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Current status of laparoscopic and robotassisted nerve-sparing radical cystectomy in male patients

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Asian Journal of Urology 2016年第3期3卷 150-155页

作者： Jian Huang Xinxiang Fan Wen Dong Department of Urology Sun Yat-sen Memorial HospitalSun Yat-sen UniversityGuangzhouChina

During radical cystectomy(RC),the neurovascular bundles are easily removed or damaged,leading to varying rates of incontinence and erectile *** nervesparing technique was developed to preserve urinary and erectile *** adoption of laparoscopic and robot-assisted technology has improved visualization and dexterity of pelvic surgeries,thus facilitate the nerve-sparing *** nerve-sparing RC is technically similar with nerve-sparing radical prostatectomy,there are still some anatomical *** are mainly three different types of nerve-sparing *** lymph node dissection(PLND)is another important factor to influence erectile function and urinary ***-sparing laparoscopic radical cystectomy(LRC)and robot-assisted radical cystectomy(RARC)may be an optimal treatment choice in well-selected younger patients with lowvolume,organ-confined *** should attempt to do,whenever possible,a nerve-sparing cystectomy at least on ***,due to the need of a well-refined surgical technique,nerve-sparing LRC and RARC is now being performed only by experienced urological surgeons.

关键词： nerve-sparing Radical cystectomy Laparoscopy Robot-assisted laparoscopy Male

The Outpatient Burch-Sling Procedure: A nerve-sparing Method for Correcting Female Urinary Incontinence

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Open Journal of Urology 2017年第12期7卷 243-251页

作者： Daryoosh Samimi John S. Samimi Department of Ob-Gyn Keck School of Medicine USC U.S. Women Institute Fountain Valley CA USA

Conventional methods to treat urinary stress incontinence, including the Sling, Burch, and Pereyra modification methods, are limited by several shortcomings due to disrupted nerve and vaginal wall integrity. The nerve-sparing Burch-Sling method represents a surgical advancement through the use of a nerve-sparing sling to treat genuine stress urinary incontinence. The procedure involves retropubic urethropexy using the FDA-approved Burch-Sling device. In this technique, the vagina is elevated bilaterally at the urethrovesical junction to the mid-urethra toward Cooper’s ligament above the base of the bladder. Then, the anterior vaginal wall and fascia are used as an endogenous suburethral sling without dissection. Two hundred twenty cases were included in this study;two hundred patients underwent the outpatient nerve-sparing sling method, and the other twenty underwent the novel abdominal Burch method. There were no major complications. The follow-up duration ranged from 6 months to eight years. All procedures were performed at the U.S. Women’s Institute at a 400-bed hospital in Fountain Valley, CA.

关键词： Outpatient Sling Procedure Burch-Sling Device “FDA” Novel Burch Procedure nerve-sparing Method Preservation of Vaginal nerve Plexus Preservation of External nerve of Urethra Minimizing Complications Reduce Financial Burden

Influence of bladder neck suspension stitches on early continence after radical prostatectomy： a prospective randomized study of 180 patients

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Asian Journal of Andrology 2011年第6期13卷 806-811页

作者： Jens-Uwe Stolzenburg Martin Nicolaus Panagiotis Kallidonis Minh Do Anja Dietel Tim Haifner George Sakellaropoulos James Hicks David Nikoleishvili Evangelos Liatsikos Department of Urology University of Leipzig Leipzig 04103 Germany Department of Urology University of Patras Medical School Patras 26500 Greece Department of Medical Physics University of Patras Patras 26500 Greece

Several techniques have been introduced to improve early postoperative continence. In this study, we evaluated the impact of bladder neck （vesicourethral anastomosis） suspension on the outcome of extraperitoneal endoscopic radical prostatectomy （EERPE）. In this research, a total of 180 patients underwent EERPE. Group 1 included patients who underwent nerve-sparing EERPE （nsEERPE）（n=45）, and Group 2 included patients who underwent nsEERPE with bladder neck suspension （BNS, n=45）. Groups 3 （n=45） and 4 （n=45） included patients who received EERPE and EERPE with BNS, respectively. Patients were randomly assigned to receive BNS with their nsEERPE or EERPE procedure. Perioperative parameters were recorded, and continence was evaluated by determining the number and weight of absorbent pads （pad weighing test） on the second day after catheter removal and by a questionnaire 3 months postoperatively. Two days after catheter removal, 11.1% of Group 1, 11.1% of Group 2, 4.4% of Group 3 and 8.9% of Group 4 were conti nent. The average urine loss was 80.4, 70.1, 325.0 and 291.3 g for the each of these groups, respectively. At 3 months, 76.5% of Group I and 81.3% of Group 2 were continent. The continence figures for Group 3 and 4 were 48.5% and 43.8%, respectively. Similar overall rates were observed in all groups. In conclusion, although there are controversial reports in the literature, early continence was never observed to be significantly higher in the BNS groups when compared with the non-BNS groups, regardless of the EERPE technique performed.

