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Find video protocols related to scientific articles indexed in Pubmed.
The da vinci robot system eliminates multispecialty surgical trainees' hand dominance in open and robotic surgical settings.
JSLS
PUBLISHED: 11-14-2014
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Handedness, or the inherent dominance of one hand's dexterity over the other's, is a factor in open surgery but has an unknown importance in robot-assisted surgery. We sought to examine whether the robotic surgery platform could eliminate the effect of inherent hand preference.
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Utilization and Timing of Blood Transfusions Following Open and Robot-Assisted Radical Prostatectomy.
J. Endourol.
PUBLISHED: 10-22-2014
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Abstract Introduction and Objectives: Radical prostatectomy (RP) is associated with a high risk of intraoperative blood loss and subsequent blood transfusions. The shift in surgical technique from open radical prostatectomy (ORP) to robot-assisted radical prostatectomy (RARP) has resulted in lower operative blood loss, and reduced the need for transfusions. We analyzed the American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) database to compare real-world, contemporary trends in utilization and timing of blood transfusion following ORP and RARP. Methods: We identified men undergoing both RARP and ORP and then queried for patients who received a blood transfusion in the perioperative period. The outcomes of interest were need and timing of perioperative blood transfusion (PBT), which was categorized into early (postoperative day [POD] ?1) or late (POD ?2). Logistic regression analysis was used to identify variables associated with the need and timing for PBT. Results: A total of 16,144 men who underwent RP were identified from 2007 to 2012. The overall PBT rate was 3.1%. Highest rate of transfusions occurred on day of surgery for patients undergoing ORP, and first POD for patients undergoing RARP. On multivariate analysis significant predictors of blood transfusion included history of bleeding disorder (OR: 2.8, p=0.002), preoperative dyspnea (odds ratio [OR]: 1.7, p=0.03), starting hematocrit <42% (OR: 1.9, p<0.001), open approach (OR: 0.09, p<0.001), year of surgery (OR: 0.5, p<0.001), resident involvement (OR: 1.6, p=0.003), and operative time (OR: 4.4, p<0.001). The only predictor of receiving a blood transfusion on POD 2 or later was having the procedure performed through a robot-assisted approach (OR: 3.7, p<0.001). Conclusions: In this study we found that the rate of perioperative transfusions is lower than previously published. A clear separation in timing of transfusion exists based on the utilized surgical approach. It is prudent that surgeons performing RARP be aware of the low, but present risk of a delayed blood transfusion.
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Effect of Postcall Fatigue on Surgical Skills Measured by a Robotic Simulator.
J. Endourol.
PUBLISHED: 10-07-2014
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Abstract Purpose: To examine the effect of a 24-hour call on residents' performance of a suturing task using the objective results calculated by the da Vinci Skills Simulator (Intuitive Surgical, Sunnyvale, CA). Subjects and Methods: Residents from urology and general surgery completed a single suturing skill immediately before and after a 24-hour call. Residents completed the task at least twice and were scored on three measures: time to complete the exercise, time to load the needle, and time to tie the knot. These scores were correlated with previous simulator experience, trainee level, and level of postcall fatigue. Results: Thirteen residents (four senior and nine junior) participated; six had no simulator experience. All time measures were significantly longer when residents were postcall (p<0.05). In the precall measures, previous robotic simulator experience was associated with improved time for completion of the exercise, needle loading, and knot tying (p<0.05). In the postcall measures, however, the difference in performance between residents with and without previous simulator experience was no longer statistically significant (p>0.05). When examining factors that predicted an increased task time on multivariate analysis, being postcall consistently increased the time to complete the exercises, while previous simulator experience and trainee level decreased the time to complete tasks. Conclusions: Previous studies have shown that postcall-related fatigue is associated with decreased surgical skills in the operative room. We demonstrate this effect by having residents test their skills, precall and postcall, using a novel easily reproducible technique. Time to complete the three measures analyzed was significantly increased following a 24-hour call for all participants. Fatigue acts as an equalizer of abilities in that the effects of fatigue nullify the benefits of having previous robotic simulator experience.
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Robot-assisted nephroureterectomy and bladder cuff excision without patient or robot repositioning: description of modified port placement and technique.
J Laparoendosc Adv Surg Tech A
PUBLISHED: 09-06-2014
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Nephroureterectomy (NUx) with full bladder cuff excision is the gold-standard treatment for upper urinary tract urothelial cancer. Although minimally invasive techniques for NUx have demonstrated comparable outcomes to those of the open technique, the robotic technique is limited by the need for intraoperative patient repositioning and robot redocking to manage the distal ureter and bladder cuff. We describe our novel technique of robotic NUx that allows for complete access to the kidney and full bladder cuff excision.
