• The data comparing robot-assisted partial nephrectomy and cystectomy to other approaches have underlying methodologic limitations and long-term studies are sparse. (va.gov)
  • Robot-assisted partial nephrectomy: current status, techniques, and future directions. (wakehealth.edu)
  • Does nephrometry scoring of renal tumors predict outcomes in patients selected for robot-assisted partial nephrectomy? (wakehealth.edu)
  • Does experience in creating a robot-assisted partial nephrectomy (RAPN) programme in an academic centre impact outcomes or complication rate? (wakehealth.edu)
  • Do statin medications impact renal functional or oncologic outcomes for robot-assisted partial nephrectomy? (wakehealth.edu)
  • Predictors of Medical and Surgical Complications After Robot-Assisted Partial Nephrectomy: An Analysis of 1139 Patients in a Multi-Institutional Kidney Cancer Database. (wakehealth.edu)
  • Robot-assisted partial nephrectomy: continued refinement of outcomes beyond the initial learning curve. (wakehealth.edu)
  • Selective arterial clamping does not improve outcomes in robot-assisted partial nephrectomy: a propensity-score analysis of patients without impaired renal function. (wakehealth.edu)
  • Predicting Complications Following Robot-Assisted Partial Nephrectomy with the ACS NSQIP® Universal Surgical Risk Calculator. (wakehealth.edu)
  • Studies providing sufficient details on renorrhaphy techniques during laparoscopic or robot‐assisted partial nephrectomy and comparative studies focused on peri‐operative outcomes were included in qualitative and quantitative analyses, respectively. (bjuinternational.com)
  • Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. (ac.ir)
  • Source: Journal of Robotic Surgery, Volume 2, Number 3 / September, 2008 Conclusions We report a large, multi-institutional series of RPN for renal tumors, confirming safety and feasibility reported in previous small, single-institution studies. (theroboticsurgeon.com)
  • Source: Washington University Website "Robotic surgery is more efficient and precise than either open or laparoscopic surgery for tumors confined to the kidney," says Bhayani, assistant professor of surgery and a leader in the field of robotic surgery. (theroboticsurgeon.com)
  • Robotic and laparoscopic partial nephrectomy for T1b tumors. (wakehealth.edu)
  • The adoption of robotic assistance has contributed to the increased utilization of partial nephrectomy for the management of renal tumors. (biomedcentral.com)
  • Radical nephrectomy is the standard for larger and central tumors. (medscape.com)
  • As an oncological urologist, Dr. Liu specializes in the surgical treatment of urinary tumors, especially in robotic and minimally invasive laparoscopic surgeries, as well as the comprehensive treatment of bladder cancer and testicular cancer, and the surgical treatment of children's tumors. (sysucc.org.cn)
  • ObjectiveTo compare the perioperative outcomes of robotic partial nephrectomy (RPN) with laparoscopic PN (LPN) performed for small renal masses (SRMs), in a large multi-institutional series and to define a new composite outcome measure, termed 'optimal outcome' for the RPN group. (wustl.edu)
  • Comparison of clamping technique in robotic partial nephrectomy: does unclamped partial nephrectomy improve perioperative outcomes and renal function? (wakehealth.edu)
  • Herbert Ruckle, MD. "Robotic Assisted Laparoscopic Prostatectomy. (llu.edu)
  • Due to recent evidence questioning the utility of the robotic platform, the use of it in urologic surgery must be revisited, especially in regard to long-term clinical and oncologic outcomes. (va.gov)
  • If the robotic platform can reduce length of stay, complications, readmissions, or improve oncologic outcomes, then costs may be more than recuperated, but this needs to be determined. (va.gov)
  • Robotic-assisted surgery for partial nephrectomy and cystectomy have a few documented short-term benefits over open or laparoscopic approaches, but the cost effectiveness is unknown, and long-term functional and oncologic outcomes are inadequately studied. (va.gov)
  • Most other differences in outcomes probably may be small or non-existent (i.e., complications, lymph node sampling [for cystectomy], warm ischemia time [for partial nephrectomy], etc. (va.gov)
  • The first is randomized data for patients undergoing partial nephrectomy, in terms of short-term outcomes. (va.gov)
