We suggest an isosceles triangle between the instruments with an angle between 25 degrees and 45 degrees and an angle of <55 degrees between the instruments and the horizontal line as the optimal geometry for intracorporeal suturing. These data should be considered when planning a reconstructive laparoscopic procedure (i.e., alignment of trocars, table position). However, further studies are required to confirm these preliminary results.
Our preliminary results with a response rate of 59% with ESWT for Peyronie's disease, including a 17% complete remission rate, is encouraging. However, further multicenter studies will have to prove if ESWT is a real therapeutic option for this disease.
Introduction: The purpose of this study was to present our long-term experience of retroperitoneal laparoscopic decortication (RLD) for patients with severely symptomatic simple renal cysts. The feasibility, safety and efficacy of this technique is reported, along with immediate and long-term clinical outcomes. Materials and Methods: Over a 6-year period, 22 consecutive patients with symptomatic simple renal cysts underwent RLD by a single surgeon. Demographic data, perioperative blood loss, length of operative procedure, length of hospital stay and complications were analyzed. Follow-up included clinical review and renal ultrasonography, at 6-monthly intervals for 1 year, and then annually. Results: The mean patient age was 45 (range 31–63) years. RLD was successfully performed in all 22 patients – no open conversions were required. There was no mortality and there were no perioperative complications. Mean duration of surgery was 101.9 min (59–117 min) and operative blood loss was <150 ml in all cases (10–150 ml). Mean length of hospital stay was 3.2 (2–6) days and return to normal activities was achieved after a mean of 15 (10–30) days. At a mean follow-up of 60 (22–93) months, 17 patients (77%) were completely relieved of symptoms, while 5 (23%) patients complained of some pain not requiring any analgesia. Renal ultrasonography showed an absence of radiological recurrence of the symptomatic renal cyst in all cases. Conclusion: RLD is a safe and effective method to treat symptomatic renal cysts, with an immediate postoperative symptomatic relief, a short convalescence period and effective 5-year clinical and radiological outcome.
Obesity forms a growing challenge in medicine worldwide. In Jordan, the obese and the overweight population form 49.7% of the total population. The latest national male to female ratio in Jordan is 1:1.06. There is a relation between obesity and renal stone formation. This study is conducted to study the relation of renal stone and obesity in the Jordanian population. All patients with urolithiasis that attended the urology clinic at Prince Hussein Bin Abdullah Urology Center at King Hussein Medical Center, Jordan, over the period from January 2006 to January 2011 were included in the study and analyzed for age, gender, body weight, number of visits to the clinic and number of procedures. Over a period of 60 months from January 2006 through January 2011, 8346 patients were treated for urolithiasis. The median age was 43.2 years. The male to female ratio was 1.46:1. 42.3% of the patients were obese, with body mass index (BMI) >30 kg/m 2 and 25.8% of the patients were overweight, with BMI >25 kg/m 2 . The normal body weight population formed 31.9% of the total population. The majority of our urolithiasis patients were obese and overweight, forming 68.1% of the population, with a higher number of clinical visits and higher number of surgical procedures. In the Jordanian population, there is a clear relation between obesity and stone formation, where the majority of stone formers was obese.
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