Are multiple cryoprobes additive or synergistic in renal cryotherapy?

Objective: To investigate the relationship between multiple cryoprobes was investigated to determine whether they work in an additive or synergistic fashion in an in vivo animal model because 1.47 mm (17-gauge) cryoprobes have been introduced to the armamentarium for renal cryotherapy.

Methods: Laparoscopic-guided percutaneous cryoablation was performed in both renal poles of 3 pigs using 3 IceRod cryoprobes.

A novel ex-vivo ureteral apparatus for assessing the impact of intraluminal pharmaceutical agents on ureteral physiology.

Background And Purpose: Safe intraluminal access to the ureter and kidney is essential for endourologic procedures. Pharmacologic manipulation of ureteral smooth muscle could conceivably ease access and decrease morbidity. To minimize systemic effects, local intraluminal administration would be optimal, but the urothelium presents a barrier to the passage of medications.

The impact of cavernosal nerve preservation on continence after robotic radical prostatectomy.

Objective: • To evaluate associations between baseline characteristics, nerve-sparing (NS) status and return of continence, as a relationship may exist between return to continence and preservation of the neurovascular bundles for potency during radical prostatectomy (RP).

Patients And Methods: • The study included 592 consecutive robotic RPs completed between 2002 and 2007. • All data were entered prospectively into an electronic database.

Differences in grip forces among various robotic instruments and da Vinci surgical platforms.

Introduction: The da Vinci surgical platform is becoming increasingly available and utilized. Due to the lack of haptic feedback, visual cues are necessary to estimate grip forces and tissue tensions during surgery. We directly measured the grip forces of robotic EndoWrist instruments using the three available da Vinci robotic surgical platforms.

First prize: Chitosan and the urothelial barrier: effects on ureteral intraluminal drug penetration and peristalsis.

Introduction: Relaxing the ureter prior to endourologic procedures could ease instrument access. In an ex-vivo model, intraluminal nifedipine has been shown to relax the ureter. Chitosan is the deacetylation product of chitin and can alter bladder urothelium.

Sprayed fibrin sealant as the sole hemostatic agent for porcine laparoscopic partial nephrectomy.

Purpose: Tisseel® is used to control minor bleeding during laparoscopic procedures. The DuploSpray MIS™ spray system allows thin, even application over a larger surface area. We use sprayed Tisseel as the sole agent to control hemorrhage and seal the renal collecting system after severe porcine laparoscopic partial nephrectomy.

Prospective randomized trial of three different methods of nephrostomy tract closure after percutaneous nephrolithotripsy.

Objective: • To evaluate the safety and efficacy of 'tubeless' nephrostomy tract closure in reducing postoperative morbidity after percutaneous nephrolithotomy (PCNL).

Materials And Methods: • In all, 31 patients undergoing PCNL were randomized into three groups, each with a different method of nephrostomy tract closure: using either a gelatin matrix haemostatic sealant (FloSeal), fascial stitch or Cope loop nephrostomy tube. • We compared operative time, estimated blood loss (EBL), postoperative stay, analgaesics use, changes in creatinine and haemoglobin levels, and stone clearance rate, as well as postoperative short-form (SF)-36 quality-of-life and pain analogue scores at five different time points after surgery.

Ice burn: protecting the flank during renal cryotherapy.

Introduction And Objectives: Cryoablation is a viable minimally invasive strategy for the treatment of small renal masses. One of the most common postoperative complaints is pain or paresthesia at the cryoprobe insertion site. The use of a 14-gauge angiocatheter to insulate the flank during renal cryotherapy was investigated.

In vitro, ex vivo and in vivo isotherms for renal cryotherapy.

Purpose: Preoperative planning for renal cryotherapy is based on isotherms established in gel. We replicated gel isotherms and correlated them with ex vivo and in vivo isotherms in a porcine model.

Materials And Methods: PERC-17 CryoProbes (1.

Impact of pneumoperitoneum on renal cryotherapy.

Purpose: Pneumoperitoneum is known to decrease blood flow to the kidney during laparoscopy. We investigated if this change in blood flow would increase the size of the cryolesion.

Materials And Methods: Twelve Yorkshire swine underwent laparoscopy-guided percutaneous cryoablation of the upper and lower pole of each kidney at four randomized pneumoperitoneum pressures (10, 15, 20, and 25 mm Hg).

Case report: omental splenosis discovered during robotic prostatectomy.

Splenosis describes ectopic splenic implants that usually occur after trauma and splenectomy. We present a case of omental splenosis discovered during robot-assisted prostatectomy.

Anatomic guide for port placement for daVinci robotic radical prostatectomy.

Background And Purpose: At present, robotic arm port placement for daVinci trade mark robot-assisted laparoscopic radical prostatectomy is based on the umbilicus. However, the robotic arm has a maximum manufactured required working distance of 25 cm. Accordingly, normal variability of patient height, weight, and umbilical location can leave the working arms too short to reach the membranous urethra.