Robotic and Open Radical Prostatectomy: The First Prospective Randomised Controlled Trial Fuels Debate Rather than Closing the Question.

Despite the finally acquired level 1 evidence, the urologic debate on open versus robotic prostatectomy still persists. This trial from Brisbane will encourage future studies that will better inform this debate and define what robotic surgery offers.

Best practices in robot-assisted radical cystectomy and urinary reconstruction: recommendations of the Pasadena Consensus Panel.

Context: Robot-assisted surgery is increasingly used for radical cystectomy (RC) and urinary reconstruction. Sufficient data have accumulated to allow evidence-based consensus on key issues such as perioperative management, comparative effectiveness on surgical complications, and oncologic short- to midterm outcomes.

Objective: A 2-d conference of experts on RC and urinary reconstruction was organized in Pasadena, California, and the City of Hope Cancer Center in Duarte, California, to systematically review existing peer-reviewed literature on robot-assisted RC (RARC), extended lymphadenectomy, and urinary reconstruction.

Perioperative Outcomes of Robotic and Laparoscopic Simple Prostatectomy: A European-American Multi-institutional Analysis.

Background: Laparoscopic and robotic simple prostatectomy (SP) have been introduced with the aim of reducing the morbidity of the standard open technique.

Objective: To report a large multi-institutional series of minimally invasive SP (MISP).

Design, Setting, And Participants: Consecutive cases of MISP done for the treatment of bladder outlet obstruction (BOO) due to benign prostatic enlargement (BPE) between 2000 and 2014 at 23 participating institutions in the Americas and Europe were included in this retrospective analysis.

A review of the current status of laparoscopic and robot-assisted sacrocolpopexy for pelvic organ prolapse.

Context: Abdominal sacrocolpopexy (ASC) represents the superior treatment for apical pelvic organ prolapse (POP) but is associated with increased length of stay, analgesic requirement, and cost compared with transvaginal procedures. Laparoscopic sacrocolpopexy (LSC) and robot-assisted sacrocolpopexy (RSC) may offer shorter postoperative recovery while maintaining equivalent rates of cure.

Objective: This review evaluates the literature on LSC and RSC for clinical outcomes and complications.

Indication for and extension of pelvic lymph node dissection during robot-assisted radical prostatectomy: an analysis of five European institutions.

Background: Several reports have shown that patients who undergo minimally invasive radical prostatectomy have a lower chance of undergoing pelvic lymph node dissection (PLND), irrespective of the disease characteristics.

Objective: We evaluated the rate and extension of PLND in patients who underwent robot-assisted radical prostatectomy (RARP). We tested the adherence of the indication for PLND to the European Association of Urology (EAU) guidelines.

Robot-assisted partial nephrectomy for renal tumors larger than 4 cm: results of a multicenter, international series.

Backgrounds: Limited data are available for the use of robot-assisted partial nephrectomy (RAPN) in tumors >4 cm. The objectives of this study were to report the perioperative outcomes of a series of patients who underwent RAPN for suspicious >4 cm renal tumors and to compare these results with those observed in a group of patients with ≤4 cm tumors.

Methods: We analyzed retrospectively the clinical records of 49 patients who underwent RAPN for suspicious of renal cell carcinoma (RCC) >4 cm in size at four centers from September 2008 to September 2010.

Validation of the preoperative aspects and dimensions used for an anatomical (PADUA) score in a robot-assisted partial nephrectomy series.

Objectives: PADUA score is a standardized anatomical classification of renal tumors proposed with the aim to objectivize the decision-making process of any urologist evaluating kidney tumors potentially suitable for nephron-sparing surgery. The system was proposed in a series of patients treated with open partial nephrectomy (PN) and was recently validated in a series of patients treated with either open or laparoscopic PN. The purpose of the present study was to validate the PADUA score in a series of consecutive patients who underwent robot-assisted PN (RPN).

Impact of the learning curve on perioperative outcomes in patients who underwent robotic partial nephrectomy for parenchymal renal tumours.

Background: Robot-assisted partial nephrectomy (RAPN) is an emerging, minimally invasive technique to treat patients with small renal masses.

Objective: To evaluate the impact of the learning curve on perioperative outcomes such as operative times and warm ischaemia times (WIT), blood loss, overall complications, and renal function impairment in patients who underwent RAPN.

Design, Setting, And Participants: We collected prospectively the clinical and pathologic records of 62 consecutive patients who underwent RAPN between September 2006 and November 2009 for renal tumours at a nonacademic teaching institution by a single surgeon with extensive prior robotic experience.

Tumor enucleoresection in robot-assisted partial nephrectomy.

The objective of this study is to describe our technique and results of the enucleoresection technique in robot-assisted partial nephrectomy. The patient is positioned in full flank position. Three robotic arms of a da Vinci system and an assistant's port are used.

Influence of an increased intracranial pressure on cerebral and systemic haemodynamics during endoscopic neurosurgery: an animal model.

Background: During endoscopic neurosurgery, direct mechanical stimulation of the brain by the endoscope and increased intracranial pressure (ICP) caused by the continuous rinsing can induce potentially lethal haemodynamic reflexes, brain ischaemia, and excessive fluid resorption.

Methods: In a newly presented rat model of endoscopic neurosurgery, stereotactic access to the cerebrospinal fluid was secured and the ICP was increased by controlled infusion until complete suppression of the cerebral perfusion pressure (CPP). The haematocrit (Hct) level was determined before and after the procedure.

Failure of a robotic arm during da Vinci prostatectomy: a case report.

We report a rare case of a da Vinci robotic arm failure during a laparoscopic robot-assisted radical prostatectomy. The articulation joint of an Endowrist needle driver was broken and positioned at such an angle that made it impossible to remove through the trocar. In addition, it was later discovered that a small piece of the instrument was detached and remained inside the abdomen of the patient without even having been identified on subsequent radiological evaluation.

Muscle relaxation does not influence venous oxygen saturation during cardiopulmonary bypass.

Study Objective: To examine whether the omission of neuromuscular blocking drugs during cardiopulmonary bypass (CPB) is associated with increased anesthetic requirements, higher frequency of intraoperative movements, and lower venous oxygen saturation (SvO(2)).

Design: Prospective, randomized study.

Setting: Large community hospital.

Large bolus dose vs. continuous infusion of cisatracurium during hypothermic cardiopulmonary bypass surgery.

Background And Objective: We investigated whether a high bolus dose of cisatracurium (8x ED95) given at induction can provide muscle relaxation for the major part of a cardiac procedure with hypothermic cardiopulmonary bypass, avoid important postoperative residual curarization and cause no waste of product.

Methods: Twenty patients were randomly assigned either to Group 1 (n = 10) or Group 2 (n = 10). Those in Group 1 were given cisatracurium in a high bolus dose (0.

Hemodynamic performance of the PRIMA Edwards stentless aortic xenograft: early results of a multicenter clinical trial.

Between June 1991 and July 1993, 200 PRIMA Edwards stentless aortic bioprostheses were implanted in 4 European centres. Mean age of the group was 68.5 years (S.

Free-hand sewn allografts, stentless (Prima Edwards) and stented (CESA) porcine bioprostheses. A comparative hemodynamic study.

In a retrospective, non-randomized study, the clinical and hemodynamic properties of 50 consecutively implanted hand-sewn allografts (group I), 50 stentless bioprostheses (group II) and 50 stented bioprostheses (group III) were compared. Preoperative hemodynamic and clinical data were identical in the three groups, except for age (group I: 54.4 +/- 8.