Single-use digital flexible cystoscope for double J removal versus reusable instruments: a prospective, comparative study of functionality, risk of infection, and costs.

Background: The removal of ureteral stent can be performed with disposable or reusable flexible cystoscopes, but limited comparative data are available on functionality, risk of infections, and costs.

Methods: We performed a multicentric, prospective, observational study on patients undergoing in-office ureteral stent removal with Isiris-α or a reusable Storz™ flexible cystoscope. Study endpoints were the functionality and effectiveness of the devices, the rate of postoperative bacteriuria and UTIs, and the costs of the procedure.

Three-dimensional Augmented Reality Robot-assisted Partial Nephrectomy in Case of Complex Tumours (PADUA ≥10): A New Intraoperative Tool Overcoming the Ultrasound Guidance.

Background: Despite technical improvements introduced with robotic surgery, management of complex tumours (PADUA score ≥10) is still a matter of debate within the field of transperitoneal robot-assisted partial nephrectomy (RAPN).

Objective: To evaluate the accuracy of our three-dimensional (3D) static and elastic augmented reality (AR) systems based on hyperaccuracy models (HA3D) in identifying tumours and intrarenal structures during transperitoneal RAPN (AR-RAPN), compared with standard ultrasound (US).

Design, Setting, And Participants: A retrospective study was conducted, including 91 patients who underwent RAPN for complex renal tumours, 48 with 3D AR guidance and 43 with 2D US guidance, from July 2017 to May 2019.

3D imaging applications for robotic urologic surgery: an ESUT YAUWP review.

Context: Despite the current era of precision surgery in robotics, an unmet need still remains for optimal surgical planning and navigation for most genitourinary diseases. 3D virtual reconstruction of 2D cross-sectional imaging has been increasingly adopted to help surgeons better understand the surgical anatomy.

Objectives: To provide a short overview of the most recent evidence on current applications of 3D imaging in robotic urologic surgery.

Retzius-sparing robot-assisted radical prostatectomy vs the standard approach: a systematic review and analysis of comparative outcomes.

Objectives: To summarize the current evidence on Retzius-sparing (RS)-robot-assisted radical prostatectomy (RARP) and to compare its oncological, peri-operative and functional outcomes with those of standard retropubic RARP (S-RARP).

Materials And Methods: After establishing an a priori protocol, a systematic electronic literature search was conducted in January 2019 using the Medline (via PubMed), Embase (via Ovid) and Cochrane databases. The search strategy relied on the 'PICO' (Patient Intervention Comparison Outcome) criteria and article selection was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

First- and Second-Generation Temporary Implantable Nitinol Devices As Minimally Invasive Treatments for BPH-Related LUTS: Systematic Review of the Literature.

Introduction: In the last decade, there has been a growing interest in minimally invasive treatment for benign prostatic hyperplasia (BPH) associated with lower urinary tract symptoms (LUTS). In this field, one of the options currently available is the temporary implantable nitinol device (iTIND) (Medi-Tate®; Medi-Tate Ltd., Or Akiva, Israel).

Robot-assisted laparoendoscopic single-site versus mini-laparoscopic pyeloplasty: a comparison of perioperative, functional and cosmetic results.

Background: New approaches have been developed to further reduce the invasiveness of laparoscopic pyeloplasty (P) as treatment for uretero-pelvic junction obstruction (UPJO). Aim of the study was to compare perioperative, functional and cosmetic results of mini-laparoscopic (mL-P) versus robot-assisted laparoendoscopic single-site P (rLESS-P).

Methods: Since April 2009 to June 2010, 12 adult patients with primary UPJO, BMI<25 and no previous abdominal surgeries were enrolled undergoing mLP (3-mm instruments only).

Percutaneously Assisted "Two-Ports" Transperitoneal Radical Nephrectomy: Initial Series.

Looking for a virtually "scarless" surgery mini-laparoscopy (ML) could be a viable alternative to conventional laparoscopy. ML is a reproducible technique and allows for the preservation of the triangulation concept, the cornerstone of laparoscopic surgery. Drawback of ML could be the poor performance of miniaturized instruments that could affect the confidence of the surgeon and limit the indications.

Robot-Assisted Extended Pelvic Lymph Nodes Dissection for Prostate Cancer: Personal Surgical Technique and Outcomes.

