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Urology

Find all the surgical interventions, lectures, experts opinions, debates, webinars and operative techniques per specialty.


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Right laparoscopic ureteroureteroplasty
Lower ureteral strictures are commonly managed with ureteral reimplant surgeries. However, some patients still have a good distal ureteral stump, which can be used in the repair of these pathologies. In those cases, reimplant ureteral surgeries and their surgical maneuvers, e.g. psoas hitch, Boari flap, are not the best management options.
This video shows a ureteroureteroplasty in a 37-year-old female patient with ureteral stricture at the level of the crossing iliac vessels due to several previous endoscopic manipulations for the treatment of ureteral/kidney stones.
The ureteroureteroplasty technique was chosen since the proximal and distal parts of the ureter near the stenosed area were healthy.
At the end of the video, preoperative MRI and 1-year follow-up CT urogram 3D reconstructions are placed side by side, demonstrating the resolution of hydronephrosis.
B Lopes-Cançado Machado, V Chamum Costa
Surgical intervention
6 months ago
1196 views
2 likes
0 comments
08:39
Right laparoscopic ureteroureteroplasty
Lower ureteral strictures are commonly managed with ureteral reimplant surgeries. However, some patients still have a good distal ureteral stump, which can be used in the repair of these pathologies. In those cases, reimplant ureteral surgeries and their surgical maneuvers, e.g. psoas hitch, Boari flap, are not the best management options.
This video shows a ureteroureteroplasty in a 37-year-old female patient with ureteral stricture at the level of the crossing iliac vessels due to several previous endoscopic manipulations for the treatment of ureteral/kidney stones.
The ureteroureteroplasty technique was chosen since the proximal and distal parts of the ureter near the stenosed area were healthy.
At the end of the video, preoperative MRI and 1-year follow-up CT urogram 3D reconstructions are placed side by side, demonstrating the resolution of hydronephrosis.
Laparoscopic peritoneal dialysis catheter placement: step by step approach
This is the case of an 87-year-old man with a history of chronic kidney disease stage 5 proposed for dialysis.
The patient had a medical history of diabetes mellitus type 2 over 10 years, hypertension, anemia treated with erythropoietin. The patient was a former smoker.
After explaining to the patient and his family the option between hemodialysis and peritoneal dialysis, the patient opted for the peritoneal one.
He was admitted electively and submitted to 3D laparoscopic peritoneal dialysis catheter placement. The surgery and post-operative period were uneventful. The patient was discharged on postoperative day 2.
F Cabral, J Grenho, R Roque, R Maio
Surgical intervention
1 year ago
1918 views
152 likes
0 comments
06:36
Laparoscopic peritoneal dialysis catheter placement: step by step approach
This is the case of an 87-year-old man with a history of chronic kidney disease stage 5 proposed for dialysis.
The patient had a medical history of diabetes mellitus type 2 over 10 years, hypertension, anemia treated with erythropoietin. The patient was a former smoker.
After explaining to the patient and his family the option between hemodialysis and peritoneal dialysis, the patient opted for the peritoneal one.
He was admitted electively and submitted to 3D laparoscopic peritoneal dialysis catheter placement. The surgery and post-operative period were uneventful. The patient was discharged on postoperative day 2.
Hand-assisted laparoscopic live donor nephrectomy
Introduction and purpose: The shortage of cadaver donor organs and the progressive acceptation of laparoscopic procedures have significantly increased the number of living donor transplants. Laparoscopic nephrectomy has been rapidly and progressively incorporated as a therapeutic option in most hospitals. We describe the current surgical technique for living donor nephrectomy in our hospital.
Materials and methods: A 42-year-old woman with a medical history of hypertension and end-stage renal disease by IgA glomerulonephritis in predialysis program underwent a living donor transplantation. The donor was her sister, a woman aged 51, with no medical past history. We performed a left laparoscopic nephrectomy, and removal of the graft was performed using a hand-assisted device fixed in a supraumbilical 5cm laparotomy.
Results: Hospital stay was 3 days for the donor and 4 days for the receptor. The receptor had a postoperative creatinine of 1.76 mg/dL. In the third year of follow-up creatinine was 1.46 mg/dL.
Conclusions: Laparoscopic donor nephrectomy has proven to be a safe, less invasive, and effective technique for the renal graft. It has encouraged donation from living donors, given its esthetic results and comfort for the donor.
S Valverde-Martinez , A Martin-Parada, A Palacios-Hernandez, O Heredero-Zorzo, P Eguiluz-Lumbreras, J Garcia-Garcia, R Gomez-Zancajo, F Gomez-Veiga
Surgical intervention
1 year ago
1478 views
148 likes
0 comments
08:47
Hand-assisted laparoscopic live donor nephrectomy
Introduction and purpose: The shortage of cadaver donor organs and the progressive acceptation of laparoscopic procedures have significantly increased the number of living donor transplants. Laparoscopic nephrectomy has been rapidly and progressively incorporated as a therapeutic option in most hospitals. We describe the current surgical technique for living donor nephrectomy in our hospital.
Materials and methods: A 42-year-old woman with a medical history of hypertension and end-stage renal disease by IgA glomerulonephritis in predialysis program underwent a living donor transplantation. The donor was her sister, a woman aged 51, with no medical past history. We performed a left laparoscopic nephrectomy, and removal of the graft was performed using a hand-assisted device fixed in a supraumbilical 5cm laparotomy.
Results: Hospital stay was 3 days for the donor and 4 days for the receptor. The receptor had a postoperative creatinine of 1.76 mg/dL. In the third year of follow-up creatinine was 1.46 mg/dL.
Conclusions: Laparoscopic donor nephrectomy has proven to be a safe, less invasive, and effective technique for the renal graft. It has encouraged donation from living donors, given its esthetic results and comfort for the donor.
Laparoscopic omentoplasty to support anastomotic urethroplasty in complex and redo pelvic fracture urethral injury patient
Introduction:
The aim of this film was to test the feasibility, safety and efficiency of a new surgical technique using elaborated perineal anastomotic urethroplasty combined with laparoscopic omentoplasty for patients with complex pelvic fracture and for whom a previous urethral defect repair failed.

Material and methods:
We performed a prospective, observational, stage 2a study to observe treatment outcomes of combined perineal and laparoscopic approaches for urethroplasty in patients with complex and redo pelvic fracture urethral defects at a single center in Pune, India, between January 2012 and January 2013.
Anterior urethral strictures were excluded. The primary aim of the study was to evaluate the efficiency of the surgical technique and the secondary aim was to test the feasibility and safety of the procedure. The procedure was considered as ineffective if any additional postoperative procedure was required.

Results:
Fifteen male patients with a median age of 19 years old were included. Seven patients were adolescents (12-18 years of age) and 8 patients were adults (19-49 years of age). The mean number of prior urethroplasties was 1.8 (1-3). All patients underwent elaborated bulbomembranous anastomosis using a perineal approach with inferior pubectomy combined with laparoscopic mobilization of the omentum into the perineum to wrap the anastomosis.
In 15 patients, 14 (93.3%) had a successful outcome and the procedure failed in 1 patient (6.6%). A 14-year-old boy developed a recurrent stricture 2 months after the procedure, which was managed using an internal urethrotomy. Median follow-up was 18 months (13-24 months).

Conclusion:
Combining a laparoscopic omentoplasty with a membranobulbar anastomosis for complex and redo pelvic fracture urethral injury is a successful, feasible and safe technique, and with minimal additional morbidity for the patient. This technique offers the advantages of a perineal incision and allows to use the omentum in order to facilitate the anastomosis.
S Kulkarni, G Barbagli, J Kulkarni, S Surana, V Batra, P Joshi
Surgical intervention
3 years ago
1200 views
66 likes
0 comments
07:58
Laparoscopic omentoplasty to support anastomotic urethroplasty in complex and redo pelvic fracture urethral injury patient
Introduction:
The aim of this film was to test the feasibility, safety and efficiency of a new surgical technique using elaborated perineal anastomotic urethroplasty combined with laparoscopic omentoplasty for patients with complex pelvic fracture and for whom a previous urethral defect repair failed.

Material and methods:
We performed a prospective, observational, stage 2a study to observe treatment outcomes of combined perineal and laparoscopic approaches for urethroplasty in patients with complex and redo pelvic fracture urethral defects at a single center in Pune, India, between January 2012 and January 2013.
Anterior urethral strictures were excluded. The primary aim of the study was to evaluate the efficiency of the surgical technique and the secondary aim was to test the feasibility and safety of the procedure. The procedure was considered as ineffective if any additional postoperative procedure was required.

Results:
Fifteen male patients with a median age of 19 years old were included. Seven patients were adolescents (12-18 years of age) and 8 patients were adults (19-49 years of age). The mean number of prior urethroplasties was 1.8 (1-3). All patients underwent elaborated bulbomembranous anastomosis using a perineal approach with inferior pubectomy combined with laparoscopic mobilization of the omentum into the perineum to wrap the anastomosis.
In 15 patients, 14 (93.3%) had a successful outcome and the procedure failed in 1 patient (6.6%). A 14-year-old boy developed a recurrent stricture 2 months after the procedure, which was managed using an internal urethrotomy. Median follow-up was 18 months (13-24 months).