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Venous thromboembolism after major urologic oncology surgery: a focus on the incidence and timing of thromboembolic events after 27,455 operations.
Urology
PUBLISHED: 08-22-2014
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To investigate the incidence and timing of venous thromboembolism (VTE) and identify risk factors for venous thromboembolism among patients undergoing major surgery for urologic malignancies. VTE events are stratified by occurrence in the inpatient vs outpatient settings.
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Utilization and Timing of Blood Transfusions Following Open and Robot Assisted Radical Prostatectomy.
J. Endourol.
PUBLISHED: 08-08-2014
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Radical prostatectomy (RP) is associated with a high risk of intraoperative blood loss and subsequent blood transfusions. The shift in surgical technique from open radical prostatectomy (ORP) to robot-assisted radical prostatectomy (RARP) has resulted in lower operative blood loss, and reduced the need for transfusions. We analyzed the American College of Surgeons National Surgical Quality Improvement Project (NSQIP) database to compare real-world, contemporary trends in utilization and timing of blood transfusion following ORP and RARP.
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Single luminal epithelial progenitors can generate prostate organoids in culture.
Nat. Cell Biol.
PUBLISHED: 05-13-2014
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The intrinsic ability to exhibit self-organizing morphogenetic properties in ex vivo culture may represent a general property of tissue stem cells. Here we show that single luminal stem/progenitor cells can generate prostate organoids in a three-dimensional culture system in the absence of stroma. Organoids generated from CARNs (castration-resistant Nkx3.1-expressing cells) or normal prostate epithelia exhibit tissue architecture containing luminal and basal cells, undergo long-term expansion in culture and exhibit functional androgen receptor signalling. Lineage-tracing demonstrates that luminal cells are favoured for organoid formation and generate basal cells in culture. Furthermore, tumour organoids can initiate from CARNs after oncogenic transformation and from mouse models of prostate cancer, and can facilitate analyses of drug response. Finally, we provide evidence supporting the feasibility of organoid studies of human prostate tissue. Our studies underscore the progenitor properties of luminal cells, and identify in vitro approaches for studying prostate biology.
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Effect of a genomic classifier test on clinical practice decisions for patients with high-risk prostate cancer after surgery.
BJU Int.
PUBLISHED: 05-03-2014
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To evaluate the impact of a genomic classifier (GC) test for predicting metastasis risk after radical prostatectomy (RP) on urologists' decision-making about adjuvant treatment of patients with high-risk prostate cancer.
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The association between socioeconomic status, renal cancer presentation, and survival in the United States: a survival, epidemiology, and end results analysis.
Urology
PUBLISHED: 04-21-2014
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To determine whether socioeconomic status (SES) predicts the size and local extent of tumors at presentation, and if this association leads to differences in survival.
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Baseline serum 25-hydroxyvitamin d levels in men undergoing radical prostatectomy: is there an association with adverse pathologic features?
Clin Genitourin Cancer
PUBLISHED: 02-06-2014
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The purpose of this study was to evaluate the prevalence of vitamin D (VitD) deficiency in men undergoing radical prostatectomy and determine whether an association exists between preoperative VitD levels and adverse pathologic features.
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Pain and analgesic use after robot-assisted radical prostatectomy.
J. Endourol.
PUBLISHED: 01-30-2014
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While robot-assisted radical prostatectomy (RARP) is associated with shortened convalescence and decreased blood loss over open prostatectomy, little objective data is available regarding postoperative pain/discomfort and use of analgesic medications after RARP. We sought to examine these parameters in a contemporary cohort.
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Dorsal penile nerve block for robot-assisted radical prostatectomy catheter related pain: a randomized, double-blind, placebo-controlled trial.
Springerplus
PUBLISHED: 01-01-2014
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Following Robotic-Assisted Radical Prostatectomy (RARP) patients routinely have penile pain and urethral discomfort secondary to an indwelling urethral catheter. Our objective was to assess the effect of dorsal penile nerve block with bupivacaine on urethral catheter-related pain after RARP.
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Outcomes with delayed dorsal vein complex ligation during robotic assisted laparoscopic prostatectomy.
Can J Urol
PUBLISHED: 12-17-2013
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There are many concerns expressed by urologists performed robotic assisted laparoscopic prostatectomy (RALP) regarding management of the dorsal vein complex (DVC). We sought to examine the influence of delayed DVC ligation versus standard DVC ligation on the apical surgical margin status and other key surgical parameters following RALP.
