Publications by authors named "Ralph V Clayman"

Objectives: To study the in vivo tissue effects of synchronous twin pulse technology. Recently, the concept of a synchronous twin pulse technique for shock wave therapy has been introduced with the development of the Twinheads' unit.

Methods: In 10 pigs (20 kidneys), one of three sites was targeted: the renal pelvis (2 pigs), the mid-zone parenchyma (5 pigs), or the lower pole parenchyma (3 pigs).

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Objectives: To determine the extent to which laparoscopy has replaced open surgery for renal malignancy.

Methods: The records of all 537 patients at Washington University who underwent surgery for localized renal malignancies from January 1997 to December 2001 were examined for clinical and pathologic information.

Results: The total procedures per year increased from 1997 to 2001, but the distribution of pathologic stages throughout the 5 years was similar.

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Purpose: To provide an overview of the state of the art of tissue chemoablation in animal and human organs and cancers. We also describe our experience with the feasibility, predictability, and reproducibility of necrosis produced by needle chemoablative therapies including ethanol, hypertonic saline, and acetic acid solutions as well as gels in a porcine renal model.

Materials And Methods: A MEDLINE search was performed for articles on animal and human tissue chemoablation published since 1965.

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Purpose: For a skilled laparoscopic surgeon the learning curve for achieving proficiency with laparoscopic radical prostatectomy (LRP) is estimated at 40 to 60 cases. For the laparoscopically naïve surgeon the curve is estimated at 80 to 100 cases. The development of a robotic interface might significantly shorten the LRP learning curve for an experienced open yet naïve laparoscopic surgeon.

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Background And Purpose: In patients with autosomal dominant polycystic kidney disease (ADPKD), laparoscopic cyst decortication (LCD) has been proposed as a means to relieve chronic cyst-related pain. We present our 7-year experience with LCD for ADPKD with regard to pain relief, hypertension, and renal function.

Patients And Methods: Between August 1994 and February 2001, 29 ADPKD patients with chronic pain (N=29), hypertension (N=21), and renal insufficiency (N=10) underwent 35 LCD procedures.

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Purpose: Laparoscopic pyeloplasty has become a viable option for the treatment of select patients with primary ureteropelvic junction obstruction with success rates similar to those of open surgery. However, little has been written on the application of this technique for secondary ureteropelvic junction obstruction. We report the largest series of secondary ureteropelvic junction obstruction managed by laparoscopic pyeloplasty.

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We describe the technique and initial clinical results with application of a novel method to achieve renal parenchymal hypothermia using retrograde ureteral access. A 38-year-old man was scheduled to undergo an open right partial nephrectomy for renal cell carcinoma. Before the open procedure, a ureteral access sheath was advanced to the ureteropelvic junction under fluoroscopic guidance; through the access sheath, a 7.

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Purpose: To determine the effect of holmium:YAG lithotripsy on the optical beam profile.

Materials And Methods: Beam profiles of the laser light from holmium:YAG optical fiber systems were characterized with a pyroelectric camera. Beam profiles were measured with 272-microm and 365-microm optical fibers both straight and bent to simulate lower-pole ureteronephroscopy.

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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.

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Objectives: To describe a technique for facilitating the urethrovesical anastomosis at the time of laparoscopic radical prostatectomy.

Methods: Two 6-in. polyglycolic acid sutures (one dyed, one white) are tied together at their tail ends and delivered into the operative field by way of a 12-mm port.

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