Conclusion:
Combining a laparoscopic omentoplasty with a membranobulbar anastomosis for complex and redo pelvic fracture urethral injury is a successful, feasible and safe technique, and with minimal additional morbidity for the patient. This technique offers the advantages of a perineal incision and allows to use the omentum in order to facilitate the anastomosis.
Video endoscopic inguinal lymphadenectomy (VEIL) for penile cancer
This video reports the endoscopic technique used for the dissection of inguinal lymph nodes as complementary treatment for penile cancer.
Laparoscopic surgery has been used in iliac and retroperitoneal lymph nodes approaches, as well as for inguinal nodes dissection (video endoscopic) with fewer sequels and faster recuperation, according to conventional surgery indications.
This technique is indicated in patients presenting with penile cancer, in the following situations:
- after local treatment;
- when there is a lymph node mass less than 4cm;
- when mobile palpable lymph nodes appear in the postoperative follow-up;
- when there are risk factors for the development of inguinal metastasis (clinical stage > T1 or information regarding the initial biopsy such as histological grade > 1, lymphatic or vascular invasion).
This operation is performed bilaterally once.
This technique duplicates the conventional technique principles, promoting a radical resection of inguinal lymph nodes, regarding the reduction of surgical morbidity.
The video demonstrates that this procedure is feasible and safe with encouraging results.
References:

1. Bevan-Thomas R, Slaton JW, Pettaway CA: Contemporary morbidity from lymphadenectomy for penile squamous cell carcinoma: the M.D. Anderson Cancer Center Experience. J Urol 2002;167:1638-42.

2. Barnholtz-Sloan JS, Maldonado JL, Pow-Sang J, Giuliano AR. Incidence trends in primary malignant penile cancer. Urol Oncol 2007;25:361-7.

3. Bishoff JA, Lackland AF, Basler JW, Teichman JM, Thompson IM: Endoscopy subcutaneous modified inguinal lymph node dissection (ESMIL) for squamous cell carcinoma of the penis. J Urol 2003:169;Suppl 4:78.

4. Dardour JC, Ktorza T: Endoscopic deep periorbital lifting: study and results based on 50 consecutive cases. Aesthetic Plast Surg 2000;24:292-8.

5. D’Ancona CA, de Lucena RG, Querne FA, Martins MH, Denardi F, Netto NR Jr: Long-term follow-up of penile carcinoma treated with penectomy and bilateral modified inguinal lymphadenectomy. J Urol 2004;172:498-501;discussion 501.

6. Folliguet TA, Le Bret E, Moneta A, Musumeci S, Laborde F: Endoscopic saphenous vein harvesting versus ‘open’ technique. A prospective study. Eur J Cardiothorac Surg 1998;13:662-6.

7. Horenblas S. Lymphadenectomy for squamous cell carcinoma of the penis. Part 2: the role and technique of lymph node dissection. BJU Int 2001;88:473-83.

8. Hungerhuber E, Schlenken B, Karl A, et al. Risk stratification in penile carcinoma: 25-year experience with surgical inguinal lymph node staging. Urology 2006;68:621-5.

9. Leijte JA, Kroon BK, Valdés Olmos RA, Nieweg OE, Horenblas S. Reliability and safety of current dynamic sentinel node biopsy for penile carcinoma. Eur Urol 2007;52:170-7.

10. Machado MT, Tavares A, Molina Jr WR, Zambon JP, Forsetto Jr P, Juliano RV, Wroclawski ER: Comparative study between videoendoscopic radical inguinal lymphadenectomy (VEIL) and standard open lymphadenectomy for penile cancer: preliminary surgical and oncological results. J Urol 2005;173:226, Abst 834.

11. Ornellas AA, Seixas AL, Marota A, Wisnescky A, Campos F, de Moraes JR. Surgical treatment of invasive squamous cell carcinoma of the penis: retrospective analysis of 350 cases. J Urol 1994;151:1244-9.

12. Hegarty PK, Dinney CP, Pettaway CA. Controversies in Ilioinguinal lymphadenectomy. Urol Clin North Am 2010;37:421-34.

13. Protzel C, Alcaraz A, Horenblas S, Pizzocaro G, Zlotta A, Hakenberg OW. Lymphadenectomy in the surgical management of penile cancer. Eur Urol 2009;55:1075-88.

14. Sotelo R, Sánchez-Salas R, Carmona O, Garcia A, Mariano M, Neiva G, Trujillo G, Novoa J, Cornejo F, Finelli A. Endoscopic lymphadenectomy for penile carcinoma. J Endourol 2007;21:364-7;discussion 367.

15. Tobias-Machado M, Tavares A, Ornellas AA, Molina WR Jr, Juliano RV, Wroclawski ER. Video endoscopic inguinal lymphadenectomy: a new minimally invasive procedure for radical management of inguinal nodes in patients with penile squamous cell carcinoma. J Urol 2007;177:953-7;discussion 958.

16. Velasquez EF, Melamed J, Barreto JE, Aguero F, Cubilla AL. Sarcomatoid carcinoma of the penis. A clinicopathologic study of 15 cases. Am J Surg Pathol 2005;29:1152-8.

17. Master V, Ogan K, Kooby D, Hsiao W, Delman K. Leg endoscopic groin lymphadenectomy (LEG procedure): step-by-step approach to a straightforward technique. Eur Urol 2009;56:821-8.
VE Corona Montes, T Machado, C Fraga, T Piéchaud
Surgical intervention
4 years ago
2604 views
76 likes
0 comments
11:31
Video endoscopic inguinal lymphadenectomy (VEIL) for penile cancer
This video reports the endoscopic technique used for the dissection of inguinal lymph nodes as complementary treatment for penile cancer.
Laparoscopic surgery has been used in iliac and retroperitoneal lymph nodes approaches, as well as for inguinal nodes dissection (video endoscopic) with fewer sequels and faster recuperation, according to conventional surgery indications.
This technique is indicated in patients presenting with penile cancer, in the following situations:
- after local treatment;
- when there is a lymph node mass less than 4cm;
- when mobile palpable lymph nodes appear in the postoperative follow-up;
- when there are risk factors for the development of inguinal metastasis (clinical stage > T1 or information regarding the initial biopsy such as histological grade > 1, lymphatic or vascular invasion).
This operation is performed bilaterally once.
This technique duplicates the conventional technique principles, promoting a radical resection of inguinal lymph nodes, regarding the reduction of surgical morbidity.
The video demonstrates that this procedure is feasible and safe with encouraging results.
References:

1. Bevan-Thomas R, Slaton JW, Pettaway CA: Contemporary morbidity from lymphadenectomy for penile squamous cell carcinoma: the M.D. Anderson Cancer Center Experience. J Urol 2002;167:1638-42.

2. Barnholtz-Sloan JS, Maldonado JL, Pow-Sang J, Giuliano AR. Incidence trends in primary malignant penile cancer. Urol Oncol 2007;25:361-7.

3. Bishoff JA, Lackland AF, Basler JW, Teichman JM, Thompson IM: Endoscopy subcutaneous modified inguinal lymph node dissection (ESMIL) for squamous cell carcinoma of the penis. J Urol 2003:169;Suppl 4:78.

4. Dardour JC, Ktorza T: Endoscopic deep periorbital lifting: study and results based on 50 consecutive cases. Aesthetic Plast Surg 2000;24:292-8.

5. D’Ancona CA, de Lucena RG, Querne FA, Martins MH, Denardi F, Netto NR Jr: Long-term follow-up of penile carcinoma treated with penectomy and bilateral modified inguinal lymphadenectomy. J Urol 2004;172:498-501;discussion 501.

6. Folliguet TA, Le Bret E, Moneta A, Musumeci S, Laborde F: Endoscopic saphenous vein harvesting versus ‘open’ technique. A prospective study. Eur J Cardiothorac Surg 1998;13:662-6.

7. Horenblas S. Lymphadenectomy for squamous cell carcinoma of the penis. Part 2: the role and technique of lymph node dissection. BJU Int 2001;88:473-83.

8. Hungerhuber E, Schlenken B, Karl A, et al. Risk stratification in penile carcinoma: 25-year experience with surgical inguinal lymph node staging. Urology 2006;68:621-5.

9. Leijte JA, Kroon BK, Valdés Olmos RA, Nieweg OE, Horenblas S. Reliability and safety of current dynamic sentinel node biopsy for penile carcinoma. Eur Urol 2007;52:170-7.

10. Machado MT, Tavares A, Molina Jr WR, Zambon JP, Forsetto Jr P, Juliano RV, Wroclawski ER: Comparative study between videoendoscopic radical inguinal lymphadenectomy (VEIL) and standard open lymphadenectomy for penile cancer: preliminary surgical and oncological results. J Urol 2005;173:226, Abst 834.

11. Ornellas AA, Seixas AL, Marota A, Wisnescky A, Campos F, de Moraes JR. Surgical treatment of invasive squamous cell carcinoma of the penis: retrospective analysis of 350 cases. J Urol 1994;151:1244-9.

12. Hegarty PK, Dinney CP, Pettaway CA. Controversies in Ilioinguinal lymphadenectomy. Urol Clin North Am 2010;37:421-34.

13. Protzel C, Alcaraz A, Horenblas S, Pizzocaro G, Zlotta A, Hakenberg OW. Lymphadenectomy in the surgical management of penile cancer. Eur Urol 2009;55:1075-88.

14. Sotelo R, Sánchez-Salas R, Carmona O, Garcia A, Mariano M, Neiva G, Trujillo G, Novoa J, Cornejo F, Finelli A. Endoscopic lymphadenectomy for penile carcinoma. J Endourol 2007;21:364-7;discussion 367.

