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Wang J, Mei L, Hao Y, Xu Y, Yang Q, Dai Z, Yang Y, Wu Z, Ji Y. Contemporary Perspectives on the Role of Vitamin D in Enhancing Gut Health and Its Implications for Preventing and Managing Intestinal Diseases. Nutrients 2024; 16:2352. [PMID: 39064795 PMCID: PMC11279818 DOI: 10.3390/nu16142352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 07/11/2024] [Accepted: 07/19/2024] [Indexed: 07/28/2024] Open
Abstract
Vitamin D, a crucial fat-soluble vitamin, is primarily synthesized in the skin upon exposure to ultraviolet radiation and is widely recognized as a bone-associated hormone. However, recent scientific advancements have unveiled its intricate association with gut health. The intestinal barrier serves as a vital component, safeguarding the intestinal milieu and maintaining overall homeostasis. Deficiencies in vitamin D have been implicated in altering the gut microbiome composition, compromising the integrity of the intestinal mucosal barrier, and predisposing individuals to various intestinal pathologies. Vitamin D exerts its regulatory function by binding to vitamin D receptors (VDR) present in immune cells, thereby modulating the production of pro-inflammatory cytokines and influencing the intestinal barrier function. Notably, numerous studies have reported lower serum vitamin D levels among patients suffering from intestinal diseases, including inflammatory bowel disease, irritable bowel syndrome, and celiac disease, highlighting the growing significance of vitamin D in gut health maintenance. This comprehensive review delves into the latest advancements in understanding the mechanistic role of vitamin D in modulating the gut microbiome and intestinal barrier function, emphasizing its pivotal role in immune regulation. Furthermore, we consolidate and present relevant findings pertaining to the therapeutic potential of vitamin D in the management of intestinal diseases.
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Affiliation(s)
- Jiaxin Wang
- State Key Laboratory of Animal Nutrition and Feeding, China Agricultural University, Beijing 100193, China; (J.W.); (L.M.); (Q.Y.); (Z.D.); (Y.Y.); (Z.W.)
| | - Lihua Mei
- State Key Laboratory of Animal Nutrition and Feeding, China Agricultural University, Beijing 100193, China; (J.W.); (L.M.); (Q.Y.); (Z.D.); (Y.Y.); (Z.W.)
| | - Yanling Hao
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, China Agricultural University, Beijing 100193, China;
| | - Yajun Xu
- Department of Nutrition and Food Hygiene, Peking University, Beijing 100083, China;
| | - Qing Yang
- State Key Laboratory of Animal Nutrition and Feeding, China Agricultural University, Beijing 100193, China; (J.W.); (L.M.); (Q.Y.); (Z.D.); (Y.Y.); (Z.W.)
| | - Zhaolai Dai
- State Key Laboratory of Animal Nutrition and Feeding, China Agricultural University, Beijing 100193, China; (J.W.); (L.M.); (Q.Y.); (Z.D.); (Y.Y.); (Z.W.)
| | - Ying Yang
- State Key Laboratory of Animal Nutrition and Feeding, China Agricultural University, Beijing 100193, China; (J.W.); (L.M.); (Q.Y.); (Z.D.); (Y.Y.); (Z.W.)
| | - Zhenlong Wu
- State Key Laboratory of Animal Nutrition and Feeding, China Agricultural University, Beijing 100193, China; (J.W.); (L.M.); (Q.Y.); (Z.D.); (Y.Y.); (Z.W.)
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, China Agricultural University, Beijing 100193, China;
| | - Yun Ji
- State Key Laboratory of Animal Nutrition and Feeding, China Agricultural University, Beijing 100193, China; (J.W.); (L.M.); (Q.Y.); (Z.D.); (Y.Y.); (Z.W.)
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Taylor Z, Keating K, Rohloff M, Maatman TJ. Robotic management of large stone disease: a case series. J Robot Surg 2020; 14:855-859. [PMID: 32141015 DOI: 10.1007/s11701-020-01060-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 02/24/2020] [Indexed: 12/23/2022]
Abstract
The gold standard for urologic management of large stone disease traditionally has been percutaneous nephrolithotomy (PCNL). An alternative to PCNL is robotic pyelolithotomy (RP), which continues to gain traction. This study is a retrospective review of ten cases performed over a 2 year period presenting operative outcomes for large stone disease treated with RP. The mean and standard deviation were calculated for age, body mass index, stone volume, stone diameter, pre-operative creatinine, operative time, robot-docked time, length of stay, post-operative creatinine, and estimated blood loss. In addition, results were collected for post-operative complications and secondary procedure requirements. Complete stone clearance was successful in 9 of 10 cases. The average renal function remained stable from a pre-operative creatinine of 0.917 mg/dL to a post-operative creatinine level of 0.943 mg/dL. This case series demonstrates that robotic assisted surgery has practical application when managing large stone disease.
