Is carbon dioxide insufflation safe for laparoscopic surgery? A model to assess the effects of carbon dioxide on transitional-cell carcinoma growth, apoptosis, and necrosis.

Purpose: To study the effects of carbon dioxide insufflation pressure and concentration on the adhesion, growth, apoptosis, and necrosis of transitional-cell carcinoma (TCC).

Materials And Methods: Adhesion and growth of the AY-27 rat TCC cell line was measured after CO2 insufflation in vitro at different pressures ranging from 0 to 15 mm Hg and after incubation in CO2-air mixtures at 5%, 10%, and 15% CO2 by volume.

Results: Tumor adhesion decreased significantly after CO2 insufflation.

Novel dual-lumen ureteral stents provide better ureteral flow than single ureteral stent in ex vivo porcine kidney model of extrinsic ureteral obstruction.

Objectives: In the instance of extrinsic ureteral obstruction, indwelling ureteral stents have a high failure rate. Although technically challenging, simultaneous insertion of two ipsilateral stents can achieve better flow rates with time. A novel dual-lumen stent, composed of two adhered ureteral stents, offers the additional benefit of easier placement than a single guidewire.

The use of robotically assisted surgery for treating urachal anomalies.

Objective: To report the management of urachal anomalies using a robotically assisted approach.

Patients And Methods: Between January 2005 and February 2006, five patients (mean age 51 years, range 24-68) were diagnosed with urachal anomalies. Two basic robot-assisted surgical approaches were used for excising the urachal anomalies: excision of the urachal remnant via partial cystectomy, and radical cystectomy for excision of urachal adenocarcinoma.

Effects of pneumoperitoneal gases and pressures on transitional cell carcinoma adhesion, growth, apoptosis and necrosis: an in vitro study.

Purpose: We studied the effects of insufflation gas and pressure on the adhesion, growth, apoptosis and necrosis of transitional cell carcinoma (TCC) in an in vitro model.

Materials And Methods: Tumor adhesion and cell growth of AY-27 rat TCC was measured after 3-hour incubation with CO2, N2 and He insufflation at different pressures (0, 10 and 15 mm Hg) in vitro. The effects of these gases on the rate of tumor cell apoptosis and necrosis were compared.

Urological laparoscopy: basic physiological considerations and immunological consequences.

Purpose: The applications of laparoscopy to urological surgery continue to grow at a steady pace. A complete understanding of the physiological and immunological changes associated with pneumoperitoneum is required. We reviewed the physiology of laparoscopy with regard to the major organ systems and summarize the effects of pneumoperitoneum on immune function.

Laparoscopic nephroureterectomy with bladder-cuff resection: techniques and outcomes.

Advancements in minimally invasive instrumentation and technique have provided the impetus to performing urologic procedures with reduced perioperative morbidity, shorter hospital stays, and, most importantly, efficacious oncologic results. At multiple centers of excellence, laparoscopic nephroureterectomy (LNU) has evolved into a new standard for the management of upper-tract transitional-cell carcinoma (TCC) that is not amenable to endoscopic resection. An LNU may be performed via a transperitoneal or retroperitoneal approach together with excision of the distal ureter and a bladder cuff.

Trends in ureteropelvic junction obstruction management among urologists in the United States.

Objectives: To determine current practice patterns in the surgical treatment of ureteropelvic junction obstruction (UPJO) among urologists in the United States.

Methods: Using the American Urological Association directory, an electronic mail survey regarding the surgical management of UPJO was sent to 1040 urologists in the United States with an electronic mail address listed in the roster.

Results: The response rate was 37.

Comparison of laparoscopic saline infused to dry radio frequency ablation of renal tissue: evolution of histological infarct in the porcine model.

Purpose: We investigated and compared the gross and histopathological features of radio frequency (RF) ablated renal tissue using saline infused RF ablation (RFA) vs dry RFA in a porcine model.

Materials And Methods: Ten porcine kidneys underwent laparoscopic RFA. The lower and upper poles of each right kidney were treated with 1 and 2 cycles of saline augmented (wet) RFA, respectively.

Ureteropelvic junction obstruction repair: when, how, what?

Purpose Of Review: To review factors that affect the success of ureteropelvic junction obstruction repair and recent developments in minimally invasive procedures for the repair of ureteropelvic junction obstruction.

Recent Findings: Recent reports and studies further confirm earlier findings that the success rate of endopyelotomy is decreased when a crossing vessel is the primary cause of ureteropelvic junction obstruction, poor renal function and significant hydronephrosis. Various minimally invasive procedures have emerged recently for the treatment of ureteropelvic junction obstruction.