Abstract:
BACKGROUND AND PURPOSE:There have been several reports of rhabdomyolysis occurring after prolonged laparoscopic procedures in the flank position. Accordingly, we evaluated interface pressures between the skin and three commonly used operating room table surfaces. The aim of our study was to determine if pressure changes could be related to body mass index (BMI), sex, position, and/or the table surface material. PATIENTS AND METHODS:Ten men and 10 women were grouped according to BMI <25 or >or=25, with five participants in each group. Subjects were placed in the left lateral decubitus position with the operating table flat, half flexed, fully flexed, half flexed with the kidney rest elevated, and fully flexed with the kidney rest elevated. Interface pressures were recorded, using an X-Sensor pressure sensing mat, for 5-minute periods in each of the described positions on each surface. RESULTS:Sex and BMI were statistically significant predictors of increased pressures (P= 0.0042 and 0.0402, respectively). The parameter estimate for the difference between men and women was 4.63 mm Hg (P= 0.0002), and the difference for BMI >or= 25 compared with <25 was also significant (P < 0.0209). Full table flexion (50-degree) produced significantly higher pressures than both flat (P= 0.0001) and the half-flexed (25-degree) position (P < 0.0001). Positions with the kidney rest elevated were associated with significantly higher pressures than without elevation (P < 0.0001). With regard to the surface used, egg crate provided lower pressures than gel pads (P= 0.0117). CONCLUSION:Women have significantly lower interface pressures when compared with men. BMI >or= 25 also increases interface pressures. The use of the kidney rest is associated with markedly increased pressure; use of a half-flexed position is preferable to a full-flexed position. These data have implications for patient positioning and identification of persons at risk for rhabdomyolysis during laparoscopic renal surgery.
journal_name
J Endouroljournal_title
Journal of endourologyauthors
Deane LA,Lee HJ,Box GN,Abraham JB,Abdelshehid CS,Elchico ER,Alipanah R,Borin JF,Johnson RW,Jackson DJ,McDougall EM,Clayman RVdoi
10.1089/end.2008.0047subject
Has Abstractpub_date
2008-06-01 00:00:00pages
1147-51issue
6eissn
0892-7790issn
1557-900Xjournal_volume
22pub_type
杂志文章abstract:PURPOSE:Since the holmium:yttrium-aluminum-garnet (Ho:YAG) laser is the flexible lithotrite of choice for ureteral stones, its application to ureteral strictures associated with ureteral calculi is convenient. The results of Ho:YAG laser endoureterotomy in this specific setting have not been defined. We report our expe...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2008.0387
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journal_title:Journal of endourology
pub_type: 杂志文章
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journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2013.0361
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abstract:INTRODUCTION AND OBJECTIVES:We evaluated patients who underwent treatment for prostate cancer and then subsequent robotic radical cystectomy (RARC). Our objective was to understand clinical, pathologic, and survival outcomes in these patients. MATERIALS AND METHODS:A total of 333 male patients underwent RARC with stan...
journal_title:Journal of endourology
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abstract:INTRODUCTION:The improvements in flexible ureteroscopes provide efficient access to the upper urinary tract and advancements in laser technology strengthens the endourologists' armamentarium. The endourologists must be aware of the advantages and the potential complications of these powerful technological equipments. O...
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更新日期:2016-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Involvement of the bladder is seen in only 1% to 2% of patients with endometriosis. The diagnosis of vesical endometriosis is difficult to formulate, and it should be confirmed by cystoscopy with biopsy. However, this examination is often insufficient because of the submucosal-transmural location...
journal_title:Journal of endourology
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abstract::The da Vinci Surgical Robotic System has recently been added to the armamentarium of minimally invasive surgeon and has been shown to be useful to urologists in performing complex operations. We report the first case of detrusor myotomy performed using the da Vinci, describe the novel technique, and review the indicat...
journal_title:Journal of endourology
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journal_title:Journal of endourology
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journal_title:Journal of endourology
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doi:10.1089/end.2010.0722
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abstract:PURPOSE:Burst wave lithotripsy (BWL) is a transcutaneous technique with potential to safely and effectively fragment renal stones. Preclinical investigations of BWL require the assessment of potential renal injury. This study evaluates the capabilities of real-time ultrasound and MRI to detect and evaluate BWL injury t...
journal_title:Journal of endourology
pub_type: 杂志文章
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abstract::We report our experience in the laparoscopic transperitoneal repair of retrocaval ureter in two cases, highlighting a new technique of stenting. ...
journal_title:Journal of endourology
pub_type: 杂志文章
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更新日期:2003-03-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2016.0217
更新日期:2017-03-01 00:00:00
abstract::Abstract Since the first description of percutaneous nephrolithotripsy (PNL) over 30 years ago, the indications for this procedure in the management of upper tract urinary stones has greatly expanded. Despite recent advances in shock wave lithotripsy and ureteroscopic technologies, PNL maintains a dominant role in the...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/end.2009.1518
更新日期:2009-10-01 00:00:00
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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:BACKGROUND AND PURPOSE:Robotic prostatectomy is exploding into popular utilization throughout much of the United States. It is expected that the rise in the number of these cases into 2006 will continue exponentially. A significant amount of research has begun to focus on the anastomosis, because the robot allows unpre...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2007.9913
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journal_title:Journal of endourology
pub_type: 杂志文章
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更新日期:2020-12-04 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2008.0147
更新日期:2008-08-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2011.0301
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journal_title:Journal of endourology
pub_type: 杂志文章,随机对照试验
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更新日期:2007-09-01 00:00:00
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journal_title:Journal of endourology
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journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2007.0260
更新日期:2008-03-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2007.0020
更新日期:2007-11-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1996.10.435
更新日期:1996-10-01 00:00:00
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journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
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更新日期:2005-06-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章,随机对照试验
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journal_title:Journal of endourology
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更新日期:2018-09-12 00:00:00
abstract::We describe flexible ureteroscopy-directed retrograde nephrostomy access using a puncture wire to achieve renal access. This is a natural extension of modern retrograde intrarenal surgical techniques and a modernization of the original Lawson technique for retrograde nephrostomy tract creation. In appropriately select...
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