Laparoscopic renal tumor cryoablation: appropriate application of real-time ultrasonographic monitoring.

Background And Purpose: Many authors who report outcomes of laparoscopic cryoablation for renal tumors comment that real-time intracorporeal ultrasonographic monitoring of the ice-ball formation is imperative. In our experience, ultrasonographic monitoring of the ice-ball formation necessitates significantly more mobilization of the kidney, and the images are difficult to interpret because of artifact and the cryoablation effect on the tissue. We report our intermediate outcomes for laparoscopic cryoablation without real-time ultrasonographic monitoring of the ice ball.

Robot-assisted laparoscopic excision and ureteroureterostomy for congenital midureteral stricture.

Congenital ureteral strictures most commonly occur at the proximal and distal segments of the ureter. Congenital midureteral stricture is a rare entity that is usually detected by prenatal ultrasonography and repaired in infants. We present the case and video of a congenital midureteral stricture in a 20-year-old woman who presented with a severe episode of pyelonephritis.

Hurdles to helium gas laparoscopy and a readily available alternative.

Background And Purpose: Although multiple series of helium insufflation-assisted laparoscopic surgery are reported, we encountered difficulty at many levels when arranging a laparoscopic nephrectomy with helium insufflation. We present our experience with attempting to use helium gas as an insufflant and our successful use of argon gas as an adjunct to CO(2) insufflation with a case report as illustration.

Materials And Methods: The patient is a 66-year-old man with a progressively enlarging 3.

Robotically assisted excision of ovarian vein for intermittent ureteral obstruction.

With the increasing popularity of robotically assisted procedures, new indications for robotically assisted surgery are being examined. Although open and laparoscopic surgical management of intermittent ureteral obstruction from ovarian vein syndrome has been reported previously, we report the first use of robotic assistance for ureterolysis and ovarian vein excision.

Does laparoscopy beget underuse of partial nephrectomy for T(1) renal masses? Competing treatment decision pathways may influence utilization.

Background And Purpose: It has been suggested that renal laparoscopy has resulted in an underuse of partial nephrectomy (PN) for small renal masses in the U.S. In the absence of evidence-based medicine (EBM) guide-lines, multiple-perspective reasoning is required where complete v partial nephrectomy and the laparoscopic v the open surgical approach must be considered.

Missed diagnoses by urologists resulting in malpractice payment.

Purpose: Missed diagnoses are a patient safety concern and they can result in malpractice allegation. The specialist physician may be liable for missed or delayed diagnoses even if an abnormality in the physician area of expertise is ruled out. We approached this largely unstudied area of medical malpractice in an effort to increase physician awareness and identify opportunities for prevention.