Overall rate, location, and predictive factors for positive surgical margins after robot-assisted laparoscopic radical prostatectomy for high-risk prostate cancer.

We report the overall rate, locations and predictive factors of positive surgical margins (PSMs) in 271 patients with high-risk prostate cancer. Between April 2008 and October 2011, we prospectively collected data from patients classified as D'Amico high-risk who underwent robot-assisted laparoscopic radical prostatectomy. Overall rate and location of PSMs were reported.

Does surgeon subjective nerve sparing score predict recovery time of erectile function following robot-assisted radical prostatectomy?

Introduction: During robot-assisted radical prostatectomy (RARP), the quality of nerve sparing (NS) was usually classified by laterality of NS (none, unilateral, and bilateral) or degree of NS (none, partial, and full). Recently, side-specific NS have been more frequently performed, but previous NS grading system might not reflect the differential NS in each side.

Aim: Herein, we assessed whether a subjective NS score (NSS) incorporating both degree of NS and NS laterality can predict the time to potency recovery following RARP.

Dehydrated Human Amnion/Chorion Membrane Allograft Nerve Wrap Around the Prostatic Neurovascular Bundle Accelerates Early Return to Continence and Potency Following Robot-assisted Radical Prostatectomy: Propensity Score-matched Analysis.

We present a propensity-matched analysis of patients undergoing placement of dehydrated human amnion/chorion membrane (dHACM) around the neurovascular bundle (NVB) during nerve-sparing (NS) robot-assisted laparoscopic prostatectomy (RARP). From March 2013 to July 2014, 58 patients who were preoperatively potent (Sexual Health Inventory for Men [SHIM] score >19) and continent (no pads) underwent full NS RARP. Postoperative outcomes were analyzed between propensity-matched graft and no-graft groups, including time to return to continence, potency, and biochemical recurrence.

An effective repetitive training schedule to achieve skill proficiency using a novel robotic virtual reality simulator.

Purpose: A robotic virtual reality simulator (Mimic dV-Trainer) can be a useful training method for the da Vinci surgical system. Herein, we investigate several repetitive training schedules and determine which is the most effective.

Methods: A total of 30 medical students were enrolled and were divided into 3 groups according to the training schedule.

The association of type of surgical closure on length of stay among infants with gastroschisis born≥34 weeks' gestation.

Background/purpose: The optimal surgical approach in infants with gastroschisis (GS) is unknown. The purpose of this study was to estimate the association between staged closure and length of stay (LOS) in infants with GS.

Design/methods: We used the Children's Hospital Neonatal Database to identify surviving infants with GS born ≥34 weeks' gestation referred to participating NICUs.

De novo CD3 negative hepatosplenic T-cell lymphoma: diagnostic challenges and pitfalls.

Hepatosplenic T-cell lymphoma is a rare and aggressive peripheral T-cell malignancy that is distinctively characterized by sinusoidal infiltration of mature medium-sized T lymphocytes in the spleen and liver. The neoplastic cells are classically surface CD3(+), CD2(+), CD5(-), CD4(-), and CD8(+/-) and manifest variable expression of markers associated with natural killer (NK) cells such as CD16 and CD56. In this article, we report the first case to date of a newly diagnosed de novo surface CD3(-) hepatosplenic T-cell lymphoma with circulating blastlike neoplastic cells expressing NK-cell-associated markers.

The Tube 3 module designed for practicing vesicourethral anastomosis in a virtual reality robotic simulator: determination of face, content, and construct validity.

Objective: To better use virtual reality robotic simulators and offer surgeons more practical exercises, we developed the Tube 3 module for practicing vesicourethral anastomosis (VUA), one of the most complex steps in the robot-assisted radical prostatectomy procedure. Herein, we describe the principle of the Tube 3 module and evaluate its face, content, and construct validity.

Materials And Methods: Residents and attending surgeons participated in a prospective study approved by the institutional review board.

How often do surgeons intervene on shoulder labral lesions detected at MR examination? A retrospective review of MR examinations correlated with arthroscopy.

Objective: We report the prevalence of surgical intervention on shoulder labral lesions detected at MR examinations and how surgeons describe labral tears seen at MR examinations in their arthroscopy reports.

Methods: A retrospective review of 100 consecutive patients aged 50 years or younger who had shoulder labral tears on MR and went on to have surgery performed. It was determined whether surgical intervention was performed on the MR lesions.

Early intravenous ibuprofen decreases narcotic requirement and length of stay after traumatic rib fracture.

Pain control after traumatic rib fracture is essential to avoid respiratory complications and prolonged hospitalization. Narcotics are commonly used, but adjunctive medications such as nonsteroidal anti-inflammatory drugs may be beneficial. Twenty-one patients with traumatic rib fractures treated with both narcotics and intravenous ibuprofen (IVIb) (Treatment) were retrospectively compared with 21 age- and rib fracture-matched patients who received narcotics alone (Control).

Evaluation of an advanced physical diagnosis course using consumer preferences methods: the nominal group technique.