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Comparison of Robot-Assisted and Open Retropubic Radical Prostatectomy for Risk of Biochemical Progression in Men with Positive Surgical Margins.
J. Endourol.
PUBLISHED: 11-09-2013
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Abstract Objective: Robot-assisted radical prostatectomy (RARP) is a minimally invasive alternative to open retropubic radical prostatectomy (RP), and is reported to offer equivalent oncologic outcomes while reducing perioperative morbidity. However, the technique of extirpation can differ based on the usage of thermal energy and coagulation during RARP, which may alter the risk of finding a positive surgical margin (PSM) as cautery may destroy residual cancer cells. We sought to evaluate whether the method of surgery (RP vs. RARP) affects the rate of biochemical recurrence (BCR) in patients with PSMs. Materials & Methods: The Columbia University Urologic Oncology Database was reviewed to identify patients who underwent RP and RARP from 2000 to 2010 and had a PSM on final pathology. BCR was defined as a postoperative prostate-specific antigen (PSA) ?0.2?ng/mL. The Kaplan-Meier analysis was utilized to calculate BCR rates based on the method of surgery. Cox regression analysis was performed to determine if the method of surgery was associated with BCR. Results: We identified 3267 patients who underwent prostatectomy, of which 910 (28%) had a PSM. Of those with a PSM, 337 patients had available follow-up data, including 229 who underwent RP (68%) and 108 who underwent RARP (32%). At a mean follow-up time of 37 months for the RP group, 103 (46%) patients demonstrated BCR; at a mean follow-up time of 44 months for the RARP group, 62 (57%) patients had a BCR (p=0.140). Two-year BCR-free rates for RP vs. RARP were 65% and 49%, respectively (log-rank p<0.001). However, after controlling for age, PSA, grade, and year of surgery, the surgical method was not significantly associated with increased risk of BCR (HR 1.25; p=0.29). Conclusion: Our results confirm the noninferiority of RARP to RP with regard to patients with PSMs. As such, all patients with a PSM at RP are at high risk for BCR and should be followed in the same manner regardless of the surgical approach.
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Characterization of perioperative leukocytosis in patients undergoing robot-assisted radical prostatectomy: effects of Gleason score and race.
J. Endourol.
PUBLISHED: 09-28-2013
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Abstract Introduction: Our objective was to determine the impact of race and tumor grade on perioperative leukocytosis on patients undergoing robot-assisted radical prostatectomy (RARP). Methods: A retrospective review of our urologic oncology database for patients undergoing RARP from August 2002 to July 2011 was conducted. A total of 768 patients were identified with complete data. Demographic data, preoperative prostate specific antigen (PSA), biopsy Gleason score, pathology Gleason score, pathology stage, margin status, and node status were collected. White blood cell (WBC) counts were captured preoperatively, 1 hour postoperatively, and on postoperative day 1. We assessed the differences in leukocyte responses according to the race and Gleason score using ANOVA testing. Results: Preoperative WBC was lowest in black men and comparable between white and Hispanic men. At 1 hour, postoperative WBC remained lowest in Black men (p<0.001). Post-RARP leukocytosis varied significantly depending on the race (p<0.001). At 1 hour, patients with Gleason 8-10 tumors had decreased WBC compared to Gleason 6 patients (p<0.05) despite similar preoperative WBC and Charlson comorbidity index values. Conclusions: We report novel clinical observations that suggest differences in the immune response associated with the race and Gleason grade following RARP. The clinical utility of these findings are yet to be determined.
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Characterization of Perioperative Leukocytosis in Patients undergoing Robotic assisted Retropubic Prostatectomy: Effects of Gleason score and Race.
J. Endourol.
PUBLISHED: 09-04-2013
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Introduction: Our objective was to determine the impact of race and tumor grade on perioperative leukocytosis on patients undergoing robot assisted retropubic prostatectomy (RARP). Methods: A retrospective review of our urologic oncology database for patients undergoing RARP from August 2002 to July 2011 was conducted. A total of 768 patients were identified with complete data. Demographic data, pre-operative PSA, biopsy Gleason score, pathology Gleason score, pathology stage, margin status, and node status were collected. White blood cell (WBC) counts were captured preoperatively, 1 hour postoperatively, and on postoperative day 1. We assessed differences in leukocyte response according to race and Gleason score using ANOVA testing. Results: Preoperative WBC was lowest in Black men and comparable between White and Hispanic men. At 1 hour post-op WBC remained lowest in Black men (p<0.001). Post-RARP leukocytosis varies significantly depending on race (p<0.001). At 1 hour patients with Gleason 8-10 tumors had decreased WBC compared to Gleason 6 patients (p<0.05) despite similar pre-op WBC and Charlson co-morbidity index values. Conclusions: We report novel clinical observations that suggest differences in immune response associated with race and Gleason grade following RARP. The clinical utility of these findings are yet to be determined.