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Affiliation(s)
- Zac Taylor
- Burrell College of Osteopathic Medicine, Las Cruces, NM, USA
| | - Kevin Keating
- Department of Urological Surgery, Metro Health, University of Michigan Health, Grand Rapids, MI, USA.
- , 5900 Byron Center, Ave SW, Wyoming, MI, 49519, USA.
| | - Matthew Rohloff
- Department of Urological Surgery, Metro Health, University of Michigan Health, Grand Rapids, MI, USA
| | - Thomas J Maatman
- Department of Urological Surgery, Metro Health, University of Michigan Health, Grand Rapids, MI, USA
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Al Tinawi B, Jessop M, Salkini MW. Utilizing da Vinci ® surgical system to treat challenging urinary stones. Urol Ann 2019; 11:304-309. [PMID: 31413511 PMCID: PMC6676859 DOI: 10.4103/ua.ua_97_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Introduction: A worldwide mounting in the incidence and prevalence of urolithiasis has been observed. The standard treatment of urologic stone disease (USD) has changed from open surgery to extracorporeal shock wave lithotripsy, percutaneous nephrolithotomy (PCNL), or ureteroscopy depending on the size and location of the stone. We are sharing our experience in utilizing Da Vinci® robotic surgical system to treat patient with urolithiasis instead of open surgical approach. Patients and Methods: We reviewed prospectively collected data of 19 patients who underwent robotic-assisted stone surgery (RSS) between January 2010 and March 2018 at our institute for USD involving 22 nephroureteral units. Results: A total number of 22 RSS were accomplished with no conversion to open. Three patients had bilateral stone and needed to have RSS on each side separately. Eleven RSS were performed on the right. The indications for RSS included as follows: morbid obesity (n = 8, mean body mass index 56.4 kg/m2), need for concurrent renal surgery (n = 3) severe contractures limiting positioning for retrograde endoscopic surgery or PCNL (n = 2), symptomatic calyceal diverticular stone with failed endoscopic approach (n = 4), and after failed PCNL (n = 2). Twenty nephrouretral unit (91%) were rendered stone free on the first attempt with complication occurring after four cases (18%). Conclusion: RSS is viable options in the treatment of challenging urologic stone with high success rate and low risk of complication. The need for open stone surgery was eliminated by RSS at our center.
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Affiliation(s)
- Basmah Al Tinawi
- Department of Urology, West Virginia University, Morgantown, WV 26505, USA
| | - Morris Jessop
- Department of Urology, West Virginia University, Morgantown, WV 26505, USA
| | - Mohamad W Salkini
- Department of Urology, West Virginia University, Morgantown, WV 26505, USA
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Zazzara M, Cardo G, Pagliarulo G, Nazaraj A, Maselli FP, De Nunzio C, Scarcia M, Romano M, Portoghese F, Ludovico GM. Robotic pyelolithotomy for the treatment of large renal stones: a single-center experience. MINERVA UROL NEFROL 2019; 71:537-543. [PMID: 31241274 DOI: 10.23736/s0393-2249.19.03432-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Few studies have reported robotic pyelolithotomy (RPL) series; furthermore, the most of all have reported small and single-center series. Herein we report our experience from 70 cases of complex kidney stones treated with RPL at our surgical center; this study reports the largest series of RPL in a minimal invasive experienced center. METHODS Between February 2016 and March 2018, 70 patients with complex renal stones (Guy's Stone Score: 4) underwent RPL and included in a prospectively maintained institutional database. Baseline characteristics, clinical data, perioperative data, postoperative data and stone free status were assessed by descriptive statistics. RESULTS Of 70 patients, 72.85% presented renal pelvis stones. The mean maximum stone diameter was 33.1±14.5 mm (median 30 mm; interquartile range 22-40 mm). Mean total operative duration was 122.5±34.4 min (median 120 min; interquartile range 105-135 min). In two patients (2.8%), a grade III complications were noted; no major complications (grade IV-V) were noted. The complete SFR, after a single robotic procedure, was 92.8%. CONCLUSIONS Our findings suggest that RPL is a safe, reproducible and minimally invasive approach as treatment of large renal stones when endoscopic treatment failed or was not available. RPL permits to achieve an excellent stone free status, in a single definitive procedure.