Objective: Extended pelvic lymph nodes dissection (EPLND) allows the removal of a higher number of lymph nodes than limited PLND. The aims of this study were to describe our robot-assisted EPLND (RAEPLND) technique with related complications, and to report the number of lymph nodes removed and the rate of lymph nodal metastasis.

Materials And Methods: 153 patients underwent RAEPLND prior to robot-assisted radical prostatectomy (RARP).

Total Anatomical Reconstruction During Robot-assisted Radical Prostatectomy: Implications on Early Recovery of Urinary Continence.

Background: The introduction of robotics revolutionized prostate cancer surgery because the magnified three-dimensional vision system and wristed instruments allow microsurgery to be performed. The advantages of robotic surgery could lead to improved continence outcomes in terms of early recovery compared with the traditional surgical methods.

Objective: To describe the total anatomical reconstruction (TAR) technique during robot-assisted radical prostatectomy (RARP).

Mini-retroperitoneoscopic adrenalectomy: our experience after 50 procedures.

Objective: To present our experience with retroperitoneoscopic adrenalectomy using 3-mm instruments (mini-rA) for adrenal tumors.

Materials And Methods: From March 2009 to May 2013, patients with adrenal tumors <6 cm in size and body mass index ≤ 35 were involved in this prospective study and underwent mini-rA performed by 3-mm instruments. Demographic, endocrine and perioperative data, and cosmetic results (using Patient Scar Assessment Questionnaire and Scoring System) were recorded and analyzed.

Clampless laparoscopic partial nephrectomy: a step towards a harmless nephron-sparing surgery?

Purpose: To evaluate the results of our technique of clampless laparoscopic partial nephrectomy (LPN) and its impact as an emerging treatment for small renal masses (SMRs).

Materials And Methods: We reviewed our prospectively maintained database: data of 117 patients who consecutively underwent LPN at our Institution from January 2009 to December 2011 were studied. Patients were divided into 2 Groups based on operative technique: Group A: clampless-LPN (cl-LPN); Group B: conventional LPN (clamping of renal artery).

Randomised controlled trial comparing laparoscopic and robot-assisted radical prostatectomy.

Background: The advantages of robot-assisted radical prostatectomy (RARP) over laparoscopic radical prostatectomy (LRP) have rarely been investigated in randomised controlled trials.

Objective: To compare RARP and LRP in terms of the functional, perioperative, and oncologic outcomes. The main end point of the study was changes in continence 3 mo after surgery.

Standard vs mini-laparoscopic pyeloplasty: perioperative outcomes and cosmetic results.

Unlabelled: Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? New techniques and instrumentation in laparoscopy including the use of 'single-port' devices and natural orifice transluminal endoscopic surgery have been proposed to reduce the invasiveness of these procedures. The introduction of small laparoscopic instruments (<3 mm) continues to further the field. To date, mini-laparoscopic instruments have been used in many urological procedures, e.

Long-term functional evaluation of the treated kidney in a prospective series of patients who underwent laparoscopic partial nephrectomy for small renal tumors.

Background: Renal scintigraphy may allow long-term monitoring of ischemic damage after partial nephrectomy (PN).

Objective: Evaluate use of renal scintigraphy for evaluating long-term effects of warm ischemia on renal function in patients with a normal contralateral kidney.

Design, Setting, And Participants: We prospectively examined kidney function of 54 patients who underwent laparoscopic PN (LPN).

Pure mini-laparoscopic transperitoneal pyeloplasty in an adult population: feasibility, safety, and functional results after one year of follow-up.

Objective: To report the results of mini-laparoscopic pyeloplasty (mLP) in an adult population. The feasibility of pure mLP has been previously reported in children.

Material And Methods: From April 2009 to February 2010, 10 patients with ureteropelvic junction obstruction (UPJO) were enrolled in this prospective study and underwent pure mLP (using only 3-mm instruments) according to the Anderson-Hynes technique.

Extraperitoneoscopic transcapsular adenomectomy: complications and functional results after at least 1 year of followup.

Purpose: Laparoscopic simple prostatectomy has been proposed to treat large glands. To date groups have investigated the feasibility and perioperative results of laparoscopic simple prostatectomy but to our knowledge no study has focused on its complications and functional results at longer followup. We investigated complications and functional results in patients with a large prostate who were treated with laparoscopic simple prostatectomy and had at least 1 year of followup.

Transvaginal natural orifice transluminal endoscopic surgery-assisted minilaparoscopic nephrectomy: a step towards scarless surgery.

