Advances in laparoscopic surgery in urology

Rassweiler, Jens; Teber, Doğu

doi:10.1038/nrurol.2016.70

Cited by 64 publications

(44 citation statements)

References 77 publications

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“…A substantial disadvantage of pure laparoscopy is the reduced range of motion due to a fixed trocar position, which determines the angle of the laparoscopic instrument in the working field 13 . Such disadvantage in terms of ergonomics is critical during difficult processes, including reconstructing parts.…”

Section: Discussionmentioning

confidence: 99%

Perioperative and oncological outcomes of laparoscopic radical cystectomy with intracorporeal versus extracorporeal ileal conduit: A matched‐pair comparison in a multicenter cohort in Japan

et al. 2020

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Abbreviations & Acronyms ASA = American Society of Anesthesiologists Cr = creatine ECUD = extracorporeal urinary diversion ECUD-IC = extracorporeal ileal conduit urinary diversion ERAS = enhanced recovery after surgery Hb = hemoglobin ICUD = intracorporeal urinary diversion ICUD-IC = intracorporeal ileal conduit urinary diversion IQR = interquartile range LRC = laparoscopic radical cystectomy RARC = robot-assisted radical cystectomy SD = standard deviation Objectives: To compare the perioperative and oncological outcomes of pure laparoscopic intracorporeal ileal conduit urinary diversion versus extracorporeal ileal conduit urinary diversion after laparoscopic radical cystectomy for bladder cancer in a multicenter cohort in Japan. Method: A total of 455 patients who underwent laparoscopic radical cystectomy carried out at 10 institutions were included in this retrospective study. The perioperative data of the intracorporeal ileal conduit urinary diversion and extracorporeal ileal conduit urinary diversion groups were compared using the propensity score matching method. The Kaplan-Meier curves were obtained to elucidate time to ureteroenteric stricture, reoperation, recurrence and survival. Results: In total, 72 matched pairs were evaluated for the final analysis. The median follow-up period was 28 and 23 months in the intracorporeal ileal conduit urinary diversion and extracorporeal ileal conduit urinary diversion groups, respectively. The operative time in the intracorporeal ileal conduit urinary diversion group was approximately 1 h longer than that in the extracorporeal ileal conduit urinary diversion group. The early and late postoperative complication rates were similar in both groups, except for the reduced wound-related complication rates in the intracorporeal ileal conduit urinary diversion group. The median days to regular oral food intake were 4 and 5 days in the intracorporeal ileal conduit urinary diversion and extracorporeal ileal conduit urinary diversion groups, respectively (P = 0.014). No significant difference was noted in the occurrence of ureteroenteric strictures and reoperation rate. Furthermore, recurrence-free, cancerspecific, and overall survival rates and recurrence patterns did not significantly differ. Conclusions: Laparoscopic intracorporeal ileal conduit urinary diversion is a safe, feasible and reproducible procedure with similar postoperative complication rates, ureteroenteric stricture rate and oncological outcomes when compared with extracorporeal ileal conduit urinary diversion, but faster postoperative bowel recovery and decreased wound-related complication rates.

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Section: Discussionmentioning

confidence: 99%

Perioperative and oncological outcomes of laparoscopic radical cystectomy with intracorporeal versus extracorporeal ileal conduit: A matched‐pair comparison in a multicenter cohort in Japan

et al. 2020

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“…Die Einführung der digitalen High-Definition (HD)-Videotechnologie kann sicherlich als Quantensprung für die gesamte Endoskopie gesehen werden mit signifikant verbesserter Auflösung, Tiefenschärfe und Helligkeit. Damit hat sich die Laparoskopie dem Dogma der schlechteren Bildqualität als beim offenen Operieren entledigt: Im Gegenteil, durch die Nähe des Laparoskops zum Objekt besteht eine deutlich bessere optische Darstellung der anatomischen Strukturen [1]. Außerdem steht wie in der Unterhaltungsindustrie die 4K-Ultra-HD-Television vor dem breiten klinischen Einsatz mit weiterer Optimierung der Bildqualität mit 8 Millionen Pixel im Vergleich zu 2 Millionen Pixel der HD-Videotechnologie (▶ Tab.…”

Section: Videotechnologieunclassified

“…Inzwischen gibt es auch unterschiedliche mechanische und elektro-mechanische Lösungsansätze für die klassische Laparoskopie, wie das Radius-System und Cambridge Endo bzw. Kymerax, Dexterité und Human Extension [1]. Die rein mechanischen Geräte nützen die Beweglichkeit des Handgelenks zur Umsetzung des Bewegungen der Instrumentenspitze (▶ Abb.…”