15. Tobias-Machado M, Tavares A, Ornellas AA, Molina WR Jr, Juliano RV, Wroclawski ER. Video endoscopic inguinal lymphadenectomy: a new minimally invasive procedure for radical management of inguinal nodes in patients with penile squamous cell carcinoma. J Urol 2007;177:953-7;discussion 958.

16. Velasquez EF, Melamed J, Barreto JE, Aguero F, Cubilla AL. Sarcomatoid carcinoma of the penis. A clinicopathologic study of 15 cases. Am J Surg Pathol 2005;29:1152-8.

17. Master V, Ogan K, Kooby D, Hsiao W, Delman K. Leg endoscopic groin lymphadenectomy (LEG procedure): step-by-step approach to a straightforward technique. Eur Urol 2009;56:821-8.
Robotic single site left dismembered pyeloplasty for ureteropelvic junction obstruction
This video demonstrates the surgical steps for a left ureteropelvic junction (UPJ) reconstruction performed by means of the new da Vinci® robotic single site platform.
This surgery can be achieved by a 2cm single incision made in the umbilicus.
The system provides 2 robotic instruments crossing into the trocar in order to have an adequate triangulation. In this set-up, the left robotic instrument is placed into the surgical field on the right side while the right robotic instrument is on the left side of the surgical field. The software of the da Vinci™ system allows for the control of the right robotic arm to the left master into the robotic console in order to have the instrument placed in the right part of the surgical field controlled by the right master. This allows for a direct and natural control of the instruments, hence solving the problem of the crossing of the instruments.
This is a great advantage when compared to standard laparoscopic single site surgery.
F Annino, T Verdacchi, M de Angelis
Surgical intervention
4 years ago
2105 views
49 likes
1 comment
05:40
Robotic single site left dismembered pyeloplasty for ureteropelvic junction obstruction
This video demonstrates the surgical steps for a left ureteropelvic junction (UPJ) reconstruction performed by means of the new da Vinci® robotic single site platform.
This surgery can be achieved by a 2cm single incision made in the umbilicus.
The system provides 2 robotic instruments crossing into the trocar in order to have an adequate triangulation. In this set-up, the left robotic instrument is placed into the surgical field on the right side while the right robotic instrument is on the left side of the surgical field. The software of the da Vinci™ system allows for the control of the right robotic arm to the left master into the robotic console in order to have the instrument placed in the right part of the surgical field controlled by the right master. This allows for a direct and natural control of the instruments, hence solving the problem of the crossing of the instruments.
This is a great advantage when compared to standard laparoscopic single site surgery.
Simultaneous robotic right partial nephrectomy and right adrenalectomy
Robot-assisted partial nephrectomy has become a safe procedure if standardized surgical steps are followed [1]. The same goes for robot-assisted adrenalectomy, with the robot offering the possibility to manage complex cases that are considered technically challenging for traditional laparoscopy [2].
A combined laparoscopic partial nephrectomy and an ipsilateral adrenalectomy have been described for upper pole renal tumors contiguously involving the adrenal gland [3].
In this video, we describe the surgical steps for a simultaneous robotic right partial nephrectomy and right adrenalectomy for two distinct renal and adrenal tumors.
References:
[1] Kaouk JH, Khalifeh A, Hillyer S, Haber GP, Stein RJ, Autorino R. Robot-assisted laparoscopic partial nephrectomy: step-by-step contemporary technique and surgical outcomes at a single high-volume institution. Eur Urol 2012;62:553-61.
[2] D’Annibale A, Lucandri G, Monsellato I, De Angelis M, Pernazza G, Alfano G, Mazzocchi P, Pende V. Robotic adrenalectomy: technical aspects, early results and learning curve. Int J Med Robot 2012;8:483-90.
[3] Ramani AP, Abreu SC, Desai MM, Steinberg AP, Ng C, Lin CH, Kaouk JH, Gill IS. Laparoscopic upper pole partial nephrectomy with concomitant en bloc adrenalectomy. Urology 2003;62:223-6.
D Rey, E El Helou, M Oderda, T Piéchaud
Surgical intervention
5 years ago
5268 views
85 likes
0 comments
13:06
Simultaneous robotic right partial nephrectomy and right adrenalectomy
Robot-assisted partial nephrectomy has become a safe procedure if standardized surgical steps are followed [1]. The same goes for robot-assisted adrenalectomy, with the robot offering the possibility to manage complex cases that are considered technically challenging for traditional laparoscopy [2].
A combined laparoscopic partial nephrectomy and an ipsilateral adrenalectomy have been described for upper pole renal tumors contiguously involving the adrenal gland [3].
In this video, we describe the surgical steps for a simultaneous robotic right partial nephrectomy and right adrenalectomy for two distinct renal and adrenal tumors.
References:
[1] Kaouk JH, Khalifeh A, Hillyer S, Haber GP, Stein RJ, Autorino R. Robot-assisted laparoscopic partial nephrectomy: step-by-step contemporary technique and surgical outcomes at a single high-volume institution. Eur Urol 2012;62:553-61.
[2] D’Annibale A, Lucandri G, Monsellato I, De Angelis M, Pernazza G, Alfano G, Mazzocchi P, Pende V. Robotic adrenalectomy: technical aspects, early results and learning curve. Int J Med Robot 2012;8:483-90.
[3] Ramani AP, Abreu SC, Desai MM, Steinberg AP, Ng C, Lin CH, Kaouk JH, Gill IS. Laparoscopic upper pole partial nephrectomy with concomitant en bloc adrenalectomy. Urology 2003;62:223-6.
Laparoscopic right lymphadenectomy (R-LND) for non-seminomatous testis tumors
This video aims to demonstrate the right side of a laparoscopic technique for the treatment of non-seminomatous testicular germ cell tumors (NSGCT). A laparoscopic left lymphadenectomy (L-LND) was published last October 2012. This video shows the right side which could be reproduced laparoscopically at our urology center. A minimally invasive procedure such as this one can be performed with experience, resulting in a magnified anatomy provided by visual optics. Careful dissection of all vascular structures will provide full access to the templates described for lymph node dissections of this kind of tumor. It is essential to consider that treatment will depend on some parameters such as histology, tumor markers, lymphovascular invasion, and in case surgery is decided upon, the patient’s preference.
References
1. Valero Fuentealba G. [Antegrade ejaculation alter modified lumboaortic laparoscopic lymphadenectomy]. Arch Esp Urol 2008;61:517-20.

2. Castillo OA, Sánchez-Salas R, Secin FP, Campero JM, Foneron A, Vidal-Mora I. Linfadenectomía retroperitoneal laparoscópica primaria para el tumor testicular de células germinales no seminomatoso en estadio clínico I. Actas Urol Esp 2011;35:22-8.
3. Donohue JP, Thornhill JA, Foster RS, Rowland RG, Bihrle R. Primary retroperitoneal lymph node dissection in clinical stage A non-seminomatous germ cell testis cancer. Review of the Indiana University experience 1965-1989. Br J Urol 1993;71:326-35.
4. Yoon GH, Stein JP, Skinner DG. Retroperitoneal lymph node dissection in the treatment of low-stage nonseminomatous germ cell tumors of the testicle: an update. Urol Oncol 2005;23:168-77.

5. Carver BS, Sheinfeld J. The current status of laparoscopic retroperitoneal lymph node dissection for non-seminomatous germ-cell tumors. Nat Clin Pract Urol 2005;2:330-5.

6. Albqami N, Janetschek G. Laparoscopic retroperitoneal lymph-node dissection in the management of clinical stage I and II testicular cancer. J Endourol 2005;19:683-92.

7. Nelson JB, Chen RN, Bishoff JT, Oh WK, Kantoff PW, Donehower RC, Kavoussi LR. Laparoscopic retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell tumors. Urology 1999;54:1064-7.

8. Bhayani SB, Ong A, Oh WK, Kantoff PW, Kavoussi LR. Laparoscopic retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell testicular cancer: a long-term update. Urology 2003;62:324-7.

9. Donohue JP, Zachary JM, Maynard BR. Distribution of nodal metastases in nonseminomatous testis cancer. J Urol 1982;128:315-20.

10. Weissbach L, Boedefeld EA. Localization of solitary and multiple metastases in stage II nonseminomatous testis tumor as basis for a modified staging lymph node dissection in stage I. J Urol 1987;138:77-82.

11. Höltl L, Peschel R, Knapp R, Janetschek G, Steiner H, Hittmair A, Rogatsch H, Bartsch G, Hobisch A. Primary lymphatic metastatic spread in testicular cancer occurs ventral to the lumbar vessels. Urology 2002;59:114-8.

12. Chang SS, Mohseni HF, Leon A, Sheinfeld J. Paracolic recurrence: the importance of wide excision of the spermatic cord at retroperitoneal lymph node dissection. J Urol 2002;167:94-6.

13. Beck SD, Cheng L, Bihrle R, Donohue JP, Foster RS. Does the presence of extranodal extension in pathological stage B1 nonseminomatous germ cell tumor necessitate adjuvant chemotherapy? J Urol 2007;177:944-6.

14. Richie JP. Clinical stage I testicular cancer: the role of modified retroperitoneal lymphadenectomy. J Urol 1990;144:1160-3.

14. Janetschek G, Peschel R, Hobisch A, Bartsch G. Laparoscopic retroperitoneal lymph node dissection. J Endourol 2001;15:449-53.

