Abstract:
INTRODUCTION:Laparoscopic trocars typically maintain pneumoperitoneum using trap door valves and silicone seals. However, valves and seals hinder passage of instruments, cause lens smudging, trap specimens and needles being removed from the abdominal cavity, and lose their seal with repeated instrument exchange. AIM:The aim of the present study was to evaluate the feasibility of a newly designed valve-less trocar. METHODS:The valve-less trocar system creates a curtain of forced gas to maintain pneumoperitoneum. A separate unit filters smoke and recirculates captured escaping gas. The valve-less trocar was trialed in consecutive laparoscopic renal procedures of a single surgeon. Perioperative parameters and outcomes were collected and analyzed. The system's safety, advantages, and disadvantages were evaluated. Insufflation gas usage, elimination, and absorption were also measured. RESULTS:Twenty-five patients underwent laparoscopic renal procedures using the valve-less trocar system. The procedures included laparoscopic partial, radical, and donor nephrectomy. The mean patient age was 58.26 years. The mean operative time was 125 minutes and the mean drop in Hb for the cohort was 2.34 g/dL (range 0.4-5.4). Two patients developed subcutaneous emphysema and of the two patients, one developed clinically insignificant pneumomediastinum postoperatively. There were no postoperative complications. The surgeon noted that the use of a valve-less trocar decreased smudging of laparoscopes, expeditiously evacuated smoke during cauterization leading to improved visualization, maintained pneumoperitoneum even while suctioning, and resulted in easy extraction of specimens and needles. It was noted that insufflation gas consumption was low and CO(2) elimination was not impaired. CONCLUSION:Use of a valve-less trocar is safe. Decreased laparoscope smudging may translate into decreased operative times and reduced gas consumption may equate to cost savings. Additionally, its use brings several advantages and convenience to the operating surgeon. However, the system should be compared with conventional trocars prospectively to demonstrate clinical and economic benefit.
journal_name
J Endouroljournal_title
Journal of endourologyauthors
Herati AS,Atalla MA,Rais-Bahrami S,Andonian S,Vira MA,Kavoussi LRdoi
10.1089/end.2009.0376subject
Has Abstractpub_date
2009-09-01 00:00:00pages
1535-9issue
9eissn
0892-7790issn
1557-900Xjournal_volume
23pub_type
杂志文章abstract:BACKGROUND AND PURPOSE:Comprehensive metabolic evaluation has become an important aspect of the management of recurrent nephrolithiasis, yet the role of stone analysis is often neglected or perhaps underestimated. The purpose of this study was to determine the role of stone analysis in medical decision making in patien...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/089277901750134548
更新日期:2001-03-01 00:00:00
abstract:PURPOSE:To investigate a new method and its effect on the procedure of dilating the ejaculatory duct and flushing the seminal vesicle with an F9 seminal vesicle scope in patients with chronic and recurrent seminal vesiculitis. PATIENTS AND METHODS:Twenty-six patients with a diagnosis based to signs, laboratory detecti...
journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
doi:10.1089/end.2010.0456
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Port-site metastasis (PSM) is a rare complication of laparoscopic intervention in urologic malignancies. Of the greater than 50 reported cases of PSM in the urologic oncology literature, only 9 have occurred after surgery for renal-cell carcinoma (RCC). We report a 10th instance of RCC metastasis...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2012.0533
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abstract:BACKGROUND AND PURPOSE:The management of urolithiasis in patients with a solitary kidney is challenging for endourologists. This study was aimed at evaluating the safety and efficacy of retrograde intrarenal surgery (RIRS) in the treatment of such patients with renal stones. PATIENTS AND METHODS:Between January 2010 a...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2014.0295
更新日期:2014-11-01 00:00:00
abstract:OBJECTIVE:To evaluate perioperative morbidity and mortality rate, a 3-year recurrence-free survival, and cancer-specific mortality rate in patients older than 80 years undergoing robot-assisted radical cystectomy (RARC). MATERIALS AND METHODS:We retrospectively collected data of 155 consecutive patients who received R...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2016.0050
更新日期:2016-07-01 00:00:00
abstract::In a 14-year-old boy with bladder augmentation, Mitrofanoff appendicovesicostomy, Malone antegrade enema stoma, and bladder neck reconstruction, urinary continence was restored by injection of Teflon with a Veress needle and the aid of a 2-mm laparoscopic port. The method has since been used for nine treatments in six...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/089277903765444401
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:There is a continuing reluctance among transplant surgeons to procure a right-kidney allograft laparoscopically. We describe our experience with right laparoscopic donor nephrectomy (RLDN) by three techniques. PATIENTS AND METHODS:We retrospectively analyzed all seven RLDNs performed at our cent...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2006.20.309
更新日期:2006-05-01 00:00:00
abstract:PURPOSE:Excessive bulking force during ureteral access sheath (UAS) placement may induce injury. The sliding friction between surfaces can be reduced with the application of ultrasonic vibration. We investigated the efficacy and safety of an ultrasonic vibration transducing device for reducing the maximal ureteral acce...