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Comparison of 3 upper tract anticarcinogenic agent delivery techniques in an ex vivo porcine model.
Urology
PUBLISHED: 06-17-2013
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To evaluate the degree of urothelial exposure using 3 upper tract delivery techniques in an ex vivo porcine model, to determine the optimal modality to locally deliver topical anticarcinogenic agents in patients with upper tract urothelial carcinoma.
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Trifecta after radical prostatectomy: is there a standard definition?
BJU Int.
PUBLISHED: 06-14-2013
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To determine the extent of variability in the definitions of the trifecta after radical prostatectomy (undetectable PSA, urinary continence and potency) to be found in the literature. To establish a consensus definition of the trifecta in an effort to standardize criteria and reporting.
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Findings of routine apical margin biopsy during robot-assisted radical prostatectomy.
J Laparoendosc Adv Surg Tech A
PUBLISHED: 04-27-2013
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Intraoperative biopsy of the apical margin during radical prostatectomy has been recommended as a way to reduce the positive margin rate at this location. However, the enhanced visibility of the apex during robot-assisted radical prostatectomy (RARP) may obviate this need, allowing for the preservation of maximal urethral length. We assessed pathologic findings of routine apical margin biopsy intraoperative frozen section (IFS) during RARP.
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Impact of a genomic classifier of metastatic risk on postoperative treatment recommendations for prostate cancer patients: a report from the DECIDE study group.
Oncotarget
PUBLISHED: 04-18-2013
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Only a minority of prostate cancer patients with adverse pathology and biochemical recurrence (BCR) post radical prostatectomy (RP) experience metastasis and die from prostate cancer. Improved risk prediction models using genomic information may enable clinicians to better weigh the risk of metastasis and the morbidity and costs of treatment in a clinically heterogeneous population.
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A Pilot Study of Laparoscopic Doppler Ultrasound Probe to Map Arterial Vascular Flow within the Neurovascular Bundle during Robot-Assisted Radical Prostatectomy.
Prostate Cancer
PUBLISHED: 02-26-2013
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Purpose. To report on the feasibility of a new Laparoscopic Doppler ultrasound (LDU) technology to aid in identifying and preserving arterial blood flow within the neurovascular bundle (NVB) during robotic prostatectomy (RARP). Materials and Methods. Nine patients with normal preoperative potency and scheduled for a bilateral nerve-sparing procedure were prospectively enrolled. LDU was used to measure arterial flow at 6 anatomic locations alongside the prostate, and signal intensity was evaluated by 4 independent reviewers. Measurements were made before and after NVB dissection. Modifications in nerve-sparing procedure due to LDU use were recorded. Postoperative erectile function was assessed. Fleiss Kappa statistic was used to evaluate inter-rater agreement for each of the 12 measurements. Results. Analysis of Doppler signal intensity showed maintenance of flow in 80% of points assessed, a decrease in 16%, and an increase in 4%. Plane of NVB dissection was altered in 5 patients (56%) on the left and in 4 patients (44%) on the right. There was good inter-rater reliability for the 4 reviewers. Use of the probe did not significantly increase operative time or result in any complications. Seven (78%) patients had recovery of erections at time of the 8-month follow-up visit. Conclusions. LDU is a safe, easy to use, and effective method to identify local vasculature and anatomic landmarks during RARP, and can potentially be used to achieve greater nerve preservation.
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Impact of surgeon and volume on extended lymphadenectomy at the time of robot-assisted radical cystectomy: results from the International Robotic Cystectomy Consortium (IRCC).
BJU Int.
PUBLISHED: 02-26-2013
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WHATS KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Lymph node dissection and its extend during robot-assisted radical cystectomy varies based on surgeon related factors. This study reports outcomes of robot-assisted extended lymphadenectomy based on surgeon experience in both academic and private practice settings.
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Detailed analysis of patients with metastasis to the prostatic anterior fat pad lymph nodes: a multi-institutional study.