15. Albqami N, Janetschek G. Laparoscopic retroperitoneal lymph-node dissection in the management of clinical stage I and II testicular cancer. J Endourol 2005;19:683-92.

16. Poulakis V, Skriapas K, de Vries R, Dillenburg W, Ferakis N, Witzsch U, Becht E. Quality of life after laparoscopic and open retroperitoneal lymph node dissection in clinical Stage I nonseminomatous germ cell tumor: a comparison study. Urology 2006;68:154-60.

17. Abdel-Aziz KF, Anderson JK, Svatek R, Margulis V, Sagalowsky AI, Cadeddu JA. Laparoscopic and open retroperitoneal lymph-node dissection for clinical stage I nonseminomatous germ-cell testis tumors. J Endourol 2006;20:627-31.

18. Bhayani SB, Allaf ME, Kavoussi LR. Laparoscopic RPLND for clinical stage I nonseminomatous germ cell testicular cancer: current status. Urol Oncol 2004;22:145-8.

19. Eggener SE, Carver BS, Sharp DS, Motzer RJ, Bosl GJ, Sheinfeld J. Incidence of disease outside modified retroperitoneal lymph node dissection templates in clinical stage I or IIA nonseminomatous germ cell testicular cancer. J Urol 2007;177:937-42.

20. Nielsen ME, Lima G, Schaeffer EM, Porter J, Cadeddu JA, Tuerk I, Kavoussi LR. Oncologic efficacy of laparoscopic RPLND in treatment of clinical stage I nonseminomatous germ cell testicular cancer. Urology 2007;70:1168-72.

21. Valdevenito Sepulveda JP, Merhe Nieva E, Valdevenito Sepulveda R, Cuevas Toro M, Gómez Gallo A, Bermúdez Luna H, Contreras Meléndez L, Gallegos Méndez I, Gallardo Escobar J. Palma Ceppi C. [Reduced retroperitoneal lymphadenectomy for clinical stage I non seminomatous germ cell testicular cancer]. Arch Esp Urol 2007;60:245-54.

22. Neyer M, Peschel R, Akkad T, Springer-Stöhr B, Berger A, Bartsch G, Steiner H. Long-term results of laparoscopic retroperitoneal lymph-node dissection for clinical stage I nonseminomatous germ-cell testicular cancer. J Endourol 2007;21:180-3.
JB Roche, VE Corona Montes, JL Hoepffner, T Piéchaud
Surgical intervention
5 years ago
3653 views
71 likes
0 comments
13:36
Laparoscopic right lymphadenectomy (R-LND) for non-seminomatous testis tumors
This video aims to demonstrate the right side of a laparoscopic technique for the treatment of non-seminomatous testicular germ cell tumors (NSGCT). A laparoscopic left lymphadenectomy (L-LND) was published last October 2012. This video shows the right side which could be reproduced laparoscopically at our urology center. A minimally invasive procedure such as this one can be performed with experience, resulting in a magnified anatomy provided by visual optics. Careful dissection of all vascular structures will provide full access to the templates described for lymph node dissections of this kind of tumor. It is essential to consider that treatment will depend on some parameters such as histology, tumor markers, lymphovascular invasion, and in case surgery is decided upon, the patient’s preference.
References
1. Valero Fuentealba G. [Antegrade ejaculation alter modified lumboaortic laparoscopic lymphadenectomy]. Arch Esp Urol 2008;61:517-20.

2. Castillo OA, Sánchez-Salas R, Secin FP, Campero JM, Foneron A, Vidal-Mora I. Linfadenectomía retroperitoneal laparoscópica primaria para el tumor testicular de células germinales no seminomatoso en estadio clínico I. Actas Urol Esp 2011;35:22-8.
3. Donohue JP, Thornhill JA, Foster RS, Rowland RG, Bihrle R. Primary retroperitoneal lymph node dissection in clinical stage A non-seminomatous germ cell testis cancer. Review of the Indiana University experience 1965-1989. Br J Urol 1993;71:326-35.
4. Yoon GH, Stein JP, Skinner DG. Retroperitoneal lymph node dissection in the treatment of low-stage nonseminomatous germ cell tumors of the testicle: an update. Urol Oncol 2005;23:168-77.

5. Carver BS, Sheinfeld J. The current status of laparoscopic retroperitoneal lymph node dissection for non-seminomatous germ-cell tumors. Nat Clin Pract Urol 2005;2:330-5.

6. Albqami N, Janetschek G. Laparoscopic retroperitoneal lymph-node dissection in the management of clinical stage I and II testicular cancer. J Endourol 2005;19:683-92.

7. Nelson JB, Chen RN, Bishoff JT, Oh WK, Kantoff PW, Donehower RC, Kavoussi LR. Laparoscopic retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell tumors. Urology 1999;54:1064-7.

8. Bhayani SB, Ong A, Oh WK, Kantoff PW, Kavoussi LR. Laparoscopic retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell testicular cancer: a long-term update. Urology 2003;62:324-7.

9. Donohue JP, Zachary JM, Maynard BR. Distribution of nodal metastases in nonseminomatous testis cancer. J Urol 1982;128:315-20.

10. Weissbach L, Boedefeld EA. Localization of solitary and multiple metastases in stage II nonseminomatous testis tumor as basis for a modified staging lymph node dissection in stage I. J Urol 1987;138:77-82.

11. Höltl L, Peschel R, Knapp R, Janetschek G, Steiner H, Hittmair A, Rogatsch H, Bartsch G, Hobisch A. Primary lymphatic metastatic spread in testicular cancer occurs ventral to the lumbar vessels. Urology 2002;59:114-8.

12. Chang SS, Mohseni HF, Leon A, Sheinfeld J. Paracolic recurrence: the importance of wide excision of the spermatic cord at retroperitoneal lymph node dissection. J Urol 2002;167:94-6.

13. Beck SD, Cheng L, Bihrle R, Donohue JP, Foster RS. Does the presence of extranodal extension in pathological stage B1 nonseminomatous germ cell tumor necessitate adjuvant chemotherapy? J Urol 2007;177:944-6.

14. Richie JP. Clinical stage I testicular cancer: the role of modified retroperitoneal lymphadenectomy. J Urol 1990;144:1160-3.

14. Janetschek G, Peschel R, Hobisch A, Bartsch G. Laparoscopic retroperitoneal lymph node dissection. J Endourol 2001;15:449-53.

15. Albqami N, Janetschek G. Laparoscopic retroperitoneal lymph-node dissection in the management of clinical stage I and II testicular cancer. J Endourol 2005;19:683-92.

16. Poulakis V, Skriapas K, de Vries R, Dillenburg W, Ferakis N, Witzsch U, Becht E. Quality of life after laparoscopic and open retroperitoneal lymph node dissection in clinical Stage I nonseminomatous germ cell tumor: a comparison study. Urology 2006;68:154-60.

17. Abdel-Aziz KF, Anderson JK, Svatek R, Margulis V, Sagalowsky AI, Cadeddu JA. Laparoscopic and open retroperitoneal lymph-node dissection for clinical stage I nonseminomatous germ-cell testis tumors. J Endourol 2006;20:627-31.

18. Bhayani SB, Allaf ME, Kavoussi LR. Laparoscopic RPLND for clinical stage I nonseminomatous germ cell testicular cancer: current status. Urol Oncol 2004;22:145-8.

19. Eggener SE, Carver BS, Sharp DS, Motzer RJ, Bosl GJ, Sheinfeld J. Incidence of disease outside modified retroperitoneal lymph node dissection templates in clinical stage I or IIA nonseminomatous germ cell testicular cancer. J Urol 2007;177:937-42.

20. Nielsen ME, Lima G, Schaeffer EM, Porter J, Cadeddu JA, Tuerk I, Kavoussi LR. Oncologic efficacy of laparoscopic RPLND in treatment of clinical stage I nonseminomatous germ cell testicular cancer. Urology 2007;70:1168-72.

21. Valdevenito Sepulveda JP, Merhe Nieva E, Valdevenito Sepulveda R, Cuevas Toro M, Gómez Gallo A, Bermúdez Luna H, Contreras Meléndez L, Gallegos Méndez I, Gallardo Escobar J. Palma Ceppi C. [Reduced retroperitoneal lymphadenectomy for clinical stage I non seminomatous germ cell testicular cancer]. Arch Esp Urol 2007;60:245-54.

22. Neyer M, Peschel R, Akkad T, Springer-Stöhr B, Berger A, Bartsch G, Steiner H. Long-term results of laparoscopic retroperitoneal lymph-node dissection for clinical stage I nonseminomatous germ-cell testicular cancer. J Endourol 2007;21:180-3.
Laparoscopic left lymphadenectomy (L-LND) for non-seminomatous testis tumors
This video demonstrates a laparoscopic technique for the treatment of clinical stage I non-seminomatous testicular germ cell tumors (NSGCT). Dissection could be reproduced laparoscopically at our urology center. The laparoscopic approach is a tool used for pathologic lymph node staging and laparoscopy has provided well-known and proven benefits (mean of hospital stay and bleeding), including minor intraoperative and postoperative complications. Currently, there are several options for clinical stage I NSGCT: surveillance, primary chemotherapy, open retroperitoneal lymph node dissection (RPLND) and laparoscopic retroperitoneal lymph node dissection (L-RPLND), and treatment will depend on some parameters such as histology, tumor markers, lymphovascular invasion, and in case surgery is decided upon, the patient’s preference goes to the procedure.