关键词： bladder suspension extraperitoneal endoscopic radical prostatectomy nerve-sparing positive surgical margins prostatectomy vesicourethral anastomosis

Intermediate-term oncological and functional outcomes in prostate cancer patients treated with perineal robot-assisted radical prostatectomy:A single center analysis

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Asian Journal of Urology 2023年第4期10卷 423-430页

作者： Umberto Carbonara Giuseppe Lippolis Luciano Rella Paolo Minafra Giuseppe Guglielmi Antonio Vitarelli Giuseppe Lucarelli Pasquale Ditonno Department of Emergency and Organ Transplantation Urology UnitAldo Moro UniversityBariItaly

Objective:In the last 10 years,robotic platforms allowed to resume of some alternative surgical approaches,including perineal robot-assisted radical prostatectomy(p-RARP).Herein,we present in detail the oncological and functional outcomes of patients who underwent p-RARP with a median follow-up of 30 ***:Patients presenting low-or intermediate-risk prostate cancer and prostate volume up to 60 mL who underwent p-RARP between November 2018 and November 2022 were ***,intraoperative,pathological,and postoperative data were collected and then ***:Thirty-seven p-RARP cases were *** patients presented mean age of 62 years and a mean Charlson comorbidity index of *** mass index of≥25 kg/m^(2)was reported by 24(64.9%)patients,as well as 7(18.9%)patients reported a past surgical *** prostate volume and median prostate-specific antigen were 41 mL and 6.2 ng/mL,*** median operative time was 242 *** positive surgical margin rate was 45.9%.In terms of postoperative complications,10 patients reported complications with any grade;however,a single case(2.7%)of major(Clavien-Dindo grade≥3)complication was *** patient with biochemical recurrence or distant metastasis was reported at 2 years of *** of continence rates were 67.6%,75.7%,and 92.9%,at 6 months,12 months,and 24 months after surgery,respectively.

关键词： Prostate cancer Robotic Perineal Radical prostatectomy Continence Robot-assisted radical prostatectomy nerve-sparing

Quality of life in rectal cancer surgery:What do the patient ask?

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World Journal of Gastrointestinal Surgery 2015年第12期7卷 349-355页

作者： Giovanni D De Palma Gaetano Luglio Center of Excellence for Technical Innovation in Surgery Department of Clinical Medicine and SurgeryUniversity of Naples Federico IISchool of Medicine Department of Clinical Medicine and Surgery University of Naples Federico IISchool of Medicine

Rectal cancer surgery has dramatically changed with the introduction of the total mesorectal excision(TME), which has demonstrated to significantly reduce the risk of local recurrence. The combination of TME with radiochemotherapy has led to a reduction of local failure to less than 5%. On the other hand, surgery for rectal cancer is also impaired by the potential for a significant loss in quality of life. This is a new challenge surgeons should think about nowadays: If patients live more, they also want to live better. The fight against cancer cannot only be based on survival, recurrence rate and other oncological endpoints. Patients are also asking for a decent quality of life. Rectal cancer is probably a paradigmatic example: Its treatment is often associated with the loss or severe impairment of faecal function, alteration of body anatomy, urogenital problems and, sometimes, intractable pain. The evolution of laparoscopic colorectal surgery in the last decades is an important example, which emphasizes the importance that themes like scar, recovery, pain and quality of life might play for patients. The attention to quality of life from both patients and surgeons led to several surgical innovations in the treatment of rectal cancer: Sphincter saving procedures, reservoir techniques(pouch and coloplasty) to mitigate postoperative faecal disorders, nerve-sparing techniques to reduce the risk for sexual dysfunction. Even more conservative procedures have been proposed alternatively to the abdominal-perineal resection, like the local excisions or transanal endoscopic microsurgery, till the possibility of a wait and see approach in selected cases after radiation therapy.

关键词： Quality of life Rectal cancer Laparoscopicsurgery Sphincter preservation nerve-sparing