Development of a novel iPad-based laparoscopic trainer and comparison with a standard laparoscopic trainer for basic laparoscopic skills testing.

Introduction: We developed the iTrainer (iT) as a portable laparoscopic trainer, which incorporates the iPad tablet. We then compared the iT with a standard pelvic trainer (SPT) to assess surgical skills as well as its image quality, resolution, brightness, comfort, and overall performance.

Materials And Methods: We designed and constructed the iT to be compatible with the Apple iPad 3 and standard laparoscopic instruments.

Comparison of optics and performance of a distal sensor high definition cystoscope, a distal sensor standard definition cystoscope, and a fiberoptic cystoscope.

Objective: To evaluate performance characteristics and optics of a new generation high-definition distal sensor (HD-DS) flexible cystoscope, a standard-definition distal sensor (SD-DS) cystoscope, and a standard fiberoptic (FO) cystoscope.

Methods: Three new cystoscopes (HD-DS, SD-DS, and FO) were compared for active deflection, irrigation flow, and optical characteristics. Each cystoscope was evaluated with an empty working channel and with various accessories.

High-fidelity simulation-based team training in urology: evaluation of technical and nontechnical skills of urology residents during laparoscopic partial nephrectomy.

Introduction: The use of low-risk simulation training for resident education is rapidly expanding as teaching centers integrate simulation-based team training (SBTT) sessions into their education curriculum. SBTT is a valuable tool in technical and communication skills training and assessment for residents. We created a unique SBTT scenario for urology residents involving a laparoscopic partial nephrectomy procedure.

In vitro evaluation of ScopeSafe fibers and the scope guardian sheath in prevention of ureteroscope endolumenal working damage.

Background And Purpose: Ureteroscope breakage is commonly related to laser fiber damage. Often, the damage is mechanical and not energy related. As such, we evaluated a novel laser fiber and sheath system in preventing mechanical ureteroscope damage during fiber insertion.

Bovine serum albumin glutaraldehyde for completely sutureless laparoscopic heminephrectomy in a survival porcine model.

Introduction: Laparoscopic partial nephrectomy (LPN) has not received widespread clinical application because of its technical challenge. Bovine serum albumin glutaraldehyde (BSAG) is a hemostatic agent that is independent of the clotting cascade. We evaluated the use of BSAG as the sole agent for parenchymal and collecting system closure during LPN in a survival porcine model.

Cytotoxic T cell immunity against the non-immunogenic, murine, hepatocellular carcinoma Hepa1-6 is directed towards the novel alternative form of macrophage colony stimulating factor.

Mouse Hepa1-6 hepatocellular carcinoma (HCC) cells were transduced with the membrane form of macrophage colony stimulating factor (mM-CSF). When mM-CSF transduced Hepa1-6 cells were injected subcutaneously into mice, these cells did not form tumors. The spleens of these immunized mice contained cytotoxic CD8+ T lymphocytes (CTL) that killed the unmodified Hepa1-6 cells.

Evaluation of the outcomes of electrosurgical induced bowel injury treated with tissue glue/sealant versus sutured repair in a rabbit model.

Introduction: Bowel injury is an uncommon, although potentially devastating, intraoperative laparoscopic complication. Questions have been raised about the possible use of a tissue adhesive to repair injured bowel. We compared glued repair and sutured repair of both large bowel (LB) and small bowel (SB) electrosurgical injuries in a rabbit model.

Comparative study of in vivo lymphatic sealing capability of the porcine thoracic duct using laparoscopic dissection devices.

Purpose: Sealing the lymphatic vessels during abdominal and pelvic surgery is important to prevent the leakage of lymphatic fluid and its resultant sequelae. To our knowledge we compared for the first time the quality of lymphatic sealing by each of 4 commonly used laparoscopic dissection devices.

Materials And Methods: A total of 12 domestic pigs were used to test dissecting devices, including monopolar scissors (Ethicon Endo-Surgery, Cincinnati, Ohio), Harmonic ACE Scalpel, LigaSure V, EnSeal and Trissector.

Third place: Flank position is associated with higher skin-to-surface interface pressures in men versus women: implications for laparoscopic renal surgery and the risk of rhabdomyolysis.

Background And Purpose: There have been several reports of rhabdomyolysis occurring after prolonged laparoscopic procedures in the flank position. Accordingly, we evaluated interface pressures between the skin and three commonly used operating room table surfaces. The aim of our study was to determine if pressure changes could be related to body mass index (BMI), sex, position, and/or the table surface material.

LapED 4-In-1 silicone training aid for practicing laparoscopic skills and tasks: a preliminary evaluation.

Objective: We developed a simple, inexpensive model to simulate four reconstructive laparoscopic procedures: pyeloplasty, vesicourethral anastomosis, bladder injury repair, and partial nephrectomy.

Materials And Methods: Liquid silicone was applied in layers to a mold to create the 4-in-1 model. A questionnaire evaluating its face and content validity was distributed to postgraduate urologists participating in a mini-residency program at the University of California-Irvine (UCI), and in the 2006 American Urological Association Hands-On course on reconstructive laparoscopic pyeloplasty.

Rapid communication: robot-assisted NOTES nephrectomy: initial report.

Background And Purpose: Natural Orifice Transluminal Endoscopic Surgery (NOTES) using the daVinci robot (Intuitive Surgical, Sunnyvale, CA) has never been applied to urologic surgery. Here we present our initial experience with a combined transvaginal and transcolonic, single-port, robot-assisted NOTES nephrectomy.

Methods: An acute experiment was performed in a female farm pig.

Antiangiogenic drugs synergize with a membrane macrophage colony-stimulating factor-based tumor vaccine to therapeutically treat rats with an established malignant intracranial glioma.

Combining a T9/9L glioma vaccine, expressing the membrane form of M-CSF, with a systemic antiangiogenic drug-based therapy theoretically targeted toward growth factor receptors within the tumor's vasculature successfully treated >90% of the rats bearing 7-day-old intracranial T9/9L gliomas. The antiangiogenic drugs included (Z)-3-[4-(dimethylamino)benzylidenyl]indolin-2-one (a platelet-derived growth factor receptor beta and a fibroblast growth factor receptor 1 kinase inhibitor) and oxindole (a vascular endothelial growth factor receptor 2 kinase inhibitor). A total of 20-40% of the animals treated with the antiangiogenic drugs alone survived, while all nontreated controls and tumor vaccine-treated rats died within 40 days.