Single-port technique evolution and current practice in urologic procedures.

Different groups described the single-port surgery since its first report in laparoscopic procedures. However, the acceptance of this technique among urologists, even after the robotic approach, was reduced in the past years. Therefore, to overcome the challenges related to the single-port surgery, a new robotic platform named da Vinci SP was created with exclusive single port technology.

Robtic-assisted radical cystectomy: Literature review.

Radical cystectomy (RC) with pelvic lymph node dissection (PLND) is the standard treatment for localized muscle-invasive bladder cancer (MIBC) and non-muscle-invasive bladder cancer (NMIBC) with recurrence or high risk of progression. Also, the robotic approach to this type of surgery is well established in the literature. Our objective is to summarize in this manuscript the most relevant articles related to the robotic-assisted radical cystectomy for prostate cancer.

The surgical learning curve for salvage robot-assisted radical prostatectomy: a prospective single-surgeon study.

Background: The aim of this study was to report the overall results and the learning curve (LC) in salvage robot-assisted radical prostatectomy (sRARP) patients, in terms of morbidity, oncological and functional outcomes in a single surgeon tertiary-referral center.

Methods: One hundred and twenty patients underwent sRARP by a single surgeon (V.P.

Management of patients who opt for radical prostatectomy during the coronavirus disease 2019 (COVID-19) pandemic: an international accelerated consensus statement.

Objective: Coronavirus disease-19 (COVID-19) pandemic caused delays in definitive treatment of patients with prostate cancer. Beyond the immediate delay a backlog for future patients is expected. The objective of this work is to develop guidance on criteria for prioritisation of surgery and reconfiguring management pathways for patients with non-metastatic prostate cancer who opt for surgical treatment.

Nosocomial SARS-CoV-2 infection in urology departments: Results of a prospective multicentric study.

Objective: To evaluate the coronavirus disease 2019 perioperative infection rate and mortality rate of patients undergoing urological surgeries during the early pandemic period in Spain.

Methods: This was a non-interventional multicenter prospective study carried out from 9 March to 3 May 2020 in two urology departments in Madrid, Spain. Clinical, microbiological and radiological data of patients who underwent surgery were collected from computerized medical records.

Establishing a successful robotic surgery program and improving operating room efficiency: literature review and our experience report.

The benefits and outcomes of robotic surgery are well established in the literature across multiple specialties. The increasing need for and dissemination of this technology associated with high costs, demand adequate planning during its implementation. Therefore, after years of training several robotic surgeons and establishing multiple robotic programs worldwide, the purpose of this article is to focus on the necessary elements in the initial phase of establishing a robotics program.

Salvage robot-assisted radical prostatectomy following failed local treatments.

Prostate cancer represents the most commonly diagnosed cancer in men and is the second-leading cause of cancer related death in the United States. Primary treatment for prostate cancer includes radiotherapy or ablative procedures such as cryotherapy, and high-intensity focused ultrasound (HIFU). Unfortunately, a large proportion of these patients, especially with high risk features, may experience disease recurrence within 10 years.

Current status of robotic surgery in urology.

A few decades ago, minimal invasive  surgery changed the way we understand and perform surgery. Before the revolution of minimal invasive techniques, we accepted and justified a certain degree of trauma on the tissues in order to provide benefit and healing  to the patient. With the adoption of new technologies, we realized that we could achieve the same or even better results with fewer side  effects.

Complications in robotic urological surgeries and how to avoid them: A systematic review.

Objectives: To review the main complications related to the robot-assisted laparoscopic (RAL) approach in urology and to suggest measures to avoid such issues.

Methods: A systematic search for articles of the contemporary literature was performed in PubMed database for complications in RAL urological procedures focused on positioning, access, and operative technique considerations. Each complication topic is followed by recommendations about how to avoid it.

Nerve-sparing in salvage robot-assisted prostatectomy: surgical technique, oncological and functional outcomes at a single high-volume institution.

Objective: To show the feasibility, oncological and functional outcomes of neurovascular bundle (NVB) preservation during salvage robot-assisted radical prostatectomy (RARP).

Patients And Methods: In the present institutional review board-approved retrospective analysis, between January 2008 and March 2016, 80 patients underwent salvage RARP, performed by a single surgeon (V.P), because of local recurrence after primary treatment.

Salvage robotic-assisted radical prostatectomy: oncologic and functional outcomes from two high-volume institutions.

Introduction: While no consensus on the optimal salvage treatment exists, only 3% of these patients will get salvage radical prostatectomies due to the assumed technical challenges of this procedure.

Objectives: Our goal is to analyze the perioperative, oncologic and functional outcomes of patients undergoing salvage robotic-assisted radical prostatectomy (sRARP) after primary treatment failure.

Materials And Methods: Data were prospectively collected and retrospectively reviewed from a combined database of more than 14,800 patients who had undergone RARP.

Safety of Live Robotic Surgery: Results from a Single Institution.

Background: Live surgery events (LSEs) have become one of the most attended activities at surgical meetings and provide a unique opportunity for the audience to observe the decision-making process used by skilled and experienced surgeons in real time. However, there is an ongoing discussion on whether patients treated during LSE are at higher risk of complications.

Objective: To examine LSE outcomes for robot-assisted radical prostatectomy (RARP) and establish patient safety and efficacy.

Robotic radical prostatectomy with concomitant repair of inguinal hernia: is it safe?

Robotic radical prostatectomy (RARP) is well established as a safe and effective treatment for prostate cancer. According to published studies, patients undergoing RARP are at increased risk of being diagnosed with an inguinal hernia after RARP and are four times more likely to have an inguinal hernia repair (IHR) following RARP. Several studies have demonstrated the effectiveness and safety of IHR during RARP.