J. Urol.
PUBLISHED: 02-15-2013
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Lymph nodes in the prostatic anterior fat pad rarely harbor metastatic disease. Therefore, the characteristics of patients with prostatic anterior fat pad lymph node metastasis are not well described in the literature. We identified the perioperative characteristics and assessed the clinical outcomes of patients with prostatic anterior fat pad lymph node metastasis.
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Evaluation of preoperative bioimpedance spectroscopy quantification of body composition on predicting postoperative outcomes following robotic assisted radical prostatectomy (RARP).
Can J Urol
PUBLISHED: 12-15-2011
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Bioimpedance spectroscopy (BIS) is a novel, precise quantification of body composition (BC) using low electrical currents through tissue. Accurate BC quantification may better predict postoperative outcomes. We compared BIS-BC and body mass index (BMI) for correlation with post-surgical outcomes in robotic assisted radical prostatectomy (RARP) patients.
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Retrospective comparison of laparoscopic partial nephrectomy versus laparoscopic renal cryoablation for small (<3.5 cm) cortical renal masses.
J Laparoendosc Adv Surg Tech A
PUBLISHED: 12-06-2011
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We compared perioperative and short-term outcomes of renal laparoscopic partial nephrectomy (LPN) and laparoscopic cryoablation (LCA) in patients with small (<3.5 cm) renal cortical neoplasms.
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Nonischemic laparoscopic partial nephrectomy using a novel wet monopolar device in a porcine model.
J. Endourol.
PUBLISHED: 10-19-2011
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Laparoscopic partial nephrectomy (LPN) is the minimally invasive standard of care for the management of a cT(1a) renal mass. We evaluated a novel saline enhanced electrosurgical resection (SEER) device for performance of a nonischemic LPN.
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Prospective randomized evaluation of gel mat foot pads in the endoscopic suite.
J. Endourol.
PUBLISHED: 10-03-2011
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Several studies that compare open and laparoscopic procedures have demonstrated that the minimally invasive surgeon has greater musculoskeletal pain when compared with open surgeons. The purpose of our study was to demonstrate whether the use of the gel mat in the endoscopic setting offered any ergonomic benefit to the surgeon.
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Independent diagnostic and post-treatment prognostic models for prostate cancer demonstrate significant correlation with disease progression end points.
J. Endourol.
PUBLISHED: 09-23-2011
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A major advance in the standard practice of tissue-based pathology is the new discipline of systems pathology (SP) that uses computational modeling to combine clinical, pathologic, and molecular measurements to predict biologic activity. Recently, a SP-based prostate cancer (PCa) predictive model for both preoperative (Px+) and postoperative (Px) prostatectomy has been developed. The purpose of this study is to calculate the percent agreement and the concordance between the Px+ and Px end points.
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Comparison of two core biopsy techniques before and after laparoscopic cryoablation of small renal cortical neoplasms.
JSLS
PUBLISHED: 09-07-2011
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Cryoablation is an acceptable treatment option for small renal cortical neoplasms (RCN). Unlike extirpative interventions, intraoperative needle biopsy is the only pathologic data for ablated tumors. It is imperative that sampled tissue accurately captures pathology. We studied the optimal intraoperative needle core biopsy protocol for small RCN during laparoscopic renal cryoablation (LCA).
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Polyglyconate unidirectional barbed suture for posterior reconstruction and anastomosis during robot-assisted prostatectomy: effect on procedure time, efficacy, and minimum 6-month follow-up.
J. Endourol.
PUBLISHED: 08-08-2011
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With widespread implementation of posterior rhabdosphincter reconstruction (RSR) followed by urethrovesical anastomosis (UVA), reconstruction has become a significant portion of robot-assisted laparoscopic prostatectomy (RALP). Successful anastomosis can be measured by time for reconstruction and the absence of urinary leak. We prospectively evaluated the experience of a single surgeon (KKB) in using the V-Loc™ wound closure device for the posterior RSR and UVA, and compared it with a standard reconstruction and anastomosis.
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Impact of HMG-CoA reductase inhibitor (statin) use on blood loss during robot-assisted and open radical prostatectomy.
J. Endourol.
PUBLISHED: 07-28-2011
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In addition to their lipid lowering effects, HMG-CoA reductase inhibitors (statins) have been shown to exert antithrombotic effects through downregulation of the coagulation cascade. Because statin use is widespread, it is important to understand the impact of these drugs on blood loss (BL) during surgery. We studied the impact of statin use on BL during robot-assisted radical prostatectomy (RARP) and open radical prostatectomy (ORP).
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Validating the use of the Mimic dV-trainer for robotic surgery skill acquisition among urology residents.