Background: Current evaluation tools of medical school courses are limited by the scope of questions asked and may not fully engage the student to think on areas to improve. The authors sought to explore whether a technique to study consumer preferences would elicit specific and prioritized information for course evaluation from medical students.

Methods: Using the nominal group technique (4 sessions), 12 senior medical students prioritized and weighed expectations and topics learned in a 100-hour advanced physical diagnosis course (4-week course; February 2012).

Magnetic resonance imaging of hip tumors.

After initial evaluation with radiography, magnetic resonance (MR) imaging is the most common modality used to establish the diagnosis and characterize osseous and soft tissue tumors of the hip. Tumors involving the proximal femur are often benign, and MR imaging can be specific in diagnosing solitary bone cyst, osteochondroma, and chondroblastoma. Benign and malignant soft tissue tumors about the hip are often nonspecific in their MR imaging appearances, but knowledge of the patient's age may direct a more limited differential diagnosis.

Postoperative shoulder magnetic resonance imaging.

Magnetic resonance imaging (MRI) and MR arthrography have proven invaluable for managing the postoperative shoulder, particularly in relation to the rotator cuff and labrum. MRI has proven to be an accurate imaging technique for differentiating expected findings versus complications in the postoperative setting. The transition from metallic hardware to bioabsorbable suture anchors used in orthopedic surgery has rendered less metallic susceptibility artifact over the years, allowing more accurate interpretation of MR images.

PSA mass screening: is there enough evidence?

Prostate cancer plays an important role in widely understood aspects of men's health, and is becoming a growing problem in terms of public life. Prostate cancer is one of the most common neoplasms among men. Male patients can live with prostate cancer for a long time so it is important to offer appropriate males adequate diagnostic tools and treatments.

Factors affecting return of continence 3 months after robot-assisted radical prostatectomy: analysis from a large, prospective data by a single surgeon.

Purpose: In this study we identified preoperative or intraoperative factors responsible for the early return of continence after robot-assisted radical prostatectomy using data from a high volume center.

Materials And Methods: Data from 1,299 patients who underwent robot-assisted radical prostatectomy performed by a single surgeon from January 2008 to June 2010 were collected prospectively and analyzed retrospectively. Patients were categorized according to whether they regained continence (no pad and no urinary leakage) within 3 months and variables were then compared.

Imaging in acute stroke.

Imaging in the acute setting of suspected stroke is an important topic to all emergency physicians, neurologists, neurosurgeons and neuroradiologist. When it comes to imaging, the American College of Radiology (ACR) continually updates its guidelines for imaging pathways through the ACR Appropriateness Criteria.1,2 This article is a general review of the imaging modalities currently used to assess and help guide the treatment of strokes.

Preliminary analysis of the feasibility and safety of salvage robot-assisted radical prostatectomy after radiation failure: multi-institutional perioperative and short-term functional outcomes.

Background And Purpose: Open radical prostatectomy after radiation treatment failure for prostate cancer is associated with significant morbidity. The purpose of the study is to report multi-institutional experiences while performing salvage robot-assisted radical prostatectomy (sRARP).

Patients And Methods: We retrospectively identified 15 patients with biopsy-proven prostate cancer after definitive radiotherapy who underwent sRARP in three academic institutions over a 20-month period.

Pentafecta: a new concept for reporting outcomes of robot-assisted laparoscopic radical prostatectomy.

Background: Widespread use of prostate-specific antigen screening has resulted in younger and healthier men being diagnosed with prostate cancer. Their demands and expectations of surgical intervention are much higher and cannot be adequately addressed with the classic trifecta outcome measures.

Objective: A new and more comprehensive method for reporting outcomes after radical prostatectomy, the pentafecta, is proposed.

Continence, potency and oncological outcomes after robotic-assisted radical prostatectomy: early trifecta results of a high-volume surgeon.

Objective: • To evaluate early trifecta outcomes after robotic-assisted radical prostatectomy (RARP) performed by a high-volume surgeon.

Patients And Methods: • We evaluated prospectively 1100 consecutive patients who underwent RARP performed by one surgeon. In all, 541 men were considered potent before RARP; of these 404 underwent bilateral full nerve sparing and were included in this analysis.

Techniques of nerve-sparing and potency outcomes following robot-assisted laparoscopic prostatectomy.

Purpose: Nerve sparing radical prostatectomy is the gold standard for the treatment of prostate cancer. Over the past decade, more and more surgeons and patients are opting for a robot-assisted procedure. The purpose of this paper is to briefly review different techniques and outcomes of nerve sparing robot assisted laparoscopic prostatectomy (RALP).

Robotic-assisted radical prostatectomy: a review of current outcomes.

With the widespread diffusion of the screening for prostate cancer, the disease has been diagnosed more commonly in the organ-confined stage, and in younger and healthier men. For these patients, radical prostatectomy (RP) is still the standard treatment. In an effort to decrease the morbidity associated with open RP, minimally invasive approaches have been described, including robotic-assisted RP (RALP).