References
1. Valero Fuentealba G. [Antegrade ejaculation alter modified lumboaortic laparoscopic lymphadenectomy]. Arch Esp Urol 2008;61:517-20.

2. Castillo OA, Sánchez-Salas R, Secin FP, Campero JM, Foneron A, Vidal-Mora I. Linfadenectomía retroperitoneal laparoscópica primaria para el tumor testicular de células germinales no seminomatoso en estadio clínico I. Actas Urol Esp 2011;35:22-8.
3. Donohue JP, Thornhill JA, Foster RS, Rowland RG, Bihrle R. Primary retroperitoneal lymph node dissection in clinical stage A non-seminomatous germ cell testis cancer. Review of the Indiana University experience 1965-1989. Br J Urol 1993;71:326-35.
4. Yoon GH, Stein JP, Skinner DG. Retroperitoneal lymph node dissection in the treatment of low-stage nonseminomatous germ cell tumors of the testicle: an update. Urol Oncol 2005;23:168-77.

5. Carver BS, Sheinfeld J. The current status of laparoscopic retroperitoneal lymph node dissection for non-seminomatous germ-cell tumors. Nat Clin Pract Urol 2005;2:330-5.

6. Albqami N, Janetschek G. Laparoscopic retroperitoneal lymph-node dissection in the management of clinical stage I and II testicular cancer. J Endourol 2005;19:683-92.

7. Nelson JB, Chen RN, Bishoff JT, Oh WK, Kantoff PW, Donehower RC, Kavoussi LR. Laparoscopic retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell tumors. Urology 1999;54:1064-7.

8. Bhayani SB, Ong A, Oh WK, Kantoff PW, Kavoussi LR. Laparoscopic retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell testicular cancer: a long-term update. Urology 2003;62:324-7.

9. Donohue JP, Zachary JM, Maynard BR. Distribution of nodal metastases in nonseminomatous testis cancer. J Urol 1982;128:315-20.

10. Weissbach L, Boedefeld EA. Localization of solitary and multiple metastases in stage II nonseminomatous testis tumor as basis for a modified staging lymph node dissection in stage I. J Urol 1987;138:77-82.

11. Höltl L, Peschel R, Knapp R, Janetschek G, Steiner H, Hittmair A, Rogatsch H, Bartsch G, Hobisch A. Primary lymphatic metastatic spread in testicular cancer occurs ventral to the lumbar vessels. Urology 2002;59:114-8.

12. Chang SS, Mohseni HF, Leon A, Sheinfeld J. Paracolic recurrence: the importance of wide excision of the spermatic cord at retroperitoneal lymph node dissection. J Urol 2002;167:94-6.

13. Beck SD, Cheng L, Bihrle R, Donohue JP, Foster RS. Does the presence of extranodal extension in pathological stage B1 nonseminomatous germ cell tumor necessitate adjuvant chemotherapy? J Urol 2007;177:944-6.

14. Richie JP. Clinical stage I testicular cancer: the role of modified retroperitoneal lymphadenectomy. J Urol 1990;144:1160-3.

14. Janetschek G, Peschel R, Hobisch A, Bartsch G. Laparoscopic retroperitoneal lymph node dissection. J Endourol 2001;15:449-53.

15. Albqami N, Janetschek G. Laparoscopic retroperitoneal lymph-node dissection in the management of clinical stage I and II testicular cancer. J Endourol 2005;19:683-92.

16. Poulakis V, Skriapas K, de Vries R, Dillenburg W, Ferakis N, Witzsch U, Becht E. Quality of life after laparoscopic and open retroperitoneal lymph node dissection in clinical Stage I nonseminomatous germ cell tumor: a comparison study. Urology 2006;68:154-60.

17. Abdel-Aziz KF, Anderson JK, Svatek R, Margulis V, Sagalowsky AI, Cadeddu JA. Laparoscopic and open retroperitoneal lymph-node dissection for clinical stage I nonseminomatous germ-cell testis tumors. J Endourol 2006;20:627-31.

18. Bhayani SB, Allaf ME, Kavoussi LR. Laparoscopic RPLND for clinical stage I nonseminomatous germ cell testicular cancer: current status. Urol Oncol 2004;22:145-8.

19. Eggener SE, Carver BS, Sharp DS, Motzer RJ, Bosl GJ, Sheinfeld J. Incidence of disease outside modified retroperitoneal lymph node dissection templates in clinical stage I or IIA nonseminomatous germ cell testicular cancer. J Urol 2007;177:937-42.

20. Nielsen ME, Lima G, Schaeffer EM, Porter J, Cadeddu JA, Tuerk I, Kavoussi LR. Oncologic efficacy of laparoscopic RPLND in treatment of clinical stage I nonseminomatous germ cell testicular cancer. Urology 2007;70:1168-72.

21. Valdevenito Sepulveda JP, Merhe Nieva E, Valdevenito Sepulveda R, Cuevas Toro M, Gómez Gallo A, Bermúdez Luna H, Contreras Meléndez L, Gallegos Méndez I, Gallardo Escobar J. Palma Ceppi C. [Reduced retroperitoneal lymphadenectomy for clinical stage I non seminomatous germ cell testicular cancer]. Arch Esp Urol 2007;60:245-54.

22. Neyer M, Peschel R, Akkad T, Springer-Stöhr B, Berger A, Bartsch G, Steiner H. Long-term results of laparoscopic retroperitoneal lymph-node dissection for clinical stage I nonseminomatous germ-cell testicular cancer. J Endourol 2007;21:180-3.
JL Hoepffner, JB Roche, VE Corona Montes, T Piéchaud
Surgical intervention
6 years ago
3221 views
51 likes
0 comments
10:37
Laparoscopic left lymphadenectomy (L-LND) for non-seminomatous testis tumors
This video demonstrates a laparoscopic technique for the treatment of clinical stage I non-seminomatous testicular germ cell tumors (NSGCT). Dissection could be reproduced laparoscopically at our urology center. The laparoscopic approach is a tool used for pathologic lymph node staging and laparoscopy has provided well-known and proven benefits (mean of hospital stay and bleeding), including minor intraoperative and postoperative complications. Currently, there are several options for clinical stage I NSGCT: surveillance, primary chemotherapy, open retroperitoneal lymph node dissection (RPLND) and laparoscopic retroperitoneal lymph node dissection (L-RPLND), and treatment will depend on some parameters such as histology, tumor markers, lymphovascular invasion, and in case surgery is decided upon, the patient’s preference goes to the procedure.

References
1. Valero Fuentealba G. [Antegrade ejaculation alter modified lumboaortic laparoscopic lymphadenectomy]. Arch Esp Urol 2008;61:517-20.

2. Castillo OA, Sánchez-Salas R, Secin FP, Campero JM, Foneron A, Vidal-Mora I. Linfadenectomía retroperitoneal laparoscópica primaria para el tumor testicular de células germinales no seminomatoso en estadio clínico I. Actas Urol Esp 2011;35:22-8.
3. Donohue JP, Thornhill JA, Foster RS, Rowland RG, Bihrle R. Primary retroperitoneal lymph node dissection in clinical stage A non-seminomatous germ cell testis cancer. Review of the Indiana University experience 1965-1989. Br J Urol 1993;71:326-35.
4. Yoon GH, Stein JP, Skinner DG. Retroperitoneal lymph node dissection in the treatment of low-stage nonseminomatous germ cell tumors of the testicle: an update. Urol Oncol 2005;23:168-77.

5. Carver BS, Sheinfeld J. The current status of laparoscopic retroperitoneal lymph node dissection for non-seminomatous germ-cell tumors. Nat Clin Pract Urol 2005;2:330-5.

6. Albqami N, Janetschek G. Laparoscopic retroperitoneal lymph-node dissection in the management of clinical stage I and II testicular cancer. J Endourol 2005;19:683-92.

7. Nelson JB, Chen RN, Bishoff JT, Oh WK, Kantoff PW, Donehower RC, Kavoussi LR. Laparoscopic retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell tumors. Urology 1999;54:1064-7.

8. Bhayani SB, Ong A, Oh WK, Kantoff PW, Kavoussi LR. Laparoscopic retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell testicular cancer: a long-term update. Urology 2003;62:324-7.

9. Donohue JP, Zachary JM, Maynard BR. Distribution of nodal metastases in nonseminomatous testis cancer. J Urol 1982;128:315-20.

10. Weissbach L, Boedefeld EA. Localization of solitary and multiple metastases in stage II nonseminomatous testis tumor as basis for a modified staging lymph node dissection in stage I. J Urol 1987;138:77-82.

11. Höltl L, Peschel R, Knapp R, Janetschek G, Steiner H, Hittmair A, Rogatsch H, Bartsch G, Hobisch A. Primary lymphatic metastatic spread in testicular cancer occurs ventral to the lumbar vessels. Urology 2002;59:114-8.

12. Chang SS, Mohseni HF, Leon A, Sheinfeld J. Paracolic recurrence: the importance of wide excision of the spermatic cord at retroperitoneal lymph node dissection. J Urol 2002;167:94-6.

13. Beck SD, Cheng L, Bihrle R, Donohue JP, Foster RS. Does the presence of extranodal extension in pathological stage B1 nonseminomatous germ cell tumor necessitate adjuvant chemotherapy? J Urol 2007;177:944-6.