Urology
PUBLISHED: 03-31-2011
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To compare robotic surgery skill acquisition of residents trained with Mimic dVTrainer (MdVT) and da Vinci Surgical System (dVSS) console. No standardized curriculum currently exists for robotic surgical education. The MdVT is a compact hardware platform that closely reproduces the experience of the dVSS.
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Effect of statin use on biochemical outcome following radical prostatectomy.
BJU Int.
PUBLISHED: 03-31-2011
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•To determine the relationship between statin use and biochemical recurrence (BCR) following radical prostatectomy (RP).
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Impacting factors for recovery of erectile function within 1 year following robotic-assisted laparoscopic radical prostatectomy.
J Sex Med
PUBLISHED: 03-22-2011
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Neurovascular bundle preservation generally results in good postoperative sexual function after radical prostatectomy. However, erectile function (EF) after radical prostatectomy is still a significant concern. The same surgical technique often results in different EF outcomes.
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Heparin prophylaxis and the risk of venous thromboembolism after robotic-assisted laparoscopic prostatectomy.
BJU Int.
PUBLISHED: 01-13-2011
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• The incidence of venous thromboembolism (VTE) after robotic-assisted laparoscopic prostatectomy (RALP) in patients receiving perioperative heparin prophylaxis was compared with those who did not receive such prophylaxis.
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Contemporary experience in the management of angiomyolipoma.
J. Endourol.
PUBLISHED: 10-04-2010
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We review our single center experience in the management of renal angiomyolipoma (AML) in patients who were treated with active surveillance (AS) or invasive treatment protocols.
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Intraoperative evaluation of renal blood flow during laparoscopic partial nephrectomy with a novel Doppler system.
J. Endourol.
PUBLISHED: 09-16-2010
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Hemostasis remains a major challenge associated with laparoscopic renal surgery. We evaluated a cost-effective novel Doppler probe (DP) for assessment of vascular control during laparoscopic partial nephrectomy (LPN).
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Gleason score concordance on biopsy-confirmed prostate cancer: is pathological re-evaluation necessary prior to radical prostatectomy?
BJU Int.
PUBLISHED: 09-14-2010
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• Gleason sum from prostate biopsy (bGS) is an important tool in classifying severity of disease, ultimately influencing clinical management. • Commonly, pathology specimens are re-evaluated internally prior to surgery. • We evaluate agreement of bGS with prostatectomy Gleason sum (pGS) and the impact of re-grading on prediction of true underlying tumor architecture.
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Use of a flexible carbon dioxide laser fiber for precise dissection of the neurovascular bundle during robot-assisted laparoscopic prostatectomy.
J. Endourol.
PUBLISHED: 06-26-2010
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Carbon dioxide (CO(2)) lasers deliver energy with minimal thermal spread to tissues during dissection. Excess thermal spread during dissection of the neurovascular bundle (NVB) can affect potency in men after robot-assisted radical prostatectomy (RARP). We report on a novel delivery mechanism for CO(2) laser energy through a flexible fiber to enhance accuracy of NVB dissection during RARP.
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Assessment of lymph node yield after pelvic lymph node dissection in men with prostate cancer: a comparison between robot-assisted radical prostatectomy and open radical prostatectomy in the modern era.
J. Endourol.
PUBLISHED: 06-26-2010
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Studies of radical prostatectomy (RP) suggest that higher lymph node yield (LNY) improves tumor staging. Robot-assisted radical prostatectomy (RARP) is becoming increasingly popular, yet LNY data are not well reported. We compare LNY from contemporary open RP (ORP) with RARP at an academic center.
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Prospective randomized single-blinded in vitro and ex vivo evaluation of new and reprocessed laparoscopic trocars.
J. Am. Coll. Surg.
PUBLISHED: 06-25-2010
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Reprocessing of single-use medical instruments has been proposed as a mechanism for managing the rising costs of health care. We compared the performance of new and reprocessed laparoscopic trocars.
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Predictors of early urinary continence after robotic prostatectomy.
Can J Urol
PUBLISHED: 06-23-2010
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We sought to identify predictors of early urinary continence after robot-assisted prostatectomy (RARP) in men who underwent a posterior rhabdosphincter reconstruction.
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Natural history of renal cortical neoplasms during active surveillance with follow-up longer than 5 years.
Urology
PUBLISHED: 06-07-2010
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To present our experience with patients who elected active surveillance for renal cortical neoplasms (RCNs) with ?5 years of follow-up. Few data are available regarding the long-term natural history of RCNs during surveillance.
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Active surveillance for renal cortical neoplasms.