  • The second is high-quality evidence with adequate long-term follow-up to assess cancer outcomes between the operative approaches for either partial nephrectomy or cystectomy. (va.gov)
  • UroToday - Positive Surgical Parenchymal Margin After Laparoscopic Partial Nephrectomy for Renal Cella: Oncological Outcomes Carcinom Thursday, 15 March 2007 BERKELEY, CA (UroToday.com) - Positive margins following supposedly curative surgery can be devastating for patient and surgeon alike. (theroboticsurgeon.com)
  • Emerging technologies to improve techniques and outcomes of robotic partial nephrectomy: striving toward the pentafecta. (wakehealth.edu)
  • Oncologic Outcomes Following Robot-Assisted Laparoscopic Nephroureterectomy with Bladder Cuff Excision for Upper Tract Urothelial Carcinoma. (wakehealth.edu)
  • Main Renal Artery Clamping With or Without Renal Vein Clamping During Robotic Partial Nephrectomy for Clinical T1 Renal Masses: Perioperative and Long-term Functional Outcomes. (wakehealth.edu)
  • Comparative Analysis of Renal Functional Outcomes and Overall Survival of Elderly vs Nonelderly Patients Undergoing Radical Nephrectomy. (wakehealth.edu)
  • Comparison of perioperative and functional outcomes of robotic partial nephrectomy for cT1a vs cT1b renal masses. (wakehealth.edu)
  • Reevaluating Warm Ischemia Time as a Predictor of Renal Function Outcomes After Robotic Partial Nephrectomy. (wakehealth.edu)
  • To summarize the available evidence on renorrhaphy techniques and to assess their impact on peri‐operative outcomes after minimally invasive partial nephrectomy (MIPN). (bjuinternational.com)
  • Integrated overview of evidence‐based technical principles for renal reconstruction during minimally invasive partial nephrectomy and suggested standardized reporting of key renorrhaphy features in clinical studies on this topic. (bjuinternational.com)
  • Traditionally, partial nephrectomy had been performed via an open approach but there has been a steady trend toward a minimally invasive approach [ 2 ]. (biomedcentral.com)
  • As partial nephrectomy is increasingly performed with a minimally invasive approach, control of intraoperative hemorrhage can be more challenging than simple manual compression of the renal parenchyma with suturing, as can be done in open surgery. (biomedcentral.com)
  • While the robotic approach has become the standard approach to prostatectomy, there are other urologic procedures (i.e., partial nephrectomy and cystectomy) in which the robotic approach is being introduced. (va.gov)
  • The utility of indocyanine green dye (ICG) has evolved significantly to the robotic operations including Robotic Assisted Radical Prostatectomy (RARP). (e-urol-sci.com)
  • We describe our technique for robotic radical cystectomy (RRC) and intracorporeal urinary diversion (ICUD), that replicates open surgical principles, and present our preliminary results. (bvsalud.org)
  • CONCLUSIONS: Robotic radical cystectomy with totally ICUD is safe and feasible. (bvsalud.org)
  • Changes in quality of life over time post radical cystectomy depend on urinary diversion type. (urologyspecialist.com.au)
  • To help clinicians, patients, and policymakers decide between robotic and other surgical approaches in patients undergoing partial nephrectomy and cystectomy, VA's Evidence Synthesis Program (ESP) in West Los Angeles, CA reviewed the literature in PubMed from 1/1/2010 through 6/29/2019 and Cochrane (all databases) from 1/1/2010 through 6/29/2019. (va.gov)
  • From these, 42 publications met inclusion criteria including: 4 cost-effectiveness analyses, 4 cost-only studies, 7 nephrectomy observational studies, and 16 articles describing 5 cystectomy randomized controlled trials (RCTs), and 11 cystectomy observational studies. (va.gov)
  • Robot-assisted surgery probably results in less blood loss than open or laparoscopic approaches, for both partial nephrectomy and cystectomy procedures. (va.gov)
  • Operating room time in cystectomy was judged to have moderate certainty that robot-assisted procedures take more time. (va.gov)
  • Robotic IVC thrombectomy is a viable alternative to open surgery for appropriately selected cases by experienced teams. (bvsalud.org)
  • Laparoscopic surgery of the kidney. (ac.ir)
  • Searching for a better definition of robotic surgery: is it really different from laparoscopy? (researchgate.net)
