Bipolar transurethral enucleation and resection of the prostate should become the endourological equivalent to open adenomectomy with fewer complications and short convalescence. The technique of bipolar transurethral enucleation and resection of the prostate can be acquired safely with a relatively short learning curve.
Microsurgical subinguinal varicocelectomy (MSV) is generally considered the gold standard nowadays in view of the lower risk of complications and recurrence. To achieve complete ligation of veins while preserving testicular artery (TA) during the procedure remains challenging despite the application of high power optical magnification and micro-Doppler ultrasonography. The use of intraoperative indocyanine green angiography (ICGA) with infrared fluorescence operative micro-scope in MSV potentially lowers the incidence of TA injury and shortens the learning curve of novice surgeons. We present our initial experience in the application of the technique in nine patients and explore the potential of the new adjunct.
Severe hyperglycemia and CT class of EPN are significant risk factors for death. CT is the investigation of choice for correct diagnosis of EPN. Additional intervention should be offered to EPN patients with Wan type 1 and Huang and Tseng class 3 CT features.
Aim:The aim of the present study was to evaluate the feasibility of the use of the video microsurgery platform and fluorescence imaging exoscope system for microsurgical subinguinal varicocoelectomy (MSV) with intraoperative indocyanine green angiography (ICGA). Patients and Methods: Two patients with three varicoceles had MSV and intraoperative ICGA performed in August 2018. A video telescopic operating microscope (VITOM) 3-D system and a VITOM II ICG system were connected to a modular FULL HD IMAGE1 S camera platform. Both telescopes were mounted for convenient positioning and switch between the telescopes. Results: The VITOM 3-D system provided excellent, high-definition image quality and anatomical details necessary for the procedure of MSV. The system offered a more ergonomic working environment for the operating surgeons. The addition of VITOM II ICG system allowed intraoperative ICGA for better identification of the testicular artery. Testicular arteries were clearly identified and preserved. The setup with holding arms and a camera platform facilitated quick switch between the video systems. Conclusions: The procedure of MSV with intraoperative ICGA can be performed efficiently with the utilization of the video microsurgery platform.
Objective: The aim of the present study was to evaluate the feasibility to expand the use of indocyanine green (ICG) to lymphatic-sparing microsurgical subinguinal varicocelectomy (MSV) in addition to ICG angiogram by using video microsurgery platform.Patients and Methods: Seven patients with 12 varicoceles had MSV and intraoperative ICG lymphography performed from July 2019 to February 2020. Intraoperative ICG lymphography was employed to confirm and preserve lymphatics after intra-parenchymal testicular injection of ICG.Results: Lymphatic vessels were clearly identified on ICG lymphography in all varicocele units with intra-parenchymal testicular injection. ICG lymphography did not significantly interfere with the quality of subsequent ICG angiography in the majority of patients. All patients were discharged uneventfully within 24 h after the operation.No complications were reported with a median follow up duration of 9 months.
Conclusions:The use of intraoperative ICG lymphography consistently provides objective assessment of lymphatic vessels during the procedure of MSV.
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