14. Richie JP. Clinical stage I testicular cancer: the role of modified retroperitoneal lymphadenectomy. J Urol 1990;144:1160-3.

14. Janetschek G, Peschel R, Hobisch A, Bartsch G. Laparoscopic retroperitoneal lymph node dissection. J Endourol 2001;15:449-53.

15. Albqami N, Janetschek G. Laparoscopic retroperitoneal lymph-node dissection in the management of clinical stage I and II testicular cancer. J Endourol 2005;19:683-92.

16. Poulakis V, Skriapas K, de Vries R, Dillenburg W, Ferakis N, Witzsch U, Becht E. Quality of life after laparoscopic and open retroperitoneal lymph node dissection in clinical Stage I nonseminomatous germ cell tumor: a comparison study. Urology 2006;68:154-60.

17. Abdel-Aziz KF, Anderson JK, Svatek R, Margulis V, Sagalowsky AI, Cadeddu JA. Laparoscopic and open retroperitoneal lymph-node dissection for clinical stage I nonseminomatous germ-cell testis tumors. J Endourol 2006;20:627-31.

18. Bhayani SB, Allaf ME, Kavoussi LR. Laparoscopic RPLND for clinical stage I nonseminomatous germ cell testicular cancer: current status. Urol Oncol 2004;22:145-8.

19. Eggener SE, Carver BS, Sharp DS, Motzer RJ, Bosl GJ, Sheinfeld J. Incidence of disease outside modified retroperitoneal lymph node dissection templates in clinical stage I or IIA nonseminomatous germ cell testicular cancer. J Urol 2007;177:937-42.

20. Nielsen ME, Lima G, Schaeffer EM, Porter J, Cadeddu JA, Tuerk I, Kavoussi LR. Oncologic efficacy of laparoscopic RPLND in treatment of clinical stage I nonseminomatous germ cell testicular cancer. Urology 2007;70:1168-72.

21. Valdevenito Sepulveda JP, Merhe Nieva E, Valdevenito Sepulveda R, Cuevas Toro M, Gómez Gallo A, Bermúdez Luna H, Contreras Meléndez L, Gallegos Méndez I, Gallardo Escobar J. Palma Ceppi C. [Reduced retroperitoneal lymphadenectomy for clinical stage I non seminomatous germ cell testicular cancer]. Arch Esp Urol 2007;60:245-54.

22. Neyer M, Peschel R, Akkad T, Springer-Stöhr B, Berger A, Bartsch G, Steiner H. Long-term results of laparoscopic retroperitoneal lymph-node dissection for clinical stage I nonseminomatous germ-cell testicular cancer. J Endourol 2007;21:180-3.
Robotic-assisted bladder neck reconstruction using the Goebell-Stoeckel technique and Mitrofanoff appendicovesicostomy
This video reports our experience with robotic bladder neck reconstruction using the Goebell Stoeckel technique and Mitrofanoff appendicovesicostomy.
It is the case of a 62-year-old woman who initially had her urinary stress incontinence treated with a suburethral sling that resulted in the migration of the prosthetic material in the urethra. After prosthesis removal, two attempts of suburethral slings and an attempt at balloon implantation also resulted in erosions and migration of the prosthetic material.
We recommend a continent derivation according to Mitrofanoff principles along with a suburethral autologous sling using Goebell Stoeckel technique.
The video demonstrates that this procedure is feasible and safe with encouraging results.
D Rey, R Mazloum, VE Corona Montes, T Piéchaud
Surgical intervention
6 years ago
1782 views
21 likes
1 comment
14:36
Robotic-assisted bladder neck reconstruction using the Goebell-Stoeckel technique and Mitrofanoff appendicovesicostomy
This video reports our experience with robotic bladder neck reconstruction using the Goebell Stoeckel technique and Mitrofanoff appendicovesicostomy.
It is the case of a 62-year-old woman who initially had her urinary stress incontinence treated with a suburethral sling that resulted in the migration of the prosthetic material in the urethra. After prosthesis removal, two attempts of suburethral slings and an attempt at balloon implantation also resulted in erosions and migration of the prosthetic material.
We recommend a continent derivation according to Mitrofanoff principles along with a suburethral autologous sling using Goebell Stoeckel technique.
The video demonstrates that this procedure is feasible and safe with encouraging results.
Laparoscopic augmentation enterocystoplasty and Mitrofanoff for neurogenic bladder
As a complementary video to the Mitrofanoff technique, we present the case of a patient with neurogenic bladder secondary to spina bifida. This video demonstrates augmentation ileocystoplasty complementary to Mitrofanoff appendicovesicostomy performed laparoscopically. Preoperative bowel preparation was not performed. Average operative time was 4.30 hours. This video shows that it is a safe, feasible and effective laparoscopic procedure with shorter recovery time and good cosmesis.

References:
1. Bagrodia A,Gargollo P. Robot-assisted bladder neck reconstruction, bladder neck sling, and appendicovesicostomy in children: description of technique and initial results. J Endourol 2011:25;8:1299-305.
2. Farrugia MK, Malone PS. Educational article: The Mitrofanoff procedure. J Pediatr Urol 2010;6:330-7.
3. Berkowitz J, North AC, Tripp R, Gearhart JP, Laksmanan Y. Mitrofanoff continent catheterizable conduits: top down or bottom up? J Pediatr Urol 2009;5:122-5.
4. Arango Rave ME, Lince Varela LF, Salazar Sanín C, Hoyos Figueroa FC, Hurtado SN, Rendón Isaza JC. [Outcomes the Mitrofanoff technique in the management of patients with neurogenic bladder: the experience in the San Vicente de Paul Universitary Hospital]. Actas Urol Esp 2009;33:69-75.
5. Gundeti MS, Eng MK, Reynolds WS, Zagaja GP. Pediatric robotic-assisted laparoscopic augmentation ileocystoplasty and Mitrofanoff appendicovesicostomy: complete intracorporeal--initial case report. Urology 2008;72:1144-7.
6. Thakre AA, Yeung CK, Peters C. Robot-assisted Mitrofanoff and Malone antegrade continence enema reconstruction using divided appendix. J Endourol 2008;22:2393-6.
7. Sahadevan K, Pickard RS, Neal DE, Hasan TS. Is continent diversion using the Mitrofanoff principle a viable long-term option for adults requiring bladder replacement? BJU Int 2008;102:236-40.
8. Lendvay TS, Shnorhavorian M, Grady RW. Robotic-assisted laparoscopic Mitrofanoff appendicovesicostomy and antegrade continent enema colon tube creation in a pediatric spina bifida patient. J Laparoendosc Adv Surg Tech A 2008;18:310-2.
9. Mhiri MN, Bahloul A, Chabchoub K. [Mitrofanoff appendicovesicostomy in children: indication and results]. Prog Urol 2007;17:245-9.
10. Leslie JA, Dussinger AM, Meldrum KK. Creation of continence mechanisms (Mitrofanoff) without appendix: the Monti and spiral Monti procedures. Urol Oncol 2007;25:148-53.
11. Basavaraj DR, Harrison SC. The Mitrofanoff procedure in the management of intractable incontinence: a critical appraisal. Curr Opin Urol 2006;16:244-7.
12. Wille MA, Zagaja GP, Shalhav AL, Gundeti MS. Continence outcomes in patients undergoing robotic assisted laparoscopic mitrofanoff appendicovesicostomy. J Urol 2011;185:1438-43.
13. Wille MA,Jayram G,Gundeti MS Feasibility and early outcomes of robotic-assisted laparoscopic Mitrofanoffappendicovesicostomy in patients with prune belly syndrome BJU Int 2012;109:1:125-9.
14. Gundeti MS, Acharya SS, Zagaja GP, Shalhav AL. Paediatric robotic-assisted laparoscopic augmentation ileocystoplasty and Mitrofanoff appendicovesicostomy (RALIMA): feasibility of and initial experience with the University of Chicago technique. BJU Int 2011;107:962-9.
15. Chabchoub K, Ketata H, Fakhfakh H, Bahloul A, Mhiri MN. [Continent urinary diversion (Mitrofanoff principle). Physical mechanisms and urodynamic explanation of continence]. Prog Urol 2008;18:120-4.
16. Karsenty G, Chartier-Kastler E, Mozer P, Even-Schneider A, Denys P, Richard F. A novel technique to achieve cutaneous continent urinary diversion in spinal cord-injured patients unable to catheterize through native urethra. Spinal Cord 2008;46:305-10.
17. Nguyen HT, Passerotti CC, Penna FJ, Retik AB, Peters CA. Robotic assisted laparoscopic Mitrofanoff appendicovesicostomy: preliminary experience in a pediatric population. J Urol 2009;182:1528-34.
18. Vian E, Soustelle L, Viale S, Costa P. [A technique of continent vesicostomy with ileocystoplasty: study of 32 patients]. Prog Urol 2009;19:116-21.
19. Hsu TH, Shortliffe LD. Laparoscopic Mitrofanoff appendicovesicostomy. Urology 2004;64:802-4.
D Rey, VE Corona Montes, T Piéchaud
Surgical intervention
6 years ago
1948 views
31 likes
0 comments
09:45
Laparoscopic augmentation enterocystoplasty and Mitrofanoff for neurogenic bladder
As a complementary video to the Mitrofanoff technique, we present the case of a patient with neurogenic bladder secondary to spina bifida. This video demonstrates augmentation ileocystoplasty complementary to Mitrofanoff appendicovesicostomy performed laparoscopically. Preoperative bowel preparation was not performed. Average operative time was 4.30 hours. This video shows that it is a safe, feasible and effective laparoscopic procedure with shorter recovery time and good cosmesis.