  • With the increasing use of robotics, many centres have reported their early experiences using it for nephron-sparing surgery.Objective: to review published literature comparing robotic partial nephrectomy (RPN) with laparoscopic partial nephrectomy (LPN).Evidence acquisition: an online systematic review of the literature according to Cochrane guidelines was conducted from 2000 to 2012 including studies comparing RPN and LPN. (soton.ac.uk)
  • Surgery: Is indocyanine green dye useful in robotic surgery? (wakehealth.edu)
  • Proficient in Nephron Sparing Surgery, including Robotic and Laparoscopic Partial Nephrectomy. (healthtrip.com)
  • However, partial nephrectomy can be technically challenging because of intraoperative hemorrhage, which limits the ability to identify the tumor margin and may necessitate the conversion to open surgery or radical nephrectomy. (biomedcentral.com)
  • During this stressful situation, it is imperative for the surgeon to have an organized approach to management of hemorrhage, as delayed management could lead to prolonged ischemic times, iatrogenic positive surgical margins from inadequate visualization, conversion to open surgery, or radical nephrectomy. (biomedcentral.com)
  • These were cases with 46, XX congenital adrenal hyperplasia, partial androgen insensitivity, mixed or partial gonadal dysgenesis, and micropenis where data about the assigned gender, childhood genital-normalizing surgery, and adult gender could be extracted. (e-urol-sci.com)
  • There is no specified recovery time after heart bypass surgery. (blkmaxhospital.com)
  • This review of an article by one of the founders of laparoscopic urology shows that with one of the common laparoscopic method to remove a kidney, ureter, and bladder cuff for transitional cell caner of the upper urinary tract lining there seems to be a higer recurrence rate and positive margins. (theroboticsurgeon.com)
  • Robotic-assisted nephroureterectomy and bladder cuff excision without intraoperative repositioning. (wakehealth.edu)
  • A treatment safety checklist for the management of hemorrhage during robotic partial nephrectomy was collaboratively developed based on prior experiences with intraoperative hemorrhage during robotic partial nephrectomy. (biomedcentral.com)
  • Safely performing robotic partial nephrectomy is dependent on attention to prevention of hemorrhage and rapid response to the challenge of intraoperative bleeding. (biomedcentral.com)
  • The Trifecta was defined as negative surgical margin, zero perioperative complications and a warm ischaemia time of ≤25 min. (wustl.edu)
  • Running-clip renorrhaphy reducing warm ischemic time during laparoscopic partial nephrectomy. (ac.ir)
  • Warm ischemia time prior to renal cooling was 6 minutes. (auanet.org)
  • Source: UroToday The mean total operative time (140 vs 156 minutes, P = .04), warm ischemia time (19 vs 25 minutes, P = .03), and length of stay (2.5 vs 2.9 days, P = .03) were significantly shorter for RPN than for LPN, respectively. (theroboticsurgeon.com)
  • The RPN group had significantly less warm ischaemic time than the LPN group ( p = 0.0008). (soton.ac.uk)
  • There was no difference regarding postoperative length of hospital stay ( p = 0.37), complications ( p = 0.86), or positive margins ( p = 0.93).Conclusions: in early experience, RPN appears to be a feasible and safe alternative to its laparoscopic counterpart with decreased warm ischaemia times noted. (soton.ac.uk)
  • Specific tumour features (i.e. size, hilar location, anatomical complexity, nearness to renal sinus and/or urinary collecting system), surgeon's experience, robot‐assisted technology, as well as the aim of reducing warm ischaemia time and the amount of devascularized renal parenchyma preserved represented the key factors driving the evolution of the renorrhaphy techniques during MIPN over the past decade. (bjuinternational.com)
  • We present ongoing robotic advances in this arena in a case series of six patients with Mayo level II-III thrombi who underwent robotic caval thrombectomy, radical nephrectomy, and retroperitoneal lymphadenectomy. (bvsalud.org)
  • The records of the patients who underwent our modified laparoscopic partial nephrectomy technique were evaluated retrospectively. (ac.ir)
