Purpose: By evaluating the technical challenges encountered during 123 laparoscopic nephrectomies, we have been able to modify the surgical technique to allow general urologists to effectively perform the procedure with minimal complications.
Design And Method: A retrospective chart review was performed on 123 patients who consecutively underwent laparoscopic nephrectomy or nephroureterectomy. Using a modified dissection approach to the hilum and en bloc ligation of the renal pedicle with a vascular stapler, a new standard of laparoscopic nephrectomy was developed at our institution.
Objectives: To evaluate the impact of the ureteral access sheath on intrarenal pressures during flexible ureteroscopy in light of the recent resurgence in their use. As such, using human cadaveric kidneys, we studied changes in intrarenal pressure in response to continuous irrigation at different pressures with and without access sheaths of various sizes and lengths.
Methods: This study was performed using seven cadaveric kidneys.
We studied simple maneuvers to optimize active deflection of the flexible ureteroscope. Up to 61 degrees of active deflection is lost if the ureteroscope is not kept in a straight alignment. Holding the ureteroscope taut, placing a super-stiff guidewire in the working channel, or using an access sheath maximizes active deflection.
View Article and Find Full Text PDFPurpose: To evaluate the effect of argon-beam coagulator (ABC) energy on suture materials.
Materials And Methods: Six absorbable and nonabsorbable suture materials (polyglactin, chromic catgut, polydioxanone, silk, poliglecaprone, and Gore-Tex) were placed under tension and exposed to ABC energy to determine breaking times. Subsequently, all suture materials were exposed to limited ABC energy, and tensiometry was used to determine decreases in breaking strengths.