Abstract:
PURPOSE:We recently described a novel technique of percutaneous non-dismembered endopyeloplasty (Fenger type). Herein, we extend this transrenal technique further and report percutaneous dismembered endopyeloplasty (Anderson-Hynes type). MATERIALS AND METHODS:In five pigs with unilateral ureteropelvic junction (UPJ) obstruction created 3 to 6 weeks earlier, percutaneous dismembered endopyeloplasty was performed. Percutaneous transrenal access to the UPJ was obtained, and the UPJ was completely dismembered from within the renal pelvis through the solitary percutaneous tract. The dismembered proximal ureter was circumferentially mobilized, and in two animals, the UPJ segment was completely excised and removed. A spatulated end-to-end endopyeloplasty anastomosis (Anderson-Hynes) was created transrenally with 5 to 10 interrupted sutures using a novel nephroscopic suturing device (Sew-Right SR-5; LSI Solutions, Rochester, NY). In two animals, the entire percutaneous procedure was performed with CO2 insufflation instead of fluid irrigation. RESULTS:The technique was developed in three pigs. Subsequently, two pigs were treated and sacrificed at 2 and 5 weeks. All UPJs were dismembered successfully, and a precisely sutured mucosa-to-mucosa anastomosis was created. Intraoperative bleeding was negligible, and the operative time ranged from 3 to 5 hours, with the majority of the time dedicated to transrenal retroperitoneal dissection of the scarred, fibrotic UPJ. Carbon dioxide insufflation was efficacious because it minimized fluid extravasation and tissue edema and additionally enhanced visibility. Postoperative pyelograms revealed an adequately funneled UPJ, with good flow into the distal ureter. The two survival animals had minimal apparent morbidity from the procedure, and retrograde pyelograms at euthanasia revealed a patent anastomosis without extravasation. A 6F catheter easily crossed the reconstructed UPJ at autopsy in all animals. CONCLUSIONS:Dismembered percutaneous Anderson-Hynes endopyeloplasty is technically feasible and is promising. Further technical experience and additional functional outcome analysis in the survival model are necessary. With the technique described herein, we introduce the concept of percutaneous intrarenal reconstructive surgery (PIRS), wherein advanced intrarenal and retroperitoneal dissection with reconstruction can be performed endourologically, further broadening the horizons of conventional percutaneous techniques.
journal_name
J Endouroljournal_title
Journal of endourologyauthors
Sharp DS,Desai MM,Molina WR,Spaliviero M,Abreu SC,Ramani AP,Kaouk JH,Gill ISdoi
10.1089/end.2005.19.210subject
Has Abstractpub_date
2005-03-01 00:00:00pages
210-7issue
2eissn
0892-7790issn
1557-900Xjournal_volume
19pub_type
杂志文章abstract:PURPOSE:To evaluate the physical properties of urethral catheters that are predictive of ease of placement and risk of urethral trauma: Stiffness, buckling, and friction forces. MATERIALS AND METHODS:Eleven Bard Lubri-Sil and 10 Kendall Dover 16F Foley catheters were tested using a linear motion stage driven by a step...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2008.0503
更新日期:2009-01-01 00:00:00
abstract:PURPOSE:The ability to maintain normothermia during surgical procedures is crucial for improvement of the quality of patient care and the outcome of the procedure. We tested the hypothesis of whether one warming protocol is able to maintain normothermic core temperatures equally well in major open and laparoscopic urol...
journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
doi:10.1089/end.2007.0324
更新日期:2008-05-01 00:00:00
abstract::The preliminary experience with 64 patients who have undergone HoLEP combined with intravesical morcellation is presented. The mean preoperative prostate volume was 75.3 cc. The mean laser time was 46.9 minutes and the morcellator time a further 10.5 minutes. A mean total of 35.5 g of tissue was obtained, and 93% of t...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1998.12.457
更新日期:1998-10-01 00:00:00
abstract:: Objective: To evaluate whether reducing the dose of fluoroscopy to ¼ of standard dose during unilateral ureteroscopy for ureteral stone treatment would impact in a reduction of total radiation emitted and whether this strategy would impact operation time, stone-free rate, ...
journal_title:Journal of endourology
pub_type: 杂志文章,随机对照试验
doi:10.1089/end.2018.0722
更新日期:2019-07-01 00:00:00
abstract:PURPOSE:To compare blind access and totally tubeless percutaneous antegrade removal and pneumatic transurethral ureterolithotripsy for the management of impacted upper-ureteral calculi >1 cm. PATIENTS AND METHODS:Seventy patients (41 male, 29 female) with impacted upper-ureteral calculi >1 cm were selected in randomiz...