journal_title:Journal of endourology
pub_type: 杂志文章,随机对照试验
doi:10.1089/end.2018.0772
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Transurethral electrovaporization of the prostate (TVP) has been utilized increasingly in the therapeutic management of benign prostatic hyperplasia (BPH). The temperature profile within both prostatic and periprostatic tissue has been presented as a parameter of safety in various preliminary ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1999.13.53
更新日期:1999-02-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2005.19.1221
更新日期:2005-12-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2014.0011
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:A variety of ureteroscopic irrigation systems are available, ranging from gravity-driven pressure bags to hand-operated pumps. Endoscopic valves maintain a watertight seal during ureteroscopy (URS) while facilitating passage of instruments. The clinical utility and ergonomics of such devices have...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2014.0891
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Whereas ureteroscopic lithotripsy is more efficacious than SWL in treating lower-ureteral stones, the same has not been universally said of its ability to treat proximal ureteral stones. Because failed proximal lithotripsy is often attributable to the complications associated with stone migration...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2004.18.862
更新日期:2004-11-01 00:00:00
abstract:PURPOSE:This study aims to provide an overview of type and frequency of musculoskeletal complaints among urologists. In addition, the urologists' knowledge about ergonomic conditions during minimally invasive urology was assessed, and they were asked how they would prefer to gain knowledge about this topic. MATERIALS ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2013.0654
更新日期:2014-05-01 00:00:00
abstract:AIM:To analyze the impact of slowing the shockwave delivery during extracorporeal shockwave lithotripsy (SWL) on the clinical patient outcome and the cost of delivering this service in a community practice. PATIENTS AND METHODS:The data from 1745 consecutive SWL procedures were analyzed at a freestanding surgery cente...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2009.0656
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:At present, open retroperitoneal lymph node dissection (RPLND) remains the preferred approach at many high-volume centers for the surgical treatment of patients with low-stage testis cancer. Despite the potential advantages of a minimally invasive approach, including improved cosmesis and shorter...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2010.0596
更新日期:2011-11-01 00:00:00
abstract::Two women with symptomatic stone-filled caliceal diverticula were treated by a retroperitoneoscopic approach. With a three-port technique, the diverticulum was marsupialized, the calculi removed, the cavity fulgurated, and perirenal fat inserted. The patients had no morbidity and remain stone and symptom free. They re...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/end.2004.18.672
更新日期:2004-09-01 00:00:00
abstract::Laparoscopic pyeloplasty represents one of the more advanced reconstructive procedures for the urologist. While early reports were replete with long operative times, there have been several changes that have added to the efficiency of the procedure. In our practice, we have found three changes to be of greatest value:...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/089277904773582750
更新日期:2004-04-01 00:00:00
abstract::Ureteral obstruction secondary to extrinsic compression is uncommon. Extrinsic compression results from both benign and malignant conditions of the retroperitoneum. In certain patients, laparoscopic ureterolysis is a minimally invasive alternative to the open approach. To date, the largest numbers of patients have und...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/end.2005.19.710
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:It is well accepted that identification and control of the adrenal vein is a critical step in laparoscopic adrenalectomy. The surgical and anatomic literature propagates the notion of a dominant or multiple dominant adrenal arteries that should likewise be controlled during surgical extirpation. MATERIALS A...
journal_title:Journal of endourology
pub_type: 杂志文章
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更新日期:2005-09-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2014.0215
更新日期:2014-12-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1994.8.95
更新日期:1994-04-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2008.0378
更新日期:2009-02-01 00:00:00
abstract::The Clinical Research Office of the Endourological Society (CROES) conducts large-scale, international, multicenter clinical trials in the field of endourology. One of the major challenges that these trials pose is to ensure that data collected remotely and online within a very short time frame are valid and reliable....
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2011.0402
更新日期:2011-11-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1997.11.1
更新日期:1997-02-01 00:00:00
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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::Cold-knife retrograde endopyelotomy is a simple, safe, and effective therapeutic option for primary and secondary symptomatic ureteropelvic junction obstruction (UPJO). Our long-term success rate with negligible complications demonstrates its durability and safety. Retrograde endopyelotomy should be considered a viabl...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2007.9828
更新日期:2008-04-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2018.0589
更新日期:2019-04-01 00:00:00
abstract:: Purpose: Kidney stone recurrence rates vary between patients. A patient's risk informs the frequency and intensity of preventative interventions. Clinicians routinely use clinical experience to estimate risk. We sought to compare clinician estimated recurrence risk with th...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2020.0978
更新日期:2020-11-16 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