Does the nephrostomy tract length impact the outcomes of percutaneous nephrolithotomy (PNL)?

Purpose: Different factors can determine the outcomes of percutaneous nephrolithotomy (PNL). We analyzed the effect of tract length (TL) on outcomes after PNL.

Methods: We performed a retrospective review of patients undergoing PNL between 2006 and 2011.

Lithotrites and postoperative fever: does lithotrite type matter? Results from the Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study.

Objective: To compare the risks of fever from different lithotrites after percutaneous nephrolithotomy (PNL).

Materials And Methods: The Clinical Research Office of the Endourological Society (CROES) PNL database is a prospective, multi-institutional, international PNL registry. Of 5,803 total patients, 4,968 received preoperative antibiotics, were supplied with complete information and included in this analysis.

Radiation exposure in the follow-up of patients with urolithiasis comparing digital tomosynthesis, non-contrast CT, standard KUB, and IVU.

Objective: To compare the effective doses (EDs) associated with imaging modalities for follow-up of patients with urolithiasis, including stone protocol non-contrast computed tomography (NCCT), kidney, ureter, and bladder radiograph (KUB), intravenous urogram (IVU), and digital tomosynthesis (DT).

Methods: A validated Monte-Carlo simulation-based software PCXMC 2.0 (STUK) designed for estimation of patient dose from medical X-ray exposures was used to determine the ED for KUB, IVU (KUB scout plus three tomographic images), and DT (two scouts and one tomographic sweep).

Obesity triples the radiation dose of stone protocol computerized tomography.

Purpose: Patients with recurrent nephrolithiasis are often evaluated and followed with computerized tomography. Obesity is a risk factor for nephrolithiasis. We evaluated the radiation dose of computerized tomography in obese and nonobese adults.

Increasing dwell time of mitomycin C in the upper tract with a reverse thermosensitive polymer.

Unlabelled: Abstract Background and Purpose: Topical chemotherapy for urothelial cancer is dependent on adequate contact time of the chemotherapeutic agent with the urothelium. To date, there has not been a reliable method of maintaining this contact for renal or ureteral urothelial carcinoma. We evaluated the safety and feasibility of using a reverse thermosensitive polymer to improve dwell times of mitomycin C (MMC) in the upper tract.

In-vitro assessment of a new portable ballistic lithotripter with percutaneous and ureteroscopic models.

Background And Purpose: The EMS Swiss LithoBreaker is a new, portable, electrokinetic lithotripter. We compared its tip velocity and displacement characteristics with a handheld, pneumatic lithotripter LMA StoneBreaker.™ We also evaluated fragmentation efficiency using in vitro models of percutaneous and ureteroscopic stone fragmentation.

Outcomes of metallic stents for malignant ureteral obstruction.

Purpose: Malignant ureteral obstruction often necessitates chronic urinary diversion and is associated with high rates of failure with traditional ureteral stents. We evaluated the outcomes of a metallic stent placed for malignant ureteral obstruction and determined the impact of risk factors previously associated with increased failure rates of traditional stents.

Materials And Methods: Patients undergoing placement of the metallic Resonance® stent for malignant ureteral obstruction at an academic referral center were identified retrospectively.

Optical performance comparison of deflectable laparoscopes for laparoendoscopic single-site surgery.

Background And Purpose: Flexible working angles and fine optical visualization are major requisite factors in performing laparoendoscopic single-site (LESS) urologic procedures. Multiple mechanical design approaches have been used to develop deflectable laparoscopes for LESS procedures. We compared the optical characteristics of three such devices using a bench top approach to simulate LESS in straight and deflected positions.

Determination of patient radiation dose during ureteroscopic treatment of urolithiasis using a validated model.

Purpose: We measured organ specific radiation dose rates and determined effective dose rates during simulated ureteroscopy using a validated model. To calculate the effective dose, patients were exposed to ureteroscopic management of stones at our institution.

