Abstract:
PURPOSE:To create a protocol for providing real-time operating room (OR) cost feedback to surgeons. We hypothesize that this protocol will reduce costs in a responsible way without sacrificing quality of care. METHODS:All OR costs were obtained and recorded for robot-assisted partial nephrectomy and laparoscopic donor nephrectomy. Before the beginning of this project, costs pertaining to the 20 most recent cases were analyzed. Items were identified from previous cases as modifiable for replacement or omission. Timely feedback of total OR costs and cost of each item used was provided to the surgeon after each case, and costs were analyzed. RESULTS:A cost analysis of the robot-assisted partial nephrectomy before the washout period indicates expenditures of $5243.04 per case. Ten recommended modifiable items were found to have an average per case cost of $1229.33 representing 23.4% of the total cost. A postwashout period cost analysis found the total OR cost decreased by $899.67 (17.2%) because of changes directly related to the modifiable items. Therefore, 73.2% of the possible identified savings was realized. The same stepwise approach was applied to laparoscopic donor nephrectomies. The average total cost per case before the washout period was $3530.05 with $457.54 attributed to modifiable items. After the washout period, modifiable items costs were reduced by $289.73 (8.0%). No complications occurred in the donor nephrectomy cases while one postoperative complication occurred in the partial nephrectomy group. CONCLUSION:Providing surgeons with feedback related to OR costs may lead to a change in surgeon behavior and decreased overall costs. Further studies are needed to show equivalence in patient outcomes.
journal_name
J Endouroljournal_title
Journal of endourologyauthors
Tabib CH,Bahler CD,Hardacker TJ,Ball KM,Sundaram CPdoi
10.1089/end.2014.0858subject
Has Abstractpub_date
2015-08-01 00:00:00pages
963-8issue
8eissn
0892-7790issn
1557-900Xjournal_volume
29pub_type
杂志文章abstract:PURPOSE:We evaluated whether epigallocatechin gallate (EGCG), a main constituent of green tea polyphenols, could protect against cellular toxicity by oxalate and whether green tea supplementation attenuates the development of nephrolithiasis in an animal model. MATERIALS AND METHODS:Cells of the NRK-52E line were incu...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2006.20.356
更新日期:2006-05-01 00:00:00
abstract:PURPOSE:To provide clinical outcomes of the Resonance metallic ureteral stent in patients with malignant ureteral obstruction, as well as clinical factors predicting stent failure. METHODS:Cancer patients who have received Resonance stents from July 2009 to March 2012 for ureteral obstruction were included for chart r...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2013.0792
更新日期:2014-06-01 00:00:00
abstract:PURPOSE:Percutaneous nephrolithotomy (PNL) is established in urology practice with routine use of fluoroscopic guidance. Herein, we retrospectively evaluated the potential factors affecting the fluoroscopic screening time (FST) during PNL. MATERIALS AND METHODS:A total of 282 patients with documented FST in detail dur...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2009.0256
更新日期:2009-11-01 00:00:00
abstract:PURPOSE:Standard laparoscopy has undergone many recent advances with the advent of three-dimensional visual systems and robotic surgical systems. In evaluating the usefulness of these new systems, it is difficult to objectively measure their advantages in the operating room. Therefore, we designed a trial using three d...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2007.0241
更新日期:2008-03-01 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:Pretreating the kidney with 100 low energy SWs with a time pause before delivering a clinical dose of SWs (Dornier HM-3, 2000 SWs, 24 kV, 120 SWs/min) has been shown to significantly reduce the size of the hemorrhagic lesion produced in that treated kidney, compared to a protocol without pretreatment. It has be...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2020.0681
更新日期:2021-01-20 00:00:00
abstract:OBJECTIVE:The purpose is to report our 10-year experience with surgical management of large or symptomatic adrenal myelolipoma. PATIENTS AND METHODS:Patients receiving surgical treatment for adrenal myelolipoma between December 2001 and September 2011 in our institution were retrospectively reviewed. Patients were div...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2013.0283
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Extended ureteral stricture is a rare complication of renal transplantation. Its management remains challenging. The aim of our study was to report our 15 years of experience with subcutaneous pyelovesical bypass graft (SPBG) in selected renal transplant patients who presented with extended urete...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2011.0085
更新日期:2011-08-01 00:00:00
abstract:PURPOSE:To assess the necessity of placing a ureteral stent after transperitoneal laparoscopic ureterolithotomy (TPLU). PATIENTS AND METHODS:In the period from May 2006 to November 2010, 46 patients underwent TPLU. There were 13 females and 33 males. All patients had an impacted stone larger than 1.5 cm in the upper a...
journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
doi:10.1089/end.2012.0082
更新日期:2012-09-01 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:PURPOSE:To review the management approach to and results of severely encrusted retained ureteral stents and analyze predictive risk factors. PATIENTS AND METHODS:Medical records from January 1996 to March 2006 were reviewed for Double-J stent complications and their final outcome. A total of 876 stents were inserted i...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2006.0250
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Clinically significant post-transplantation lymphoceles are not uncommon. Surgical marsupialization with internal peritoneal drainage is the treatment of choice. We describe the successful laparoscopic formation of a peritoneal window for post-transplantation lymphocele drainage as an effective a...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2006.20.904
更新日期:2006-11-01 00:00:00
abstract:INTRODUCTION:Irreversible electroporation (IRE) is a non-thermal minimally invasive technique that is used to treat small renal masses (SRMs). Prior work has demonstrated greater narcotic requirements after radiofrequency ablation (RFA) for tumors that are closer to body-wall musculature. We hypothesized that pain afte...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2017.0201
更新日期:2017-08-01 00:00:00
abstract:INTRODUCTION:Radical prostatectomy undoubtedly causes inflammatory damage to surrounding neuromuscular tissues (i.e., bladder, urethra, and nerves) that may contribute to urinary incontinence. We report the use of local hypothermia during robot-assisted laparoscopic prostatectomy to attenuate this injury. METHODS:Regi...
journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
doi:10.1089/end.2009.0411
更新日期:2009-09-01 00:00:00
abstract::A new tip design of a 3.3F electrohydraulic probe for endoureteral lithotripsy was evaluated in comparison to a regular probe. The peak pressure, as well as the slope of the shock front, depend solely on the voltage. Increasing the capacity leads merely to broader pulses. A laser-like short high-pressure pulse has a g...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1993.7.35
更新日期:1993-02-01 00:00:00
abstract:INTRODUCTION:Histotripsy is a nonthermal, noninvasive, pulsed ultrasound technology that homogenizes tissue within the targeted volume. From previous experiments, it appeared that the resultant fibrotic response from histotripsy was limited compared with the typical tissue response seen after thermoablation. The object...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2014.0585
更新日期:2015-07-01 00:00:00
abstract:: Introduction and Objectives: After transurethral prostatectomy, erectile dysfunction and ejaculatory dysfunction are significant concerns for patients. We compared ejaculatory hood-sparing technique in patients who underwent photoselective vaporization of the prostate usin...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2019.0558
更新日期:2020-03-01 00:00:00
abstract::Because of the high rate of ipsilateral multifocal disease and the low incidence of contralateral disease, upper tract transitional-cell carcinoma has historically been treated with radical nephroureterectomy. This operation has been performed laparoscopically in many medical centers, with various techniques. The diff...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2000.14.859
更新日期:2000-12-01 00:00:00
abstract::It seems likely, and indeed inevitable, that medical device usage will continue its rapid increase over the next 10 to 20 years and beyond. For surgeons, these new inventions will come in many forms but should take into account biocompatibility and resistance to encrustations and to microorganisms. This review focuses...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/end.1999.13.1
更新日期:1999-02-01 00:00:00
abstract:PURPOSE:The aim of this study is to assess the effectiveness, safety, and reproducibility of the micro-ureteroscopy (m-URS) in the treatment of distal ureteral stones in women. MATERIALS AND METHODS:A multicenter, prospective observational study was designed and conducted between March and December 2015. We included w...