J. Urol.
PUBLISHED: 03-17-2010
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We retrospectively evaluated our single center experience with patients with renal cortical neoplasms who elected active surveillance.
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Clinical outcomes after radical prostatectomy in diabetic patients treated with metformin.
Urology
PUBLISHED: 03-09-2010
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To investigate the relationship between diabetes and metformin use with outcomes after radical prostatectomy (RP) for clinically localized cancer.
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Active surveillance for larger (cT1bN0M0 and cT2N0M0) renal cortical neoplasms.
Urology
PUBLISHED: 02-26-2010
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To report our experience with patients undergoing active surveillance (AS) with Stage T1bN0M0 and T2N0M0 tumors. AS is a reasonable option for selected patients with renal cortical neoplasms (RCNs). Most patients undergoing AS are high-risk surgical candidates with Stage T1a lesions. The natural history of larger (Stage cT1bN0M0 and cT2N0M0) RCNs remains undefined.
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Prospective randomized evaluation of FOOT gel pads for operating room staff COMFORT during laparoscopic renal surgery.
Urology
PUBLISHED: 01-14-2010
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We evaluated the comfort level of our laparoscopy team during and after laparoscopic renal surgery, with or without the use of gel footpads.
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Current role of robot-assisted pyelolithotomy for the management of large renal calculi: a contemporary analysis.
J. Endourol.
PUBLISHED: 09-30-2009
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The scope of robot-assisted surgery continues to expand with the application of these systems to management of large upper-tract urinary stones, with or without concomitant pyeloplasty. The known advantages of the robot-assisted approach, including enhanced optics, dexterity, wristed instrumentation, and ergonomics, can facilitate complex reconstruction of the collecting system, including uteropelvic junction repair. With the favorable outcomes of contemporary robot-assisted pyeloplasty series, robot-assisted applications have been translated to pyelolithotomy with or without concomitant upper-tract reconstruction. The early results of robot-assisted lithotomy reveal the procedure is a safe and efficacious approach for patients with large renal stones; nevertheless, the technique has met limited success in cases of large staghorn calculi. Our purpose was to evaluate the current role of robot-assisted pyelolithotomy for the management of large renal calculi.
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Synchronous cryoablation of multiple renal lesions: short-term follow-up of patient outcomes.
Urology
PUBLISHED: 07-30-2009
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To report on various perioperative and short-term clinical outcomes of 7 patients who underwent cryoablation of multiple renal lesions during the same operative setting. Cryotherapy is the most well studied minimally invasive ablative technique for the treatment of renal tumors.
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Pilot study of Alteplase (tissue plasminogen activator) for treatment of urinary clot retention in an in vitro model.
J. Endourol.
PUBLISHED: 07-15-2009
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The management of urinary clot retention and hematuria involves manual irrigation with sterile water or normal saline via a Foley catheter followed by continuous bladder irrigation. Irrigation may become difficult because of the formation of dense blood clots. Tissue plasminogen activator (t-PA/Alteplase) may be a useful pharmacological agent to improve the efficacy of manual irrigation of large, dense clots. The goal of the current study was to compare t-PA to sterile water for clot irrigation in an in vitro model.
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Significant change in predicted risk of biochemical recurrence after radical prostatectomy more common in black than in white men.
Urology
PUBLISHED: 07-09-2009
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To examine by race how frequently the data after radical prostatectomy translates into a substantial change in prognosis. Many nomograms exist to predict the survival outcomes using the pretreatment clinical parameters and post-treatment pathologic parameters. Race might be an important factor affecting their predictive ability.
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The number of negative pelvic lymph nodes removed does not affect the risk of biochemical failure after radical prostatectomy.
BJU Int.
PUBLISHED: 06-22-2009
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To assess patients who had radical prostatectomy (RP) and pelvic lymph node dissection (PLND) for pT2-4 N0M0 prostate cancer, to determine if LN yield affects the risk of biochemical failure (BCF), as the extent of PLND at the time of RP has become increasingly uncertain with the decreasing trend in tumour stage.
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Robot-assisted radical cystoprostatectomy in complex surgical patients: single institution report.
Can J Urol
PUBLISHED: 06-06-2009
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To evaluate the safety and feasibility of robotic-assisted radical cystoprostatectomy (RRCP) in a salvage setting for patients with a history of radiation and chemotherapy treatment, complex pelvic anatomy, and significant comorbidities.
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Has the advent of minimally invasive surgery altered the risk profile of patients undergoing prostatectomy?
