期刊文献+
共找到4篇文章
< 1 >
每页显示 20 50 100
Robotic assisted laparoscopic simple suprapubic prostatectomy--The Smith Institute for Urology experience with an evolving technique 被引量:2
1
作者 Sammy E.Elsamra Nikhil Gupta +4 位作者 Haris Ahmed david leavitt Jessica Kreshover Louis Kavoussi Lee Richstone 《Asian Journal of Urology》 2014年第1期55-59,共5页
Objective:Despite a multitude of minimally invasive surgical options available for benign prostatic enlargement,open simple prostatectomy(OSP)remains the standard for large prostates(typically greater than 100 g).OSP,... Objective:Despite a multitude of minimally invasive surgical options available for benign prostatic enlargement,open simple prostatectomy(OSP)remains the standard for large prostates(typically greater than 100 g).OSP,however,is associated with significant morbidity.Recently,a few reports touting robotic application to simple prostatectomy have been published.Herein,we reviewed our series of robotic assisted laparoscopic simple suprapubic prostatectomy(RALSSP)and detailed modifications in our technique as our experience increased.Methods:All RALSSP cases performed between January 2013 and January 2014 were reviewed for demographics,pre-operative features,and perioperative outcomes.All parameters were tabulated and mean values were calculated.Student’s t-test was utilized with p<0.05 deemed significant.Details regarding surgical technique were reviewed and highlighted.Results:Fifteen patients underwent RALSSP during this period.Mean age of these men was 68.7 years.Mean body mass index(BMI)was 28.5 kg/m^2.American Society of Anesthesiologists(ASA)score was on average 2.6.Average International Prostate Symptom Score(IPSS)was 16.2 with the majority of men experiencing some adverse clinical sequela of such benign prostatic hyperplasia(BPH).For those patients not in retention,preoperative post-void residual(PVR)was 428 mL.All patients underwent successful RALSSP without need for conversion or need for blood transfusion.Mean estimated blood loss(EBL)was 290 mL.Five patients underwent other concurrent procedures(e.g.,cystolithotomy).Mean length of hospital stay(LOS)was 2.4 days and only five patients required continuous bladder irrigation(CBI)postoperatively.Postoperative PVR improved to a mean of 33 mL and IPSS improved to 4.5(p<0.001).No major complications were identified.Adaptation of low transverse cystotomy,utilization of a robotic tenaculum in the#3 arm with its control by a surgeon on a second console,and the utilization of mucosal advancement have all subjectively aided in performance of RALSSP and perioperative outcomes.Conclusion:RALSSP allows for feasible performance of prostate adenoma enucleation with low risk of blood transfusion,short LOS,and significant improvement in IPSS and PVR;all while maintaining a minimally invasive approach.The use of a robotic tenaculum controlled by the secondary console and the mucosal advancement facilitate excellent outcomes and may play a role in minimizing hematuria and need for CBI. 展开更多
关键词 Robotic assisted laparoscopic simple suprapubic prostatectomy Benign prostatic hyperplasia Blood loss Hospital stay
下载PDF
Percutaneous nephrolithotomy in octogenarians and beyond:How old is too old? 被引量:1
2
作者 Bradley Morganstern Riccardo Galli +6 位作者 Piruz Motamedinia david leavitt Mohamed Keheila Eric Ghiraldi david Hoenig Arthur Smith Zeph Okeke 《Asian Journal of Urology》 2015年第4期208-213,共6页
Objective:To specifically report perioperative characteristics and outcomes in patients 80 years and older undergoing percutaneous nephrolithotomy(PCNL).PCNL has been established as feasible in the elderly;however,to ... Objective:To specifically report perioperative characteristics and outcomes in patients 80 years and older undergoing percutaneous nephrolithotomy(PCNL).PCNL has been established as feasible in the elderly;however,to our knowledge no one has specifically reported feasibility in patients 80 years and older.Methods:We retrospectively reviewed perioperative data of octogenarians who underwent PCNL at a high stone volume single institution,and matched them to patients<65 years of age by stone burden and sex.Patient demographics,perioperative outcomes and postoperative complications were compared.Results:Thirty-three octogenarians(mean age 83.6 years)with 36 renal units were matched to 67 controls(mean age 48.6 years)with 72 renal units.Octogenarians had a higher mean American Society of Anesthesiologists(ASA)score,more comorbidities,and worse renal function.There were no differences in operative characteristics,length of hospital stay or stone free rates.Of the patients with preoperative urinary decompression(ureteral stent or nephrostomy tube)prior to PCNL,the elderly were more likely to have a history of urosepsis.Octogenarians did not experience more minor Clavien(Ⅰ-Ⅱ)or major Clavien(Ⅲa-Ⅳb)complications.Conclusion:Octogenarians who undergo PCNL were more likely to have cardiovascular comorbidities and a prior history of sepsis.Despite these risk factors,in appropriately selected patients PCNL can be safely and successfully performed in octogenarians without increased perioperative complications relative to a younger cohort. 展开更多
关键词 Percutaneous nephrolithotomy ELDERLY Percutaneous stone extraction complications Clavien OCTOGENARIANS Percutaneous stone extraction
下载PDF
尊严
3
作者 david leavitt 张巧毅 《英语知识》 2009年第2期17-21,共5页
西奥面临着两种药物选择,一种是可以拯救视力的药物,另一种是可以维持生命的药物。于是他做出选择:使自己不变成盲人。他停止服用药片,开始注射药物。而注射药物需要将导管插入心脏上方。这是一个痛苦不堪的过程——但是没出几天,... 西奥面临着两种药物选择,一种是可以拯救视力的药物,另一种是可以维持生命的药物。于是他做出选择:使自己不变成盲人。他停止服用药片,开始注射药物。而注射药物需要将导管插入心脏上方。这是一个痛苦不堪的过程——但是没出几天,西奥眼里的雾状物就开始消失,他又能看见了。他想起了曾经和母亲一起去纽约市看展览时的情景。那时他才12岁,就是不承认需要戴眼镜。 展开更多
关键词 尊严 药物 纽约市 注射 视力 盲人 状物
下载PDF
Advances in percutaneous stone surgery
4
作者 Christopher Hartman Nikhil Gupta +3 位作者 david leavitt david Hoenig Zeph Okeke Arthur Smith 《Asian Journal of Urology》 2015年第1期26-32,共7页
Treatment of large renal stones has changed considerably in recent years.The increasing prevalence of nephrolithiasis has mandated that urologists perform more surgeries for large renal calculi than before,and this ha... Treatment of large renal stones has changed considerably in recent years.The increasing prevalence of nephrolithiasis has mandated that urologists perform more surgeries for large renal calculi than before,and this has been met with improvements in percutaneous stone surgery.In this review paper,we examine recent developments in percutaneous stone surgery,including advances in diagnosis and preoperative planning,renal access,patient position,tract dilation,nephroscopes,lithotripsy,exit strategies,and post-operative antibiotic prophylaxis. 展开更多
关键词 NEPHROLITHIASIS Kidney calculi Percutaneous nephrolithotomy
下载PDF
上一页 1 下一页 到第
使用帮助 返回顶部