The feasibility of a transvaginal hybrid natural orifice transluminal endoscopic surgery (NOTES) nephrectomy has already been demonstrated using standard laparoscopic ports through the abdominal wall. We evaluated the feasibility of a transvaginal NOTES-assisted minilaparoscopic nephrectomy (mLN). The patient is positioned in a semilumbotomy position with legs separated to allow for vaginal access.

Flexible pneumocystoscopy for double J stenting during laparoscopic and robot assisted pyeloplasty: our experience.

We present our results in terms of feasibility, safety and efficacy of flexible pneumocystoscopy during double J stenting in patients undergoing laparoscopic pyeloplasty (LP). The patient is placed on the flank at a 45 degrees angle. Laparoscopic pyeloplasty according to the Anderson-Hynes technique is carried out by transperitoneal access.

Laparoscopic vesico-vaginal fistula repair: our experience and review of the literature.

Purpose: To describe our experience with laparoscopic transperitoneal vesico-vaginal fistula (VVF) repair and we review current literature.

Methods: Four patients with VVF underwent transperitoneal transvesical laparoscopic repair, with the same principles of open abdominal approach. We considered: operation time, complications, hospital stay, Foley catheter duration, and recurrence during the follow-up.

Selective versus standard ligature of the deep venous complex during laparoscopic radical prostatectomy: effects on continence, blood loss, and margin status.

Background: Continence after laparoscopic radical prostatectomy is critical to patients and to surgeons. In this setting, the management of deep venous complex (DVC) without involvement of the sphincter fibres could be an important step of the procedure.

Objective: To evaluate the effects of a personal selective suture of the plexus (selective ligature of the deep venous complex [SLDVC]) on continence, blood loss, and surgical margin status during laparoscopic radical prostatectomy (LRP).

A second cycle of tamsulosin in patients with distal ureteric stones: a prospective randomized trial.

Objective: To evaluate, in a prospective randomized pilot study, the effectiveness and safety of tamsulosin, administered in patients with distal ureteric stones and who have already undergone an unsuccessful first cycle of medical expulsive therapy (MET).

Patients And Methods: We evaluated the effectiveness and safety of tamsulosin, administered as a further therapy, in patients previously unsuccessfully treated with combined expulsive 10-day therapy (tamsulosin + deflazacort) for distal ureteric stones. Ninety-one patients were enrolled and randomized into two groups, each receiving a different therapy for 10 days.

Transperitoneal left laparoscopic pyeloplasty with transmesocolic access to the pelvi-ureteric junction: technique description and results with a minimum follow-up of 1 year.

Objectives: To describe and evaluate the safety and outcome of transperitoneal left laparoscopic pyeloplasty (TLLP) with a direct approach to the pelvi-ureteric junction (PUJ) through the mesentero-colic space, which avoids mobilization of the descending colon.

Patients And Methods: From March 2005 to June 2006, 18 consecutive patients underwent TLLP with direct access. For each patient age, gender, body mass index (BMI), hospital stay, skin-to-skin operative time, time from incision of the posterior peritoneum to dissection of the PUJ, blood loss, time to resumption of oral intake and complications were recorded.

Biological glues and collagen fleece for hemostasis during laparoscopic partial nephrectomy: technique and results of prospective study.

Purpose: The aim of this prospective study was to evaluate the advantages or disadvantages of the use of fibrin glue and collagen fleece during laparoscopic partial nephrectomy.

Patients And Methods: Two groups of patients were studied. Group A (n = 24) received parenchymal suture, whereas Group B (n = 20) received parenchymal suture with fibrin glue and collagen fleece.

Fast and safe closing of urethra during laparoscopic radical cystectomy.

Purpose: To present a simple alternative technique to close the membranous urethra during laparoscopic radical cystectomy.

Patients And Methods: A series of 18 laparoscopy-assisted cystectomies were performed in our institute from November 2002 to May 2005. In order to prevent neoplastic-cell spillage, in 14 of these patients, the membranous urethra was closed with Hem-o-lok clips after careful dissection of the urethra and withdrawal of the bladder catheter.

Left laparoscopic radical nephrectomy with direct access to the renal artery: technical advantages.

Objectives: To evaluate the technical advantages of early ligature of the renal artery at the level of the Treitz ligament during left laparoscopic radical nephrectomy (LRN).

Material And Methods: Twenty-six patients underwent LRN for organ-confined lesions. We grouped measured parameters (see Results) on the basis of the first 13 and last 13 patients, and compared both subgroups.