Urology
PUBLISHED: 01-08-2009
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To determine whether the decreased short-term morbidity associated with minimally invasive surgery (MIS) has resulted in an alteration in the disease-specific risk profile of prostatectomy patients. MIS in many fields has resulted in an expansion in the pool of patients willing to undergo surgery.
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Optimal strategy for penile rehabilitation after robot-assisted radical prostatectomy based on preoperative erectile function.
BJU Int.
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WHATS KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Removing of prostate for the treatment of localized prostate cancer is associated with a variable loss of erectile function due to injury of the nerves of erection during operation. Some researchers have reported that after nerve-sparing radical prostatectomy (RP), the natural recovery time of erectile function is at least 2 years. Factors such as thermal damage, ischaemic injury, mechanically induced nerve stretching and the local inflammatory effects of surgical trauma may also impair the cavernous nerves during RP. The concept of penile rehabilitation was first studied by Montorsi et al. in 1997. They showed that the use of any drug or device at or after RP could maximize the recovery of erectile function. Penile rehabilitation programmes (PRPs) with vasoactive agents, such as oral phosphodiesterase-5 inhibitors (PDE5Is), intraurethral and intracavernosal vasoactive agents, and vacuum erection devices (VEDs) can protect erectile tissue integrity and prevent corporal smooth muscle atrophy and diminish collagen formation. The present findings are consistent with previous reports that PRPs have a significant beneficial effect on early erectile function recovery and that preoperative erectile function is one of the important predictors of erectile function after RP. Patients can be referred for penile rehabilitation if they have any degree of erectile function (mild, moderate or normal) before operation. We also showed that the combination of PDE5Is and VEDs for PRPs offers the shortest erectile function recovery period.
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R.E.N.A.L. nephrometry score accurately predicts complications following laparoscopic renal cryoablation.
J. Urol.
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The R.E.N.A.L. nephrometry is a standardized scoring system that quantifies the complexity of kidney tumors. We evaluated our experience with laparoscopic cryoablation and determined the ability of nephrometry to predict complications.
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Pathological confirmation of nerve-sparing types performed during robot-assisted radical prostatectomy (RARP).
BJU Int.
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WHATS KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Incremental nerve-sparing techniques (NSTs) improve postoperative erectile function after robot-assisted radical prostatectomy (RARP). However, there are no studies to date that histologically confirm the surgeon intended NST. Thus, in the present study, we histologically confirmed that the surgeon performed the nerve preservation as his intended NSTs during RARP. Also, we found that there was more variability in fascia width outcome on the left side compared with the right. Therefore, when performing nerve preservation on the surgeons non-dominant side, we need to pay more close attention.
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The first assistant sparing technique robot-assisted partial nephrectomy decreases warm ischemia time while maintaining good perioperative outcomes.
J. Endourol.
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Prolonged warm ischemia time (WIT) and operative time (OT) during robot-assisted partial nephrectomy (RAPN) can adversely affect renal function and clinical outcomes. Minimizing the duration of WIT and OT is critical to achieving good results postoperatively. Our standard technique for RAPN has evolved into an intracorporeal preparation (ICP) that minimizes the reliance on the first assistant. The goal of the current study was to analyze outcomes after ICP RAPN compared with those of the standard RAPN.
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Clinical, pathologic, and functional outcomes after nephron-sparing surgery in patients with a solitary kidney: a multicenter experience.
J. Endourol.
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Surgical management of a renal neoplasm in a solitary kidney is a balance between oncologic control and preservation of renal function. We analyzed patients with a renal mass in a solitary kidney undergoing nephron-sparing procedures to determine perioperative, oncologic, and renal functional outcomes.
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Is there a difference in laterality during robot-assisted radical prostatectomy? Assessment of lymph node yield and neurovascular bundle dissection.
J. Endourol.
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The da Vinci Surgical System (dVSS) has been reported to eliminate innate hand dominance of the surgeon. There are no studies to date, however, that specifically address whether the dVSS has its own inherent "handedness" resulting from the fixed left-right preference of specific instrument docking and assistant positioning. We identified the pelvic lymph node (LN) and neurovascular bundle (NVB) dissections as well as positive surgical margin rates as procedure points during robot-assisted radical prostatectomy (RARP) that could be influenced by laterality and sought to illustrate left-right consistency.
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The effect of extralumenal safety wires on ureteral injury and insertion force of ureteral access sheaths: evaluation using an ex vivo porcine model.
Urology
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To evaluate the effect that a safety wire (SW) had on insertion force and direct ureteral trauma using ureteral access sheaths (UAS) in an ex vivo porcine model.
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What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

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In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.