A prospective study of laparoscopic radical nephrectomy for T1 tumors--is transperitoneal, retroperitoneal or hand assisted the best approach?

Purpose: We designed a prospective, randomized clinical trial to compare 3 common approaches to laparoscopic radical nephrectomy, namely transperitoneal, retroperitoneal and hand assisted.

Materials And Methods: A total of 33 patients with a solid renal mass of 7 cm or less were prospectively enrolled in alternating fashion to a hand assisted procedure, a transperitoneal procedure with morcellation and a retroperitoneal procedure with intact specimen extraction. A single surgeon performed all operations.

Infectious response to E. coli: molecular and genetic pathways.

Urinary tract infections are most commonly caused by type 1-piliated Escherichia coli (UPEC) and result in urothelial apoptosis, local cytokine release and neutrophil infiltration. A human urothelial cell line was incubated with various E. coli isolates and was then characterized by flow cytometry.

Retrieval of migrated ureteral stent by intussusception of ureteral balloon dilator tip.

A vexing complication of ureteral stent placement is inadvertent proximal migration. The retrieval of a migrated ureteral stent may be performed using a myriad of techniques but usually requires ureteroscopic extraction. We report a novel, time-efficient technique to capture and reposition a migrated ureteral stent without ureteroscopic manipulation.

Mast cell activation triggers a urothelial inflammatory response mediated by tumor necrosis factor-alpha.

Purpose: Mast cells have been implicated in bladder inflammation and pathogenesis. To determine if mast cell secretion products can modulate urothelial inflammatory responses we developed an in vitro model of mast cell-urothelial cell interactions.

Materials And Methods: Cultures of the immortalized urothelial cell line TEU-2 were incubated in the conditioned medium of mast cell cultures.

Repair of a diaphragmatic injury during hand assisted laparoscopic nephrectomy using an onlay patch of polypropylene and polyglactin mesh.

Purpose: We describe a simple and time efficient technique for repairing a diaphragmatic injury occurring during right hand assisted laparoscopic radical nephrectomy.

Materials And Methods: A dual layer polypropylene and polyglactin mesh was created extracorporeally by sewing a 2 x 2 piece of polypropylene mesh to a 2 x 2 piece of polyglactin mesh with 4, 4-zero interrupted polyglactin sutures. This dual layer was then positioned manually over the diaphragmatic rent and secured with a laparoscopic stapling device.

Hand-assisted vs. retroperitoneal laparoscopic nephrectomy.

Purpose: We retrospectively compared our initial experience with the hand-assisted and retroperitoneal laparoscopic nephrectomy techniques to determine if there are important differences between these approaches.

Patients And Methods: Twenty-four laparoscopic cases consisting of 12 hand-assisted and 12 retroperitoneal nephrectomies were compared. All cases but one were radical nephrectomies with intact specimen extraction performed for suspected stage T1 neoplasms.

Uropathogenic Escherichia coli potentiates type 1 pilus-induced apoptosis by suppressing NF-kappaB.

Urinary tract infections (UTIs) are among the most common inflammatory diseases. Acute UTIs are typically caused by type 1-piliated Escherichia coli and result in urothelial apoptosis, local cytokine release, and neutrophil infiltration. To examine the urothelial apoptotic response, a human urothelial cell line was incubated with various E.

Hand-assisted laparoscopic radical nephrectomy: the experience of the inexperienced.

Purpose: We retrospectively examined the experience of novice laparoscopic surgeons performing hand-assisted laparoscopic radical nephrectomy. The purpose was to determine if urologists with minimal laparoscopic training could perform hand-assisted laparoscopic nephrectomies in a safe and efficient manner.

Materials And Methods: The first six hand-assisted laparoscopic radical nephrectomies performed by four different urology residents at the Chicago Lakeside VA hospital were reviewed.

Bedside ureteral stenting for the critically ill patient: technical considerations.

Bedside ureteral stenting, although a challenging technique, can be achieved with frequent success by using some simple endoscopic maneuvers. By understanding the relationship of the working port to the lens and light source, surgeons can supinate or pronate their wrist to cannulate the ureteral orifices with greater success.