journal_title:Journal of endourology
pub_type: 杂志文章,多中心研究
doi:10.1089/end.2016.0503
更新日期:2016-11-01 00:00:00
abstract:PURPOSE:To compare the outcomes of retroperitoneoscopic nephroureterectomy (RNU) with those of open retroperitoneal nephroureterectomy (ORNU) for upper urinary tract cancer. PATIENTS AND METHODS:This study included 240 consecutive patients who received a clinical diagnosis of localized upper urinary tract cancer and u...
journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
doi:10.1089/end.2007.0154
更新日期:2008-08-01 00:00:00
abstract:PURPOSE:We assessed whether high shock number is associated with higher rates of acute complication development after extracorporeal shockwave lithotripsy (SWL). PATIENTS AND METHODS:A retrospective chart review of 372 patients who underwent 436 SWL procedures at 24 kV using a Medstone STS-T lithotripter (Medstone Int...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2013.0025
更新日期:2013-08-01 00:00:00
abstract:PURPOSE:To assess the feasibility and report early outcomes of robot-assisted anatrophic nephrolithotomy (RAN) as a treatment modality for patients with complex staghorn calculi. PATIENTS AND METHODS:In this single-center prospective study, seven consecutive patients underwent RAN for complex staghorn calculi. After d...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2013.0597
更新日期:2014-03-01 00:00:00
abstract:PURPOSE:To determine the temperature-time threshold of local cell death in vivo for thermal therapy in a prostate cancer animal model and to use this value as a benchmark to quantify global tissue injury. MATERIALS AND METHODS:Two studies were designed in the Dunning AT-1 rat prostate tumor hind limb model. For both s...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/089277901750426436
更新日期:2001-08-01 00:00:00
abstract::Laser systems used for prostatectomy may be right-angle (sidefiring) devices, which are either refractive or reflective, or contact devices. The tissue physics of these systems differ, and as a result, there are very real differences in the optimal exposure techniques. An understanding of the device being used is esse...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1995.9.85
更新日期:1995-04-01 00:00:00
abstract:OBJECTIVE:The aim of our study was to evaluate if there is any advantage of three-dimensional helical computed tomography (3D-HCT) over intravenous urogram (IVU) in the morphometric and morphological analysis of lower pole spatial anatomy of the kidney. PATIENTS AND METHODS:We analyzed 52 renal collecting systems in 3...
journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
doi:10.1089/end.2009.0262
更新日期:2009-12-01 00:00:00
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...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2015.0747
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Clinical and surgical factors predict renal function decline after laparoscopic partial nephrectomy (LPN). Additional histopathologic predictors may be found in the specimen's nonneoplastic tissue but were not studied. This study investigated the significance of histologic findings in addition to...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2010.0646
更新日期:2011-09-01 00:00:00
abstract:PURPOSE:To compare the efficacy of extracorporeal shockwave lithotripsy (SWL) in patients with radiopaque and radiolucent ureteral calculi. PATIENTS AND METHODS:Between September 2001 and August 2002, a total of 113 consecutive patients with ureteral calculi (58 radiopaque [Group 1], 55 radiolucent [Group 2]) were tre...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/089277903772036154
更新日期:2003-12-01 00:00:00
abstract:PURPOSE:To present the combination of laparoscopy and nephroscopy for the treatment of stones in pelvic ectopic kidneys. PATIENTS AND METHODS:The series included seven male and four female patients (mean age 43 +/- 9 years). Laparoscopy-assisted percutaneous nephrolithotomy (PCNL) was performed for caliceal stones in ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2007.9930
更新日期:2007-10-01 00:00:00