Materials And Methods: A validated anthropomorphic male phantom was placed on a fluoroscopy table and underwent simulated ureteroscopy.

Organ-specific radiation dose rates and effective dose rates during percutaneous nephrolithotomy.

Background And Purpose: Radiation exposure during medical procedures continues to be an increasing concern for physicians and patients. We determined organ-specific dose rates and calculated effective dose rates during right and left percutaneous nephrolithotomy (PCNL) using a validated phantom model.

Materials And Methods: A validated anthropomorphic adult male phantom was placed prone on an operating room table.

Pathologic evaluation of hemostatic agents in percutaneous nephrolithotomy tracts in a porcine model.

Background And Purpose: Hemostatic agents have been suggested as an adjunct for tubeless percutaneous nephrolithotomy (PCNL). We pathologically evaluated the percutaneous tracts injected with the fibrin sealant (FS) Evicel and hemostatic gelatin matrix (HGM) Surgiflo at various time intervals to determine their absorption and tract closure rates. We also evaluated whether these agents reduced urine leak rates in a porcine model.

Modern applications of ureteroscopy for intrarenal stone disease.

Purpose Of Review: Ureteroscopy continues to improve as a method for management of intrarenal stone disease. The development of new technologies and enhanced application of existing therapies is expanding the indications of ureteroscopy for the management of renal calculi.

Recent Findings: Improvements in image quality have been achieved with the adoption of digital ureteroscopes.

Robot assisted partial nephrectomy versus laparoscopic partial nephrectomy for renal tumors: a multi-institutional analysis of perioperative outcomes.

Purpose: Robot assisted partial nephrectomy is rapidly emerging as an alternative to laparoscopic partial nephrectomy for the treatment of renal malignancy. We present the largest multi-institution comparison of the 2 approaches to date, describing outcomes from 3 experienced minimally invasive surgeons.

Materials And Methods: We performed a retrospective chart review, evaluating 118 consecutive laparoscopic partial nephrectomies and 129 consecutive robot assisted partial nephrectomies performed between 2004 and 2008 by 3 experienced minimally invasive surgeons at 3 academic centers.

Robotic partial nephrectomy with sliding-clip renorrhaphy: technique and outcomes.

Background: Robotic partial nephrectomy (RPN) is emerging as an alternative to traditional laparoscopic partial nephrectomy (LPN). Despite the potential advantages of the robotic approach, renorrhaphy remains a challenging portion of the procedure.

Objective: To present our technique and outcomes for RPN, including sliding-clip renorrhaphy.

The role of nephron-sparing robotic surgery in the management of renal malignancy.

Purpose Of Review: Robotic-assisted partial nephrectomy is an emerging technique for the treatment of renal malignancy. Our aim is to review the initial reported experience with robotic partial nephrectomy, evaluating techniques, early outcomes, and potential advantages of the robotic approach over the traditional laparoscopic approach.

Recent Findings: Early experience with robotic partial nephrectomy demonstrates good oncologic outcomes.

Robotic partial nephrectomy versus laparoscopic partial nephrectomy for renal cell carcinoma: single-surgeon analysis of >100 consecutive procedures.

Objectives: To compare a single-surgeon experience of laparoscopic partial nephrectomy (LPN) and robotic-assisted partial nephrectomy (RPN) in 102 consecutive patients.

Methods: The clinical, pathologic, and follow-up information from 102 consecutive procedures (40 RPNs and 62 LPNs) was reviewed.

Results: No statistically significant differences were found between the groups with regard to age, body mass index, or American Society of Anesthesiologists score.

Proceedings of the First Annual Worldwide Robotic Renal Symposium: lessons learned for future robotic renal surgeons.

The First Annual Worldwide Robotic Renal Symposium was held on 26-27 June 2008 at Washington University in Saint Louis. The symposium featured numerous live surgeries and lectures on all aspects of robotic renal surgery. Several innovations were discussed, which may allow participants to perform robotic renal surgery with greater efficiency and precision.