journal_title:Journal of endourology
pub_type: 杂志文章,随机对照试验
doi:10.1089/end.2006.20.616
更新日期:2006-09-01 00:00:00
abstract:: Objective: The aim of this study was to introduce the "ultrathin parenchyma" resection in a robot-assisted partial nephrectomy (RAPN) via the retroperitoneal approach, and to assess the feasibility, security, and effectiveness of this technique. Me...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2019.0698
更新日期:2020-03-01 00:00:00
abstract::In 2005 we reported in this journal the treatment of cystic nephroma, a rare but presumed benign renal tumor, with percutaneous resection. Initial follow-up confirmed removal of the intra-pelvic portion of the cystic nephroma and persistence of the unresected intra-parenchymal portion. Surveillance with computed tomog...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2007.0441
更新日期:2008-07-01 00:00:00
abstract:PURPOSE:To determine whether on-clamp partial nephrectomy (ON-PN) has any significant impact on long-term renal function in a two kidney model. PATIENTS AND METHODS:From November 1999 to July 2013, 607 patients underwent PN at our institution. After excluding patients with solitary kidneys, multiple renal masses, and ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2014.0476
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Surgical outcomes depend on patient and disease-related factors, as well as the technical skill of the surgeon. Various distractions in the operating room (OR) environment have been shown to negatively impact a surgeon's performance. A survey was conducted with the objective to evaluate and chara...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2012.0704
更新日期:2013-09-01 00:00:00
abstract:PURPOSE:Our study sought to demonstrate the effects of remote ischemic preconditioning (R-IPC) on renal function in a large animal (porcine) solitary-kidney model. METHODS:Twelve pigs were assigned to two groups: Each underwent a right nephrectomy followed by a week of recovery. Group 1 (No-IPC) underwent left renal h...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2014.0563
更新日期:2015-05-01 00:00:00
abstract:INTRODUCTION/OBJECTIVE:We sought to examine the contemporary relationship between case volume and outcome for percutaneous nephrolithotomy (PCNL) using a publically available administrative database. METHODS:A weighted sample of 7785 patients was obtained from the 2010 Healthcare Cost and Utilization Project (HCUP) Na...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2013.0172
更新日期:2013-09-01 00:00:00
abstract:PURPOSE:We developed a genitourinary skills training (GUST) curriculum for incoming third year medical students (MS3) and performed a follow-up study of comfort with and utilization of these skills. MATERIALS AND METHODS:GUST consisted of a didactic lecture followed by skills sessions including standardized patient te...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2012.0284
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:No literature exists examining the risk factors for failure after robot-assisted laparoscopic pyeloplasty for ureteropelvic junction obstruction (UPJO) in children. The goal of this study was to compare the success of robot-assisted pyeloplasty between UPJO kidneys with preoperative renal functio...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2014.0876
更新日期:2015-08-01 00:00:00
abstract:PURPOSE:Percutaneous stone surgery can be challenging in spina bifida (SB) patients due to their body habitus and spinal cord anomalies. A safe surgical approach may necessitate acceptance of lower stone-free (SF) rates. We seek to determine if anatomic complexity, as measured by spinal cord curvature and torso length,...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2016.0769
更新日期:2017-04-01 00:00:00
abstract::Inability to remove a urethral catheter after radical retropubic prostatectomy is an uncommon complication. We describe removal of a urethral catheter entrapped in vesicourethral anastomotic sutures, which was safely performed endoscopically using a holmium laser. ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2005.19.83
更新日期:2005-01-01 00:00:00
abstract::Four techniques of intracorporeal lithotripsy are now available: ballistic, ultrasonic, electrohydraulic, and laser. Their therapeutic efficacies have generally been evaluated and compared, but very few data have been available on their relative risks of iatrogenic trauma to the urothelial wall. We conducted a compara...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1994.8.293
更新日期:1994-08-01 00:00:00
abstract::Growing data suggest that lymphadenectomy is a critical component of the surgical management of urologic malignancies with both diagnostic and therapeutic benefit. The increased use of minimally invasive approaches for the management of urologic malignancies may be in conflict with the need for more extensive lymphade...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/end.2009.0562
更新日期:2010-08-01 00:00:00
abstract::Standard laparoscopic surgery requires maintenance of the working cavity by continual carbon dioxide insufflation and exaggerated Trendelenburg positioning. Both cardiopulmonary and metabolic adverse effects may result from these maneuvers, which may be avoided by a gasless approach to laparoscopic surgery. We investi...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1995.9.483
更新日期:1995-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the effects on the potency of a bilateral cavernosal nerve-sparing approach to robot-assisted radical cystectomy (RARC) in a preoperatively potent population. PATIENTS AND METHODS:We conducted a retrospective review of 254 patients who underwent RARC between 2003 and 2012 at our single institutio...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2014.0315
更新日期:2014-11-01 00:00:00
abstract:PURPOSE:To determine the effects of previous open nephrolithotomy on the results and morbidity of subsequent percutaneous nephrolithotomy (PCNL). PATIENTS AND METHODS:Between March 2005 and January 2006, 89 patients underwent PCNL at our institution. We compared the patients who had had previous open surgery on the sa...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2006.0293
更新日期:2007-04-01 00:00:00
abstract:PURPOSE:To describe the surgical technique of robot-assisted sacral colpopexy (RASCP) and to assess its feasibility and safety in a high-volume laparoscopic center. PATIENT AND METHODS:12 women with symptomatic urogenital prolapse with or without concomitant urinary stress incontinence were treated with RASCP by one s...
journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
doi:10.1089/end.2010.0160
更新日期:2010-12-01 00:00:00
abstract:INTRODUCTION AND OBJECTIVE:Despite guidelines, routine 24-hour urine testing is completed in <10% of high-risk, recurrent stone formers. Using surrogates for metabolic testing, such as key patient characteristics, could obviate the cost and burden of this test while providing information needed for proper stone prevent...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2017.0352
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Renal Fine Needle Aspiration Cytology (FNAC) has gained popularity due to increasing options in management of renal lesions such as energy ablation and active surveillance. The diagnostic yield of renal FNAC varies between 40-90%. We hypothesized that adequate and diagnostic FNA samples would be ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2008.9724
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:To determine whether or not temporary drainage is necessary immediately following laparoscopic (lap) and robot-assisted (rob) pyeloplasty (PP). PATIENTS AND METHODS:Of 99 patients undergoing lap PP (n = 23) or rob PP (n = 76) for treatment of ureteropelvic junction obstruction (UPJO), 52 had no drainage, 47 ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2016.0655
更新日期:2017-03-01 00:00:00
abstract:PURPOSE:The purpose of this study was to assess the extent of the increased intracranial pressure (ICP) resulting from CO2 pneumoperitoneum and steep Trendelenburg positioning using ultrasonographic measurement of optic nerve sheath diameter (ONSD) in patients undergoing robot-assisted laparoscopic radical prostatectom...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2014.0019
更新日期:2014-07-01 00:00:00
abstract:PURPOSE:To evaluate the safety and oncologic efficacy of extravesical laparoscopic stapling of the distal ureter and bladder cuff during nephroureterectomy for pelvicaliceal transitional-cell carcinoma (TCC). PATIENTS AND METHODS:Patients with primary pelvicaliceal TCC and no history of TCC of the bladder or ureter wh...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2006.0306
更新日期:2007-09-01 00:00:00
abstract::Ureteral stents find wide application in urology. The majority of patients with indwelling ureteral stents are at an increased risk of urinary tract infection. Stent encrustation and its associated complications lead to significant morbidity. This review critically evaluates various polymers that find their applicatio...
journal_title:Journal of endourology
pub_type: 历史文章,杂志文章,评审
doi:10.1089/end.2009.0516
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Nephroureterectomy (NU) with bladder cuff excision is the gold standard treatment for patients with upper urinary tract urothelial cancer. We report our initial experience with laparoendoscopic single-site plus one port (LESS POP) technique for NU and bladder cuff excision. PATIENTS AND METHODS:...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2013.0735
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:To determine the preoperative and perioperative predictive factors of morbidity/mortality in patients undergoing percutaneous nephrolithotomy (PCNL), using the Clavien's classification. MATERIALS AND METHODS:We performed a retrospective chart review of patients who underwent PCNL between January 2005 and Jan...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2013.0781
更新日期:2014-09-01 00:00:00
abstract:: Purpose: Photoselective vaporization of the prostate (PVP) with a 940-nm diode laser is an option for treating symptoms caused by benign prostatic hyperplasia (BPH). Here, we present our experience using this technology. Methods: ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2019.0311
更新日期:2019-12-01 00:00:00