Robot-assisted laparoscopic pyeloplasty with and without a ureteral stent.

Objective: Robot-assisted laparoscopic pyeloplasty (RALP) has been shown to be an efficacious treatment for ureteropelvic junction obstruction. Although the use of a ureteral stent is commonplace, the water-tight anastomosis possible with robotic assistance may obviate its need. We report a feasibility study of unstented RALPs and present our experience with both the stented (SRP) and unstented (URP) approach.

Comparison of laparoscopy training using the box trainer versus the virtual trainer.

Background And Objectives: To evaluate whether training on a virtual reality laparoscopic simulator improves the performance on a laparoscopic box trainer.

Methods: Twenty-six subjects were trained using a box trainer, and 17 participants were trained using a virtual simulator. Participants in the experimental group completed 1 session of 5 exercises on the box trainer, 4 sessions on the virtual simulator, and a final session on the box trainer.

Robot-assisted laparoscopic nephrectomy and contralateral ureteral reimplantation in children.

Background: Robot-assisted laparoscopic surgery (RALS) has expanded the role for minimally invasive surgery within pediatrics. RALS may be particularly beneficial for the treatment of children with a refluxing nonfunctioning renal moiety and contralateral vesicoureteral reflux. In this report, we describe a single RALS procedure, which includes both nephrectomy or partial nephrectomy, and contralateral extravesical ureteral reimplantation (EVUR).

Symptoms related to ureteral stents in renal transplants compared with stents placed for other indications.

Objective: To use a validated questionnaire to compare indwelling ureteral stent symptoms in patients who had the ureteral stent placed during renal transplantation with patients who had retrograde insertion of the stent in a native kidney during endoscopic procedures.

Methods: Symptoms related to the presence of a ureteral stent were assessed prospectively in the two patient groups. Just before stent removal, patients completed a validated Ureteral Stent Symptom Questionnaire evaluating urinary symptoms, body pain, general health, work performance, and sexual function.

The use of a Doppler ultrasound probe during vascular dissection in laparoscopic renal surgery.

Introduction And Objective: There have been many reports regarding the use of intraoperative ultrasound to identify vascular structures. However, few have examined the application of Doppler technology for the identification and dissection of hilar vessels during laparoscopic renal surgery (LRS). We describe the design and utility of what is, to our knowledge, the only available disposable laparoscopic Doppler probe (LDP).

Validation of a novel virtual reality robotic simulator.

Purpose: We evaluated the face, content, and construct validity of what is, to our knowledge, the only available virtual reality simulator based on a complete kinematic representation of the da Vinci surgical system.

Materials And Methods: A total of 5 experts (EPs) and 15 novices (NVs) completed exercises on the Mimic dV-Trainer (MdVT). All participants completed three repetitions of the following tasks: (1) Ring and Cone, (2) String Walk, and (3) Letterboard.

Robot assisted laparoscopic partial nephrectomy: a viable and safe option in children.

Purpose: The safety, benefits and usefulness of laparoscopic partial nephrectomy have been demonstrated in the pediatric population. We describe our technique, and determine the safety and feasibility of robot assisted laparoscopic partial nephrectomy based on our initial experience.

Materials And Methods: We retrospectively reviewed robot assisted laparoscopic partial nephrectomy performed at our institution between 2002 and 2005.

Pathologic upstaging after laparoscopic radical nephrectomy.

Objective: Accurate tumor staging in renal cancer is critical for prognostic projections, follow-up schedules, clinical trials and potential systemic therapies. We studied patients undergoing laparoscopic radical nephrectomy (LRN) to determine the extent of upstaging on histopathology evaluation and correlated the clinical and pathology staging to determine the factors responsible for upstaging.

Patients And Methods: A retrospective review of patients undergoing LRN for renal cell cancer was performed.

Robot-assisted laparoscopic distal ureterectomy and ureteral reimplantation with psoas hitch.

For midureteral and distal-ureteral tumors not amenable to endoscopic resection, distal ureterectomy with ureteral reimplantation is a treatment option. When ureteral length is insufficient for direct reimplantation, additional length can be gained with either a psoas hitch or a Boari flap. We describe our technique for robot-assisted laparoscopic distal ureterectomy and ureteral reimplantation with psoas hitch.