  • Robotic versus laparoscopic partial nephrectomy: a systematic review and meta-analysis. (ac.ir)
  • Specializations: Expertise in kidney transplantation, robotic and laparoscopic urological surgeries, endourology, stone disease management, and urological cancer surgeries. (healthtrip.com)
  • Irrigation and cooling of the autograph was performed with the use of a laparoscopic specimen bag and intracorporeal instillation of ice slush. (auanet.org)
  • Intracorporeal cold ischemia was achieved with intra-arterial irrigation of Wisconsin fluid and ice slush hypothermia performed with the use of a laparoscopic specimen bag without extracting the organ from the body. (auanet.org)
  • Oncologic outcome of 132 cases of laparoscopic radical nephrectomy with intact specimen removal for T1-2N0M0 renal cell carcinoma. (wakehealth.edu)
  • This study aimed to document the surgical and oncologic results of nephron sparing of non-ischemic laparoscopic partial nephrectomy without the step of hilus controlling and even without dissecting to expose the main renal vascularity and directly focusing on mass removal. (ac.ir)
  • Present un-controlled results pointed that tumor-focusing nephron-sparing non-ischemic partial lap-aroscopic nephrectomy may be preferable for small-sized, low-complex renal masses. (ac.ir)
  • Hemorrhage is further concerning as control can occupy valuable time during which the renal unit is ischemic due to renal vascular clamping during tumor excision. (biomedcentral.com)
  • He is one of the first surgeons in China to carry out robot-assisted/laparoscopic retroperitoneal lymph node dissection for testicular cancer and ultra-expanded lymph node dissection for bladder cancer. (sysucc.org.cn)
  • Near-infrared fluorescence imaging to facilitate super-selective arterial clamping during zero-ischaemia robotic partial nephrectomy. (wakehealth.edu)
  • Indocyanine green cannot predict malignancy in partial nephrectomy: histopathologic correlation with fluorescence pattern in 100 patients. (wakehealth.edu)
  • Completely intracorporeal robotic renal autotransplantation has been previously described, but this technique is still in its infancy. (auanet.org)
  • In this video, we demonstrate our technique of robotic renal autotransplantation performed in a completely intracorporeal fashion, replicating the open approach. (auanet.org)
  • UroToday - Incidence of Benign Pathologic Findings at Partial Nephrectomy for Solitary Renal Mass Presumed to be Renal Cell Carcinoma on Preoperative Imaging The authors conclude that there is no reliable indicator of benign pathology preoperatively in solitary renal masses, as all of these were considered to be renal cell carcinoma on preoperative imaging. (theroboticsurgeon.com)
  • Evaluation of renal function under controlled hypotension in zero ischemia robotic assisted partial nephrectomy. (ac.ir)
  • A systematic review of the literature was performed in January 2018 without time restrictions, using MEDLINE, Cochrane and Web of Science databases according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement recommendations. (bjuinternational.com)
  • This procedure should be reserved for experienced robotic surgeons at centers where autotransplantation is performed routinely, as transplant expertise is required. (auanet.org)
  • To our knowledge, a comprehensive safety checklist does not exist to guide surgeons on the management of hemorrhage during robotic partial nephrectomy. (biomedcentral.com)
  • We developed such an safety checklist based on the cumulative experiences of high volume robotic surgeons. (biomedcentral.com)
  • Thus, the existing literature does little to educate surgeons on how to deal with bleeding during robotic partial nephrectomy while clamped. (biomedcentral.com)
  • The goal of this manuscript is to educate robotic surgeons in factors to minimize hemorrhage during robotic partial nephrectomy. (biomedcentral.com)
  • We describe a safe and feasible method for performing robotic renal autotransplantation without need for renal extraction. (auanet.org)
  • Mean operation time, estimated blood loss, and transfusion rates were 138.62 ± 38.45 minutes (range: 90-240 min), 242.24 ± 107.12 mL (range: 100-500 mL), and 19%, respectively. (ac.ir)
  • Quantitative synthesis showed that running suture was associated with shorter operating and ischaemia time, and lower postoperative complication and transfusion rates than interrupted suture. (bjuinternational.com)