Section: Instrumente Mit 7 Freiheitsgradenunclassified

Zukunft der Laparoskopie und Robotik in der Urologie

et al. 2018

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ZusammenfassungDie Robotik hat die klassische Laparoskopie in den letzen Jahren etwas an den Rand gedrängt. Dennoch hat sich auch die Laparoskopie und Retroperitoneoskopie in den letzten Jahren technologisch weiterentwickelt mit 4K-Ultra-HD-Videotechnologie, 3D-HD-Videosystemen, miniaturisierten Instrumenten, modernen Schneid- und Koagulationsverfahren, Instrumenten mit 7 Freiheitsgraden und ergnomischen Plattformen Ethos Chair®. Aufgrund der auslaufendenden Patente von Intuitive Surgical wird ab 2019 eine Konkurrenzsituation mit neuen Herstellern von Operationsrobotern existieren. Diese müssen erst belegen, ob sie den hohen Qualitätsstandard der Da-Vinci-Serie (SI, X, XI) bieten können. Dies betrifft die Art der Konsole, Anordnung der Roboterarme, Technologie des 3D-Videosystems und Qualität und Freiheitsgrade der Endeffektoren. Robotersysteme für die Endourologie sind Avicenna Roboflex® für die flexible Ureteroskopie und AquaBeam®-System für die Roboter-assistierte Aquaablation der Prostata. Während Roboflex ähnlich dem Da-Vinci-System die Ergonomie des Eingriffes erleichtert, ersetzt die robotergestützte Aquaablation erstmals den Operateur.

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“…This technique provide a complete video and image of operative area. 10 Previous studies on this topic also shown results in favour of endoscopic ligation in terms of minimum complications and postoperative recovery till one year of procedure, and it is documented that endoscopic haemorriodectomy should be preferred over conventional haemorriodectomy in the treatment of internal bleeding hemorrhoids.…”

Section: Introductionmentioning

confidence: 98%

Hemorrhoidectomy; Stapled Versus Conventional Hemorrhoidectomy in Terms of Post-Operative Pain and Hospital Stay

Ahmed

Ahmad

Amjid

et al. 2017

TPMJ

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ABSTRACT… Objectives: Is to compare outcomes in terms of mean post-operative pain and hospital stay between stapled versus conventional hemorrhoidectomy. Hypothesis: There is a difference in mean post-operative pain and hospital stay between stapled and conventional hemorrhoidectomy, stapled technique is better than conventional technique. Study Design: Randomized control trial. Setting: Department of General Surgery Bakhtawar Amin Memorial Hospital Multan. Period: February 2016 February 2017. Methodology: A total number of 60 patients enrolled in the study, both genders. Statistical software SPSS ver.23 was used to analyze the data. Mean and SD were calculated and presented for numerical variables like duration of hemorrhoids, age and pain score while frequencies and percentage were calculated and presented for categorical variables like ender and grade of hemorrhoids. Independent t-test and chi square test were applied to see effect modification. P value ≤0.05 was considered as significant. Results: Total number of 60 (100%) patients in the study, 32 (53.3%) were male and 28 (46.7 %) were female. Mean hospital stay in group A was 1.63 ± 0.71 and in group B means duration of hospital stay was 1.73 ± 0.74. A P value was 0.001. On stratification of data it is concluded that in group A 9 patients have no pain 6 have mild and 6 have moderate pain and 5 patients have severe pain, similarly in group B, 3 patients have no pain 2 have mild pain 1 have moderate pain and no patient have severe pain. P value for male patients was 2.65. Conclusion: This study confirms that stapled hemorrhoidectomy is associated with less postoperative pain with no effect of age and gender on outcome.

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Advances in laparoscopic surgery in urology

Cited by 64 publications

References 77 publications

Perioperative and oncological outcomes of laparoscopic radical cystectomy with intracorporeal versus extracorporeal ileal conduit: A matched‐pair comparison in a multicenter cohort in Japan

Perioperative and oncological outcomes of laparoscopic radical cystectomy with intracorporeal versus extracorporeal ileal conduit: A matched‐pair comparison in a multicenter cohort in Japan

Zukunft der Laparoskopie und Robotik in der Urologie

Hemorrhoidectomy; Stapled Versus Conventional Hemorrhoidectomy in Terms of Post-Operative Pain and Hospital Stay

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