References:
1. Bagrodia A,Gargollo P. Robot-assisted bladder neck reconstruction, bladder neck sling, and appendicovesicostomy in children: description of technique and initial results. J Endourol 2011:25;8:1299-305.
2. Farrugia MK, Malone PS. Educational article: The Mitrofanoff procedure. J Pediatr Urol 2010;6:330-7.
3. Berkowitz J, North AC, Tripp R, Gearhart JP, Laksmanan Y. Mitrofanoff continent catheterizable conduits: top down or bottom up? J Pediatr Urol 2009;5:122-5.
4. Arango Rave ME, Lince Varela LF, Salazar Sanín C, Hoyos Figueroa FC, Hurtado SN, Rendón Isaza JC. [Outcomes the Mitrofanoff technique in the management of patients with neurogenic bladder: the experience in the San Vicente de Paul Universitary Hospital]. Actas Urol Esp 2009;33:69-75.
5. Gundeti MS, Eng MK, Reynolds WS, Zagaja GP. Pediatric robotic-assisted laparoscopic augmentation ileocystoplasty and Mitrofanoff appendicovesicostomy: complete intracorporeal--initial case report. Urology 2008;72:1144-7.
6. Thakre AA, Yeung CK, Peters C. Robot-assisted Mitrofanoff and Malone antegrade continence enema reconstruction using divided appendix. J Endourol 2008;22:2393-6.
7. Sahadevan K, Pickard RS, Neal DE, Hasan TS. Is continent diversion using the Mitrofanoff principle a viable long-term option for adults requiring bladder replacement? BJU Int 2008;102:236-40.
8. Lendvay TS, Shnorhavorian M, Grady RW. Robotic-assisted laparoscopic Mitrofanoff appendicovesicostomy and antegrade continent enema colon tube creation in a pediatric spina bifida patient. J Laparoendosc Adv Surg Tech A 2008;18:310-2.
9. Mhiri MN, Bahloul A, Chabchoub K. [Mitrofanoff appendicovesicostomy in children: indication and results]. Prog Urol 2007;17:245-9.
10. Leslie JA, Dussinger AM, Meldrum KK. Creation of continence mechanisms (Mitrofanoff) without appendix: the Monti and spiral Monti procedures. Urol Oncol 2007;25:148-53.
11. Basavaraj DR, Harrison SC. The Mitrofanoff procedure in the management of intractable incontinence: a critical appraisal. Curr Opin Urol 2006;16:244-7.
12. Wille MA, Zagaja GP, Shalhav AL, Gundeti MS. Continence outcomes in patients undergoing robotic assisted laparoscopic mitrofanoff appendicovesicostomy. J Urol 2011;185:1438-43.
13. Wille MA,Jayram G,Gundeti MS Feasibility and early outcomes of robotic-assisted laparoscopic Mitrofanoffappendicovesicostomy in patients with prune belly syndrome BJU Int 2012;109:1:125-9.
14. Gundeti MS, Acharya SS, Zagaja GP, Shalhav AL. Paediatric robotic-assisted laparoscopic augmentation ileocystoplasty and Mitrofanoff appendicovesicostomy (RALIMA): feasibility of and initial experience with the University of Chicago technique. BJU Int 2011;107:962-9.
15. Chabchoub K, Ketata H, Fakhfakh H, Bahloul A, Mhiri MN. [Continent urinary diversion (Mitrofanoff principle). Physical mechanisms and urodynamic explanation of continence]. Prog Urol 2008;18:120-4.
16. Karsenty G, Chartier-Kastler E, Mozer P, Even-Schneider A, Denys P, Richard F. A novel technique to achieve cutaneous continent urinary diversion in spinal cord-injured patients unable to catheterize through native urethra. Spinal Cord 2008;46:305-10.
17. Nguyen HT, Passerotti CC, Penna FJ, Retik AB, Peters CA. Robotic assisted laparoscopic Mitrofanoff appendicovesicostomy: preliminary experience in a pediatric population. J Urol 2009;182:1528-34.
18. Vian E, Soustelle L, Viale S, Costa P. [A technique of continent vesicostomy with ileocystoplasty: study of 32 patients]. Prog Urol 2009;19:116-21.
19. Hsu TH, Shortliffe LD. Laparoscopic Mitrofanoff appendicovesicostomy. Urology 2004;64:802-4.
Robot-assisted cystoprostatectomy with intracorporeal urinary diversion using a Hautmann technique
It is the case of a 62-year-old man diagnosed with a T2bN0M0 transitional cell adenocarcinoma, which was evidenced by pathological findings after resection of a bladder tumor.
Seven ports are required prior to the installation of the DaVinci® robotic system:
- 12mm port on superior border of umbilicus.
- Right robotic port at the midline between anterior superior iliac spine and umbilicus. - Two 5mm ports on both sides of right robotic port.
- Additional 12mm port between the two 5mm ports once dissection of bladder pedicles has been started.
- Two left robotic ports in left iliac fossa and anterior axillary line.
This video demonstrates the cystoprostatectomy technique with a W-pouch intracorporeal neobladder (Hautmann ileal neobladder), which is feasible in specialized centers.
References:
1. Kaufman DS, Shipley WU, Feldman AS. Bladder cancer. Lancet 2009;374(9685):239-49.
2. Lee DJ, Rothberg MB, McKiernan JM, Benson MC, Badani KK. Robot-assisted radical cystoprostatectomy in complex surgical patients: single institution report. Can J Urol 2009;16(3):4664-9.
3. Tunuguntla HS, Nieder AM, Manoharan M. Neobladder reconstruction following radical cystoprostatectomy for invasive bladder cancer. Minerva Urol Nefrol 2009;61(1):41-54.
4. Barocas DA, Patel SG, Chang SS, Clark PE, Smith JA Jr, Cookson MS. Outcomes of patients undergoing radical cystroprostatectomy for bladder cancer with prostatic involvement on final pathology. BJU Int 2009;104(8):1091-7.
5. Pruthi RS, Stefaniak H, Hubbard JS, Wallen EM. Robotic anterior pelvic exenteration for bladder cancer in the female: outcomes and comparisons to their male counterparts. J Laparoendosc Adv Surg Tech A 2009;19(1):23-7.
6. Kefer JC, Campbell SC. Current status of prostate-sparing cystectomy. Urol Oncol 2008;26(5):486-93.
7. Rawal S, Raghunath SK, Khanna S, Jain D, Kaul R, Kumar P, Chhabra R, Brushan K. Minilaparotomy radical cystoprostatectomy (Minilap RCP) in the surgical management of urinary bladder carcinoma: early experience. Jpn J Clin Oncol 2008;38(9):611-6.
8. Park SY, Cho KS, Ham WS, Choi HM, Hong SJ, Rha KH. Robot-assisted laparoscopic radical cystoprostatectomy with ileal conduit urinary diversion: initial experience in Korea. J Laparoendosc Adv Surg Tech A 2008;18(3):401-4.
9. Gregori A, Galli S, Goumas I, Scieri F, Stener S, Gaboardi F. A cost comparison of laparoscopic versus open radical cystoprostatectomy and orthotopic ileal neobladder at a single institution. Arch Ital Urol Androl 2007;79(3):127-9.
10. Young JL, Finley DS, Ornstein DD. Robotic-assisted laparoscopic cystoprostatectomy for prostatic carcinosarcoma. JSLS 2007;11(1)109-
12.
11. Nuñez-Mora C, Cabrera P, Garcia-Mediero JM, de Fata FR, Gonzalez J, Angulo J. Laparoscopic radical cystectomy and orthotopic urinary diversion in the malepatient: technique. Arch Esp Urol 2011;64(3):195-206.
12. Rehman J, Sangalli MN, Guru K, de Naeyer G, Schatteman P, Carpentier P, Mottrie A. Total intracorporeal robot-assisted laparoscopic ileal conduit (Bricker) urinary diversion: technique and outcomes. Can J Urol 2011;18(1):5548-56.
13. Canda AE, Asil E, Balbay MD. An unexpected resident in the ileum detected during robot-assisted laparoscopic radical cystoprostatectomy and intracorporeal Studer pouch formation: Taenia saginata parasite. J Endourol 2011;25(2):301-3.
14. Lin T, Huang J, Han J, Xu K, Huang H, Jiang C, Liu H, Zhang C, Yao Y, Xie W, Shah AK, Huang L. Hybrid laparoscopic endoscopic single-site surgery for radical cystoprostatectomy and orthotopic ileal neobladder: an initial experience of 12 cases. J Endourol 2011;25(1):57-63.
15. Josephson DY, Chen JA, Chan KG, Lau CS, Nelson RA, Wilson TG. Robotic-assisted laparoscopic radical cystoprostatectomy and extracorporeal continent urinary diversion: highlight of surgical techniques and outcomes. Int J Med Robot 2010;6(3):315-23.
16. Kasraeian A, Barret E, Cathelineau X, Rozet F, Galiano M, Sánchez-Salas R, Vallancien G. Robot-assisted laparoscopic cystoprostatectomy with extended pelvic lymphadenectomy, extracorporeal enterocystoplasty, and intracorporeal enterourethral anastomosis: initial Montsouris Experience. J Endourol 2010;24(3):409-13.
17. Varinot J, Camparo P, Roupret M, Bitker MO, Capron F, Cussenot O, Witjes JA, Compérat E. Full analysis of the prostatic urethra at the time of radical cystoprostatectomy for bladder cancer: impact on final disease stage. Virchows Arch 2009;455(5):449-53.
18. Palou Redorta J, Gaya Sopena JM, Gausa Gascon K, Sanchez-Martin F, Rosales Bordes A, Rodriguez Faba O, Villavicencio Mavrich H. Robotic radical cystoprostatectomy: oncological and functional analysis. Actas Urol Esp 2009;33(7):759-66.
D Rey, VE Corona Montes, T Piéchaud
