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Objective: To evaluate the feasibility of using a voice-controlled robot Automated Endoscopic System for Optimal Positioning (AESOP) for holding and maneuvering the endoscope in the trans-sphenoidal approach to the pituitary. Design: To compare the manual approach to the voice-activated robotic scope holder in maneuvering the endoscope and resecting pituitary lesions using a two-handed technique. Setting: Robotic laboratory at Louisiana State University Health Sciences Center, Shreveport. Cadavers: Ten fresh cadaver heads. Main Outcome Measures: To determine the feasibility, advantages, and disadvantages of a single neurosurgeon maneuvering the endoscope, visualizing key anatomical features in the sphenoid, and resecting skull base lesions after the approach by an otolaryngologist. Results: The learning curve for utilization of the voice-controlled robotic arm was short. The compact cart with the AESOP took up little space and allowed the standard setup for this procedure. The elimination of the need for manual stabilization of the endoscope permitted the use of both hands for the actual procedure. The elimination of the tremor inherent with holding the endoscope manually allowed the scope to be placed closer to the target organ with fewer collisions. The most significant advantage was the ability of AESOP to save three anatomical positions, which could be returned to with a single voice command. Conclusions: Recently, the endoscopic-endonasal approach to the sella has gained popularity. The voiceactivated robotic scope holder is safe and has several advantages over current

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The purpose of this study was to assess whether regular instillation of urokinase during abscess drainage leads to an improved outcome compared to saline irrigation alone. One hundred patients referred for image-guided abdominal abscess drainage were randomized between thrice daily urokinase instillation or saline irrigation alone. At the end of the study, patient medical records were reviewed to determine drainage, study group, Altona (PIA II) and Mannheim (MPI) scoring, duration of drainage, procedure-related complications, hospital stay duration, and clinical outcome. The technical success rate of the percutaneous abscess drainage was 100%. The success or failure of abscess remission did not differ significantly between groups (success rate of 91.5% in the urokinase group vs. 88.8% in the saline group; failure rate was of 8.5 vs. 21.2%, respectively); however, days of drainage, main hospital stay, and overall costs were significantly reduced in patients treated with urokinase compared to the control group (P < 0.05). No adverse effects from urokinase were observed. Surgical scores were a useful homogeneity factor, and MPI showed a good correlation with prognosis, while PIA results did not have a significant correlation. For drainage of complex abscesses (loculations, hemorrhage, viscous material), fibrinolytics safely accelerate drainage and recovery, reducing the length of the hospital stay and, therefore, the total cost.