Hand-assisted laparoscopic approach to renal harvest for autotransplantation.

Purpose: To describe a laparoscopic hand-assisted approach to renal autotransplantation that allows both harvest and transplant through the same incision.

Patients And Methods: Three patients underwent renal autotransplantation from May 2003 to April 2004, two for loin pain-hematuria syndrome and one for severe ureteral-stricture disease. Two patients underwent autotransplantation on the left and one on the right.

Incisional hernia following hand-assisted laparoscopic surgery for renal cell cancer.

Objectives: For renal cell cancer, the hand-assisted laparoscopic approach provides several advantages while maintaining equal advantages with regards to patient recovery. We offer our experience with laparoscopic hand-assisted radical nephrectomy and the incidence of ventral wall hernia.

Methods: Between February 1999 and July 2002, we performed 50 laparoscopic hand-assisted radical nephrectomies.

A review of surgical simulation with attention to validation methodology.

The use of simulation technology for teaching and evaluating surgical skills has gained considerable attention in recent years. This is driven by interest in quality of care, concerns over increasing operative complexity, constraints on the use of animal models, limited available patient material, medicolegal pressures, and fiscal mandates for cost-effective performance. Traditional mechanical models are yielding to techniques dependent on electronic technology, including virtual reality.

An assessment of the use of a continent catheterizable stoma in female tetraplegics.

Objectives: To evaluate the success of a continent catheterizable stoma in females with cervical spinal cord injury which resulted in neurogenic bladder dysfunction, the management of which may require clean intermittent catheterization despite altered hand function.

Patients And Methods: Six female tetraplegic patients with a lesion at C7 or above (age range 12-22 years) had a continent catheterizable abdominal stoma formed as part of their bladder management. As an objective measure of effectiveness, the time to complete catheterization was assessed before and after surgery.

Hand-assisted laparoscopy for multiple organ removal.

Simultaneous removal of multiple organs is a situation seldom encountered by the urologist but may be needed in patients with adult polycystic kidney disease or malignancies or infectious processes involving more than one organ. Historically, open surgery has been considered necessary to gain adequate exposure. However, hand-assisted laparoscopic surgery is suitable for many of these patients.

Correlation of ureteral stone measurements by CT and plain film radiography: utility of the KUB.

Background And Purpose: The practice of utilizing helical CT to evaluate patients suspected of renal colic is increasing. Little is known about the accuracy of CT in estimating stone size or the utility of an accompanying plain abdominal radiograph (KUB film). The purpose of our study was to compare ureteral stone size estimation by helical CT and plain film and determine whether a KUB film provides additional information useful in patient management.

Intestinal Oxalobacter formigenes colonization in calcium oxalate stone formers and its relation to urinary oxalate.

Background And Purpose: Oxalobacter formigenes is an anaerobic commensal colonic bacterium capable of degrading oxalate through the enzyme oxalyl-CoA decarboxylase. It has been theorized that individuals who lack this bacterium have higher intestinal oxalate absorption, leading to a higher urinary oxalate concentration and an increased risk of calcium oxalate urolithiasis. We performed a prospective, controlled study to evaluate O.

Extraperitoneal laparoscopy-assisted percutaneous nephrolithotomy in a left pelvic kidney.

Treatment of urolithiasis within a pelvic kidney presents a technical challenge. We report an extraperitoneal laparoscopy-assisted percutaneous approach to access the lower-pole calix of a pelvic kidney for percutaneous nephrolithotomy.

Renal intrapelvic pressure during percutaneous nephrolithotomy and its correlation with the development of postoperative fever.

Purpose: Systemic absorption of irrigation fluid containing bacteria or endotoxin may lead to fever and urosepsis after percutaneous nephrolithotomy. Although to our knowledge the exact method of absorption is undefined, intrapelvic pressure greater than 30 mm. Hg has been shown to result in pyelovenous-lymphatic backflow.