Seminal vesicle mass: An unusual site for metastatic hepatocellular carcinoma after orthotopic liver transplant.

Metastasis of hepatocellular carcinoma (HCC) to the seminal vesicle is extraordinarily rare, with only two other cases reported in the literature. Herein we present the first documented case of a seminal vesicle as the initial site of solitary metastasis in a patient with a history of liver transplantation for HCC. We aim to provide more information regarding the disease process, histopathology, and management strategy.

Long-Wave Infrared Imaging for Intraoperative Cancer Detection-What is the True Temperature of a Cancer?

Background: During cancer operations, the cancer itself is often hard to delineate-buried beneath healthy tissue and lacking discernable differences from the surrounding healthy organ. Long-wave infrared, or thermal, imaging poses a unique solution to this problem, allowing for the real-time label-free visualization of temperature deviations within the depth of tissues. The current study evaluated this technology for intraoperative cancer detection.

Comparative Effectiveness of Treatment Strategies for Squamous Cell Carcinoma of the Bladder.

Background: While there is established evidence supporting the use of radical cystectomy (RC) and perioperative chemotherapy for muscle-invasive urothelial carcinoma of the bladder, such evidence does not exist for squamous cell carcinoma.

Objective: We present the largest study to date of patients with squamous cell carcinoma and compare the effectiveness of possible treatment regimens for overall survival.

Design, Setting, And Participants: The National Cancer Data Base was queried for cases of localized, muscle-invasive pure squamous cell bladder cancer, classified as clinical stage T2/3N0M0.

Minimally-Invasive Ureteral Reconstruction for Ureteral Complications of Kidney Transplants.

Objective: To present the technique, feasibility and results of minimally-invasive reconstruction of the transplanted ureter using the native ipsilateral ureter in post-transplant ureteral strictures and vesicoureteral reflux (VUR) causing graft pyelonephritis. Ureteral complications after kidney transplantation represent a significant cause of morbidity potentially leading to graft dysfunction or loss.

Methods: A prospective database from October 2011 to August 2018 identified renal transplant recipients who underwent minimally-invasive pyeloureterostomies or ureteroureterostomies using the ipsilateral ureter.

Novel Technique Prevents Lymphoceles After Transperitoneal Robotic-assisted Pelvic Lymph Node Dissection: Peritoneal Flap Interposition.

Introduction: To determine the efficacy of our novel technique to prevent lymphocele formation after pelvic lymph node dissection (PLND) after robotic-assisted radical prostatectomy (RARP) using the existing peritoneum of the bladder.

Technical Considerations: We evaluated 155 consecutive patients undergoing RARP with PLND over 24 months. Group A included the first 77 patients with PLND using standard technique (no peritoneal flap).

Underutilization of immediate intravesical chemotherapy following TURBT: results from NSQIP.

Introduction: A single perioperative dose of intravesical chemotherapy (IVC) following transurethral resection of bladder tumors (TURBT) for non-muscle invasive bladder cancer has demonstrated a reduction in tumor recurrence. In this study, we investigate the contemporary (2010) utilization of IVC following TURBT using a prospective national database.

Materials And Methods: Using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database, we identified patients with bladder cancer using ICD-9 codes.

Comparison of positive surgical margin rates in high risk prostate cancer: open versus minimally invasive radical prostatectomy.

Objective: We compared positive surgical margin (PSM) rates for patients with high risk prostate cancer (HRCaP) who underwent open radical retropubic (RRP), robotic (RALP), and laparoscopic (LRP) prostatectomy at a single institution.

Materials And Methods: We performed a retrospective review of our prospectively maintained IRB approved database identifying prostate cancer patients who underwent RRP, RALP, or LRP between January 2000 and March 2010. Patients were considered to have HRCaP if they had biopsy or final pathologic Gleason score ≥ 8, or preoperative PSA ≥ 20, or pathologic stage ≥ T3a.

Laparoscopy for the detection and treatment of early complications from minimally invasive urologic surgery.

