  
Life Outcomes ◽  
Prosthesis Implantation ◽  
Quality Of Life Outcomes

scholarly journals Results of laparoscopic for the management of bile duct stones

2020 ◽  
Vol 10 (4) ◽  
Author(s):  
Quoc Phong Le ◽  
Keyword(s):  
Bile Duct ◽  
Postoperative Complications ◽  
Bile Ducts ◽  
Clinical Characteristics ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Bile Duct Stones ◽  
Stone Clearance ◽  
Open Conversion ◽  
Laparoscopic Choledochotomy

Abstract Introduction: To describe clinical and para-clinical characteristics of bile duct stones and results of laparoscopic choledochotomies in management of bile duct stones. Materials and methods: Retrospective and prospective study in 152 bile duct stones patient, who underwent laparoscopic choledochotomy with or without usage of flexible bile ducts scope and electrohydraulic technique, from January 2009 to May 2019 at Hue Central Hospital. Results: Mean age 54,2 (22 - 84), 66 male and 86 female, mean operative time: 135 minutes (90 - 235), intraoperative complications: 3,29%, open conversion: 5,92%. Complete stone clearance was achieved in 91,6% patients. Postoperative complications: 7,69%. Conclusions: Managementofbileductstonesbylaparoscopiccholedochotomy is safe and effective with high percentage of stones clearence, as well as low intraoperative and postoperative complications. This procedure can achieve good results if bile ducts scope and electrohydraulic technique were concomitantly applied.

scholarly journals Importance of the vessel distribution at splenic hilum for laparoscopic Warshaw procedure

2021 ◽  
Vol 8 (11) ◽  
pp. 3416
Author(s):  
Shinichiro Ono ◽  
Tomohiko Adchi ◽  
Amane Kitasato ◽  
Masaaki Hidaka ◽  
Akihiko Soyama ◽  
...  
Keyword(s):  
High Risk ◽  
Operative Time ◽  
Gastric Varices ◽  
Splenic Infarction ◽  
Safe Procedure ◽  
Splenic Vessel ◽  
Splenic Hilum ◽  
Splenic Vessels ◽  
Median Operative Time

The laparoscopic Warshaw procedure (LWP) is a considered to carry a risk of splenic infarction and perigastric varices formation. We retrospectively analyzed the clinical outcomes and relationship between the distribution of the splenic hilum vessels and splenic infarction in patients who underwent LWP from February 2007 to February 2017.  A total of 19 patients underwent LWP, and the median follow-up duration was 78 months. The median operative time and blood loss were 295 min and 200 gr. Six patients with splenic partial infarction and 3 with gastric varices were detected, but they have not needed any treatments. According to the classification by Michels, the distribution of splenic vessels were divided as distributed type and magistral type at the splenic hilum. In our study, 16 patients were distributed type and 3 were magistral type. Three of the 16 patients developed splenic infarction in distributed type. In contrast, all of magistral patients showed splenic infarction. Although LWP is a safe procedure, there is a high risk of splenic infarction if the splenic vessel distribution is a magistral type. Understanding the type before surgery leads to the identification of an appropriate vascular dissection position and reduces postoperative complications.

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