Can dehydrated human amnion/chorion membrane accelerate the return to potency after a nerve-sparing robotic-assisted radical prostatectomy? Propensity score-matched analysis.

The objective of this study is to determine if the use of dehydrated human amnion/chorion membrane (dHACM) allograft wrapped around the NVB during a robotic-assisted radical prostatectomy (RARP) accelerates the return to potency. 940 patients with preoperative SHIM >20 underwent RARP with some degree of bilateral NS. Of these, 235 patients underwent RARP, with bilateral placement of dHACM graft around the NVBs.

Use of Scaffolding Tissue Biografts To Bolster Vesicourethral Anastomosis During Salvage Robot-assisted Prostatectomy Reduces Leak Rates and Catheter Times.

Background: One of the key factors contributing to morbidity associated with salvage radical prostatectomy is a significant vesicourethral anastomosis (VUA) disruption or postoperative tissue dehiscence in the region of the distal bladder neck that causes a large prolonged urinary leak, perineal pain, and delayed catheter removal.

Objective: To describe our surgical technique using a urinary bladder extracellular matrix (UB-ECM) scaffold incorporated into the base of the VUA and the distal bladder neck during salvage robot-assisted radical prostatectomy (sRARP) and to assess outcomes and safety.

Design, Setting, And Participants: From March to July 2015, 15 patients underwent sRARP performed after primary therapy failure by a single surgeon.

Prediction of biochemical recurrence after radical prostatectomy. New tool for selecting candidates for adjuvant radiation therapy.

Objective: To design a risk summation to select patients for adjuvant radiation therapy after prostatectomy.

Materials And Method: A retrospective study was conducted on 629 patients with localised prostate cancer (pN0-pNx) who were treated with prostatectomy and with a prostate-specific antigen (PSA) value <0.2ng/mL at 2-3 months.

[Recto-urethral fistula secondary to prostate cancer].

Objectives: There are various treatments forprostate cancer nowadays, including techniques that have been used for manyyears such as surgery and radiotherapy, and newer procedures that are gaining prominence in the Urological field like cryotherapy or HIFU (high intensity focused ultrasound). Rectourethral fistula is a rare complication that demands the urologist a great capacity; it may happen after either existent treatment.

Methods: PubMed literature review with articles published during the last 10 years using the terms "rectourethral fistula" and "prostate cancer".

Prognostic factors in patients with stage pT0/pT1/pTa in the radical cystectomy specimen.

Objectives: To identify risk factors for progression in patients with invasive bladder carcinoma who were pT0/pT1/pTa after cystectomy.

Methods: We analyzed the clinical records of 97 post-cystectomy pT0/pT1/pTa patients for the following variables: hydronephrosis, carcinoma in situ (CIS), lymphovascular invasion, history of non-muscular invasive disease, residual tumor in the specimen and lymphatic invasion (pN). pN+patients were excluded from definitive analysis.

Urachal adenocarcinoma. Case report and bibliographic review.

Objective: Literature review of adenocarcinoma of the urachus in connection with two cases recently diagnosed and treated in our center.

Methods/results: We report 2 cases of urachus Adenocarcinoma treated in our institution, both underwent extended partial cystectomy including excision of the urachus up to the umbilicus.

Conclusion: Urachal adenocarcinoma is an exceptional tumor, of poor prognosis, the treatment of which is surgical (partial cystectomy), and the main predictors of disease-free survival are the degree of tumor differentiation and the free margins of the surgical specimen.

Impossible bladder catheter removal. What can we do?

Objective: The inability to remove a bladder catheter due to impossible balloon removal is a situation with controversial management; there are no action guidelines and it is limited to individual experience in most cases. In this article, we review the techniques described for removing a urethral catheter and we share our experience with one case.

Methods: A 70-year-old male with permanent bladder catheter was referred to the emergency department due to an inability to deflate the self-retaining balloon during routine change in his health centre.

Traumatic rupture of horseshoe kidney.

We present the case of a 25-year-old male who came to the emergency room for pain and abdominal distension following trauma to the mesogastrium. A CT scan was performed, revealing a voluminous retroperitoneal hematoma with laceration of both inferior renal poles with regard to rupture of the isthmus of a horseshoe kidney. The patient presented anemization and increased pain, requiring selective embolization by means of arteriography of a branch of the right renal artery and placement of a double J stent due to urinary extravasation in the lower left kidney pole.

Predictive factors for recurrence in clinically localized squamous cell carcinoma of the penis. Analisys of our case series.

Objective: To evaluate the predictive factors for relapse in clinically localized squamous cell carcinoma of the penis undergoing surgical treatment.

Methods: Forty-nine patients were diagnosed with cancer of the penis in our Service between 1999 and 2009. In the present study we excluded 18 subjects: 9 due to the presence of palpable adenopathies, 6 due to histological characteristics other than squamous cell carcinoma, two lost to follow-up, and one due to death at the time of diagnosis.

Intravenous sildenafil as a preconditioning drug against hemodynamic consequences of warm ischemia-reperfusion on the kidney.

Purpose: We designed an experimental model of renal ischemia-reperfusion to evaluate the preemptive effect of intravenous sildenafil according to the dose administered (0.7 vs 1.4 mg/kg) and the time of administration (30 minutes before ischemia or during ischemia).

Cadaver donor kidney retransplantation in the pediatric patient: complications and long-term outcome.

Purpose: We compared the outcome of second and third kidney allografts with that of the first kidney allograft in pediatric recipients.

Materials And Methods: We classified 173 cadaveric kidney recipients into 2 groups. Group 1 comprised 120 first transplants and group 2 comprised 53 retransplants, including 43 second and 10 third transplants.