  • Whereas the perioperative complications were Clavien grades I, II, and III (74%, 23%, and 3%, respectively), mean hospital stay and fol-low-up time were 4.05 ± 1.97 and 19.67 ± 13.57 (ranges: 2-10 days and 1-44 months), respectively. (ac.ir)
  • There is a signal that length-of-stay may be shorter and major complications may be fewer for robot-assisted cases of partial nephrectomy, but again the certainty of evidence is low . (va.gov)
  • Yuksel OH, Otunctemur A, Ozbek E, Uruc F, Verit A. Should oncological cases of upper urinary system be excluded at the beginning of the laparoscopic learning curve? (ac.ir)
  • Overall median (range) operative time and estimated blood loss was 7 h (4.8-13) and 200 mL (50-1200), respectively. (bvsalud.org)
  • Total operating room time was 433 minutes and estimated blood loss was 100 cc. (auanet.org)
  • There was no difference between the two groups regarding operative times ( p = 0.58), estimated blood loss ( p = 0.76), or conversion rates ( p = 0.84). (soton.ac.uk)
  • Barbed suture had lower operating and ischaemia time and less blood loss than non‐barbed suture. (bjuinternational.com)
  • Series on robotic partial nephrectomy report a reasonable blood loss (Table 1 ). (biomedcentral.com)
  • Table 1 Selected reports from 2009-2012 of estimated blood loss during robotic partial nephrectomy with hilar clamping. (biomedcentral.com)
  • Operative time was 40 minutes (35-50). (espu.org)
  • The recommendations not met were using the Shouldice technique for any non-mesh open inguinal herniorrhaphy, using local anesthesia for open repair of reducible inguinal hernias, using lightweight mesh, and avoiding the use of prophylactic antibiotics in laparoscopic herniorrhaphy. (researchgate.net)
  • The single‐layer suture technique was associated with shorter operating and ischaemia time than the double‐layer technique. (bjuinternational.com)
  • PATIENT SUMMARY: We present ongoing robotic surgical advances in a case series of six patients with blood clots in the inferior vena cava. (bvsalud.org)
  • 0.05 considered significant.Evidence synthesis: a total of 717 patients were included, 313 patients in the robotic group and 404 patients in the laparoscopic group (seven studies). (soton.ac.uk)
  • A nonrandomized prospective comparison of robotic-assisted partial nephrectomy in the elderly to a younger cohort: an analysis of 339 patients with intermediate-term follow-up. (wakehealth.edu)
  • Ischemia is not an independent predictive factor of chronic renal failure after partial nephrectomy in a solitary kidney in patients without pre-operative renal insufficiency. (univ-rennes.fr)
  • Bottom line Many of us determine which low-flow As well as insufflation in the course of laparoscopic surgical treatments is a member of a lesser number of hemodynamic alterations, far better affected individual satisfaction ratings, reducing postoperative discomfort results.A new 60-year-old woman maintained any distal distance break along with have open up decrease interior fixation which has a volar sealing dish. (huskerchem.com)
  • By the end of 2017, more than 750,000 robotic procedures were being performed in the United States annually, including over 125,000 urologic robotic procedures. (va.gov)
  • We constructed a method for performing renal autotrasplant via a robotic approach without the necessity of kidney extraction. (auanet.org)
  • However, the benefits for robotic approach may still be realized despite patient-level differences (VA patient population has greater burden of comorbidities than the general population), which will need to be confirmed in future studies. (va.gov)
  • The abstract is reproduced below and you can click on the button to read the full article, which is freely available to all readers for at least 30 days from the time of this post. (bjuinternational.com)
  • A single institution experience of 141 cases of laparoscopic radical nephrectomy with cost-reductive measures. (wakehealth.edu)
  • Cases assigned female had more than five times greater likelihood of assigned gender incongruence (95% confidence interval = 1.96-14.92). (e-urol-sci.com)
  • Encourage employees to ask their physicians how much time they can take to seek second opinions and make a decision on their treatment. (surgerysecondopinion.com)