Laparoscopic cecostomy tube placement in an Indiana pouch.

A cecostomy tube is normally placed in an Indiana pouch for drainage and irrigation in the postoperative period. A clinical dilemma occurs when the cecostomy tube fails or is dislodged in the early postoperative period. We present the laparoscopic replacement of a cecostomy tube in the immediate postoperative period.

Recurrent pelvic floor defects after abdominal sacral colpopexy.

Purpose: The incidence of site specific pelvic organ prolapse defects following sacral colpopexy is not clearly reported. We evaluated site specific pelvic organ defects after colpopexy and determined its impact on patient satisfaction.

Materials And Methods: A total of 40 women with vault prolapse underwent abdominal sacral colpopexy, culdeplasty and paravaginal repair.

Evaluation of surgical models for renal collecting system closure during laparoscopic partial nephrectomy.

Objectives: To evaluate the utility of the porcine and canine models for collecting system closure after partial nephrectomy involving violation of the renal collecting system. Advanced surgical technologies and novel techniques for performing laparoscopic partial nephrectomy are frequently evaluated in an animal model.

Methods: After evaluation of the upper urinary tract with retrograde pyelography, laparoscopic partial nephrectomy, including violation of the renal collecting system, was performed in 8 domestic pigs (group 1) and 2 dogs (group 2) with documented normal upper urinary tract physiology.

Laparoscopic ureterocalicostomy: development of a technique simplified by application of Nitinol clips and a wet monopolar electrosurgery device.

Purpose: We developed a technique for laparoscopic ureterocalicostomy with the use of intracorporeal suturing and subsequently simplified the technique by application of experimental Nitinol clips.

Materials And Methods: We performed laparoscopic ureterocalicostomy on 16 domestic swine divided into four groups of four animals each. The kidney was exposed laparoscopically, and the renal artery was atraumatically clamped.

Impact of a double-pigtail stent on ureteral peristalsis in the porcine model: initial studies using a novel implantable magnetic sensor.

Background And Purpose: The effect of stents on ureteral peristalsis in vivo is not entirely clear. We sought to develop a minimally invasive method for its study.

Materials And Methods: In female domestic pigs, electrical potentials from the ureter were measured by bipolar steel-wire electromyography electrodes delivered laparoscopically.

Enhanced renal parenchymal cryoablation with novel 17-gauge cryoprobes.

Objectives: To evaluate novel, 17-gauge cryoprobes with a modified heat exchange mechanism to evaluate the area of ablation that could be achieved with 17-gauge (1.47-mm) cryoprobes.

Methods: Eleven pigs were divided into four groups.

Enhanced renal cryoablation with hilar clamping and intrarenal cooling in a porcine model.

Objectives: To evaluate the effects of renal vascular control and intrarenal cooling on the size of renal lesions attainable with a 3.4-mm cryoprobe.

Methods: Three groups of pigs underwent unilateral laparoscopic renal cryoablation with a 3.

Ureteral access strategies: pro-access sheath.

Routine use of the ureteral access sheath during flexible ureteroscopic procedures provides consistent, reliable, and unencumbered access to the upper tracts. The ureteral access sheath can be reliably and easily deployed if used properly and requires no special training. As such, it can be easily adopted into current urologic practice.

Application of a fixed retractor system to facilitate laparoscopic radical prostatectomy.

Purpose: We report application of a fixed retractor system for reduction of the steep Trendelenberg position required to achieve deep pelvic access for laparoscopic radical prostatectomy.

Materials And Methods: A fixed retractor system consisting of a flexible arm that can be locked in position and an expandable 5 mm laparoscopic retractor were used to gain exposure to the deep pelvis. We describe in detail our technique for laparoscopic radical prostatectomy incorporating the fixed retractor system to facilitate each step of the procedure.

Modified renal morcellation for renal cell carcinoma: laboratory experience and early clinical application.

Objectives: To present our modified technique to expedite the entrapment and morcellation process. Standard renal morcellation is typically performed using a 12-mm incision, with the specimen entrapped within a durable LapSac. Because the LapSac does not have a deployment mechanism, its application is technically demanding and time consuming.

Renal hypothermia achieved by retrograde endoscopic cold saline perfusion: technique and initial clinical application.

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.