Objective: To evaluate the role of laparoscopy for the detection and management of early postoperative complications after minimally invasive urologic surgery.

Patients And Methods: From October 2003 to September 2008, data were prospectively collected for all patients needing surgical intervention within 21 days after urologic minimally invasive procedures. No patients operated on for a postoperative complication during this period were excluded.

Unidirectional barbed suture versus standard monofilament for urethrovesical anastomosis during robotic assisted laparoscopic radical prostatectomy.

Purpose: V-Loc™180 (Covidien Healthcare, Mansfield, MA) is a new unidirectional barbed suture that may reduce loss of tension during a running closure. We evaluated the use of the barbed suture for urethrovesical anastomosis (UVA) during robotic assisted laparoscopic prostatectomy (RALP). Time to completion of UVA, post-operative anastomotic leak rate, and urinary incontinence were compared in patients undergoing UVA with 3-0 unidirectional-barbed suture vs.

Robotic versus open distal ureteral reconstruction and reimplantation for benign stricture disease.

Background And Purpose: Minimally invasive techniques are currently used for numerous urologic procedures, given decreased morbidity and equivalent outcomes to open surgery. There is, however, a relative paucity of data related to robot-assisted ureteral reimplantation (RAUR) in adult patients for benign stricture disease. We sought to determine the periprocedure outcomes of open distal ureteral reimplantation vs RAUR at our institution.

Pure laparoscopic donor nephrectomy: 3-year experience and analysis of a refined technique to maximize graft function.

Purpose: Strategies for vascular control and limiting warm ischemia time (WIT) vary between institutions for laparoscopic live donor nephrectomy (LLDN). We refined our technique and retrospectively determined whether it safely provides an allograft of comparable quality to published series.

Patients And Methods: Fifty consecutive LLDN between February 2003 and November 2006 were reviewed.

Comparing the Gleason prostate biopsy and Gleason prostatectomy grading system: the Lahey Clinic Medical Center experience and an international meta-analysis.

Background: The accuracy of the prostate biopsy Gleason grade to predict the prostatectomy Gleason grade varies tremendously in the literature.

Objectives: Determine the accuracy and distribution of the prostate biopsy Gleason grade and prostatectomy Gleason grade at LCMC (Lahey Clinic Medical Center) and worldwide.

Design, Setting, And Participants: Participants included 2890 patients who had not received preoperative hormones, and for whom preoperative and postoperative Gleason sums were available.

Management of renal cell carcinoma with vena cava and atrial thrombus: minimal access vs median sternotomy with circulatory arrest.

Objective: To review our experience with approaches for managing renal cell carcinoma (RCC) with venous thrombi extension at and above the level of the hepatic veins, comparing surgery and peri-operative outcomes in patients with cardiopulmonary bypass (CPB) with deep hypothermic cardiac arrest (DHCA) either by minimal access (MA) or traditional median sternotomy (TMS).

Patients And Methods: From 1986 to 2005, 50 radical nephrectomies with inferior vena cava (IVC) thrombectomies were performed at our institution using TMS (22 patients) and MA (28) techniques. Patient demographics were compared using Student's t-, Fisher's exact and Pearson chi-square tests.

Transperitoneal laparoscopic radical prostatectomy: descending technique.

Laparoscopic radical prostatectomy has evolved over the last decade to become a common treatment for clinically localized prostate cancer at specialized institutions. During that time, various technical modifications have been pioneered by groups throughout the world. We present our technique of transperitoneal laparoscopic radical prostatectomy through a descending approach.

Laparoscopic radical cystectomy with ileal conduit urinary diversion.

Objective: To report on the surgical technique of laparoscopic radical cystoprostatectomy with ileal conduit urinary diversion.

Methods: A 79 years old man with histologically proven transitional cell carcinoma of the bladder stageT 2b NxMx underwent a laparoscopic radical cystoprostatectomy with ileal conduit urinary diversion. The cystoprostatectomy was performed with laparoscopic technique.