Surgical intervention
6 years ago
4696 views
99 likes
0 comments
10:22
Robot-assisted cystoprostatectomy with intracorporeal urinary diversion using a Hautmann technique
It is the case of a 62-year-old man diagnosed with a T2bN0M0 transitional cell adenocarcinoma, which was evidenced by pathological findings after resection of a bladder tumor.
Seven ports are required prior to the installation of the DaVinci® robotic system:
- 12mm port on superior border of umbilicus.
- Right robotic port at the midline between anterior superior iliac spine and umbilicus. - Two 5mm ports on both sides of right robotic port.
- Additional 12mm port between the two 5mm ports once dissection of bladder pedicles has been started.
- Two left robotic ports in left iliac fossa and anterior axillary line.
This video demonstrates the cystoprostatectomy technique with a W-pouch intracorporeal neobladder (Hautmann ileal neobladder), which is feasible in specialized centers.
References:
1. Kaufman DS, Shipley WU, Feldman AS. Bladder cancer. Lancet 2009;374(9685):239-49.
2. Lee DJ, Rothberg MB, McKiernan JM, Benson MC, Badani KK. Robot-assisted radical cystoprostatectomy in complex surgical patients: single institution report. Can J Urol 2009;16(3):4664-9.
3. Tunuguntla HS, Nieder AM, Manoharan M. Neobladder reconstruction following radical cystoprostatectomy for invasive bladder cancer. Minerva Urol Nefrol 2009;61(1):41-54.
4. Barocas DA, Patel SG, Chang SS, Clark PE, Smith JA Jr, Cookson MS. Outcomes of patients undergoing radical cystroprostatectomy for bladder cancer with prostatic involvement on final pathology. BJU Int 2009;104(8):1091-7.
5. Pruthi RS, Stefaniak H, Hubbard JS, Wallen EM. Robotic anterior pelvic exenteration for bladder cancer in the female: outcomes and comparisons to their male counterparts. J Laparoendosc Adv Surg Tech A 2009;19(1):23-7.
6. Kefer JC, Campbell SC. Current status of prostate-sparing cystectomy. Urol Oncol 2008;26(5):486-93.
7. Rawal S, Raghunath SK, Khanna S, Jain D, Kaul R, Kumar P, Chhabra R, Brushan K. Minilaparotomy radical cystoprostatectomy (Minilap RCP) in the surgical management of urinary bladder carcinoma: early experience. Jpn J Clin Oncol 2008;38(9):611-6.
8. Park SY, Cho KS, Ham WS, Choi HM, Hong SJ, Rha KH. Robot-assisted laparoscopic radical cystoprostatectomy with ileal conduit urinary diversion: initial experience in Korea. J Laparoendosc Adv Surg Tech A 2008;18(3):401-4.
9. Gregori A, Galli S, Goumas I, Scieri F, Stener S, Gaboardi F. A cost comparison of laparoscopic versus open radical cystoprostatectomy and orthotopic ileal neobladder at a single institution. Arch Ital Urol Androl 2007;79(3):127-9.
10. Young JL, Finley DS, Ornstein DD. Robotic-assisted laparoscopic cystoprostatectomy for prostatic carcinosarcoma. JSLS 2007;11(1)109-
12.
11. Nuñez-Mora C, Cabrera P, Garcia-Mediero JM, de Fata FR, Gonzalez J, Angulo J. Laparoscopic radical cystectomy and orthotopic urinary diversion in the malepatient: technique. Arch Esp Urol 2011;64(3):195-206.
12. Rehman J, Sangalli MN, Guru K, de Naeyer G, Schatteman P, Carpentier P, Mottrie A. Total intracorporeal robot-assisted laparoscopic ileal conduit (Bricker) urinary diversion: technique and outcomes. Can J Urol 2011;18(1):5548-56.
13. Canda AE, Asil E, Balbay MD. An unexpected resident in the ileum detected during robot-assisted laparoscopic radical cystoprostatectomy and intracorporeal Studer pouch formation: Taenia saginata parasite. J Endourol 2011;25(2):301-3.
14. Lin T, Huang J, Han J, Xu K, Huang H, Jiang C, Liu H, Zhang C, Yao Y, Xie W, Shah AK, Huang L. Hybrid laparoscopic endoscopic single-site surgery for radical cystoprostatectomy and orthotopic ileal neobladder: an initial experience of 12 cases. J Endourol 2011;25(1):57-63.
15. Josephson DY, Chen JA, Chan KG, Lau CS, Nelson RA, Wilson TG. Robotic-assisted laparoscopic radical cystoprostatectomy and extracorporeal continent urinary diversion: highlight of surgical techniques and outcomes. Int J Med Robot 2010;6(3):315-23.
16. Kasraeian A, Barret E, Cathelineau X, Rozet F, Galiano M, Sánchez-Salas R, Vallancien G. Robot-assisted laparoscopic cystoprostatectomy with extended pelvic lymphadenectomy, extracorporeal enterocystoplasty, and intracorporeal enterourethral anastomosis: initial Montsouris Experience. J Endourol 2010;24(3):409-13.
17. Varinot J, Camparo P, Roupret M, Bitker MO, Capron F, Cussenot O, Witjes JA, Compérat E. Full analysis of the prostatic urethra at the time of radical cystoprostatectomy for bladder cancer: impact on final disease stage. Virchows Arch 2009;455(5):449-53.
18. Palou Redorta J, Gaya Sopena JM, Gausa Gascon K, Sanchez-Martin F, Rosales Bordes A, Rodriguez Faba O, Villavicencio Mavrich H. Robotic radical cystoprostatectomy: oncological and functional analysis. Actas Urol Esp 2009;33(7):759-66.
Single incision right nephrectomy for severe hydrophrenosis in a transplanted patient
Laparoscopy is becoming the "gold standard" approach for nephrectomy when treating different benign and malignant diseases as well as for living donor transplantation.
During the last few months in both experimental and clinical settings, new techniques such as Natural Orifice Transluminal Endoscopic Surgery (NOTES™) and Single Incision Laparoscopic Surgery (SILS) or Single Port Laparoscopic Surgery (SPLS) have been attempted in order to reduce even more the surgical trauma in laparo-endoscopic procedures.
SPLS allows to perform different surgical procedures using the umbilicus as the only site to access the abdominal cavity and, by using special trocars and instruments, to perform the operation using the same techniques and principles of standard laparoscopic surgery.
The video describes our personal technique for totally single incision right nephrectomy for severe hydronephrosis in a patient who has undergone a kidney transplant a few years earlier.
A 62-year-old patient underwent a kidney transplant 5 years earlier due to a renal failure caused by a glomerular nephritis. The native kidneys were left in place.
Several admissions of patients presenting with recurrent sepsis were reported to the infectious disease department.
Recurrent sepsis was likely to be caused by the hydronephrosis induced by a large stone located in the middle part of the ureter.
The abdominal MRI showed the severe hydronephrosis of the native right kidney as well as a large stone.
A single incision nephrectomy was performed with no complications and the patient’s postoperative course was uneventful.
L Boni, G Dionigi, E Cassinotti, M Di Giuseppe, E Colombo, L Giavarini, SM Tenconi, F Cantore, M Tozzi, R Dionigi
Surgical intervention
8 years ago
3802 views
34 likes
0 comments
10:10
Single incision right nephrectomy for severe hydrophrenosis in a transplanted patient
Laparoscopy is becoming the "gold standard" approach for nephrectomy when treating different benign and malignant diseases as well as for living donor transplantation.
During the last few months in both experimental and clinical settings, new techniques such as Natural Orifice Transluminal Endoscopic Surgery (NOTES™) and Single Incision Laparoscopic Surgery (SILS) or Single Port Laparoscopic Surgery (SPLS) have been attempted in order to reduce even more the surgical trauma in laparo-endoscopic procedures.
SPLS allows to perform different surgical procedures using the umbilicus as the only site to access the abdominal cavity and, by using special trocars and instruments, to perform the operation using the same techniques and principles of standard laparoscopic surgery.
The video describes our personal technique for totally single incision right nephrectomy for severe hydronephrosis in a patient who has undergone a kidney transplant a few years earlier.
A 62-year-old patient underwent a kidney transplant 5 years earlier due to a renal failure caused by a glomerular nephritis. The native kidneys were left in place.
Several admissions of patients presenting with recurrent sepsis were reported to the infectious disease department.
Recurrent sepsis was likely to be caused by the hydronephrosis induced by a large stone located in the middle part of the ureter.
The abdominal MRI showed the severe hydronephrosis of the native right kidney as well as a large stone.
A single incision nephrectomy was performed with no complications and the patient’s postoperative course was uneventful.