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Affiliation(s)
- Michele Zazzara
- Department of Urology, "F. Miulli" General Hospital, Acquaviva delle Fonti, Bari, Italy -
| | - Giuseppe Cardo
- Department of Urology, "F. Miulli" General Hospital, Acquaviva delle Fonti, Bari, Italy
| | - Giovanni Pagliarulo
- Department of Urology, "F. Miulli" General Hospital, Acquaviva delle Fonti, Bari, Italy
| | - Arjan Nazaraj
- Department of Urology, "F. Miulli" General Hospital, Acquaviva delle Fonti, Bari, Italy
| | - Francesco P Maselli
- Department of Urology, "F. Miulli" General Hospital, Acquaviva delle Fonti, Bari, Italy
| | - Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Marcello Scarcia
- Department of Urology, "F. Miulli" General Hospital, Acquaviva delle Fonti, Bari, Italy
| | - Michele Romano
- Department of Urology, "F. Miulli" General Hospital, Acquaviva delle Fonti, Bari, Italy
| | - Filippo Portoghese
- Department of Urology, "F. Miulli" General Hospital, Acquaviva delle Fonti, Bari, Italy
| | - Giuseppe M Ludovico
- Department of Urology, "F. Miulli" General Hospital, Acquaviva delle Fonti, Bari, Italy
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Sood A, Ghani KR, Hemal AK. Reply to Yuqi Xia, Weimin Yu, and Fan Cheng's Letter to the Editor re: Ryan Swearingen, Akshay Sood, Rabii Madi, et al. Zero-fragment Nephrolithotomy: A Multi-center Evaluation of Robotic Pyelolithotomy and Nephrolithotomy for Treating Renal Stones. Eur Urol 2017;72:1014-21. Eur Urol 2018; 74:e77-e78. [PMID: 29803583 DOI: 10.1016/j.eururo.2018.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 05/08/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Akshay Sood
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA.
| | - Khurshid R Ghani
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
| | - Ashok K Hemal
- Department of Urology, WakeForest Baptist Health, Winston-Salem, NC, USA
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Madi R, Hemal A. Robotic Pyelolithotomy, Extended Pyelolithotomy, Nephrolithotomy, and Anatrophic Nephrolithotomy. J Endourol 2018; 32:S73-S81. [DOI: 10.1089/end.2017.0718] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Rabii Madi
- Department of Urology, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Ashok Hemal
- Department of Urology, Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina
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Müller PF, Schlager D, Hein S, Bach C, Miernik A, Schoeb DS. Robotic stone surgery - Current state and future prospects: A systematic review. Arab J Urol 2017; 16:357-364. [PMID: 30140470 PMCID: PMC6104666 DOI: 10.1016/j.aju.2017.09.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 09/19/2017] [Accepted: 09/27/2017] [Indexed: 12/23/2022] Open
Abstract
Objective To provide a comprehensive review of robot-assisted surgery in urolithiasis and to consider the future prospects of robotic approaches in stone surgery. Materials and methods We performed a systematic PubMed© literature search using predefined Medical Subject Headings search terms to identify PubMed-listed clinical research studies on robotic stone surgery. All authors screened the results for eligibility and two independent reviewers performed the data extraction. Results The most common approach in robotic stone surgery is a robot-assisted pyelolithotomy using the da Vinci™ system (Intuitive Surgical Inc., Sunnyvale, CA, USA). Several studies show this technique to be comparable to classic laparoscopic and open surgical interventions. One study that focused on ureteric stones showed a similar result. In recent years, promising data on robotic intrarenal surgery have been reported (Roboflex Avicenna™; Elmed Medical Systems, Ankara, Turkey). Initial studies have shown its feasibility and high stone-free rates and prove that this novel endoscopic approach is safe for the patient and comfortable for the surgeon. Conclusions The benefits of robotic devices in stone surgery in existing endourological, laparoscopic, and open treatment strategies still need elucidation. Although recent data are promising, more prospective randomised controlled studies are necessary to clarify the impact of this technique on patient safety and stone-free rates.
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Affiliation(s)
- Philippe F Müller
- Department of Urology, Faculty of Medicine, University of Freiburg, Medical Centre, Freiburg, Germany
| | - Daniel Schlager
- Department of Urology, Faculty of Medicine, University of Freiburg, Medical Centre, Freiburg, Germany
| | - Simon Hein
- Department of Urology, Faculty of Medicine, University of Freiburg, Medical Centre, Freiburg, Germany
| | - Christian Bach
- Department of Urology, University Hospital Aachen, Aachen, Germany
| | - Arkadiusz Miernik
- Department of Urology, Faculty of Medicine, University of Freiburg, Medical Centre, Freiburg, Germany
| | - Dominik S Schoeb
- Department of Urology, Faculty of Medicine, University of Freiburg, Medical Centre, Freiburg, Germany
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Andrade HS, Zargar H, Caputo PA, Akca O, Ramirez D, Kara O, Stein RJ, Kaouk JH. Robotic pyelolithotomy for staghorn nephrolithiasis during partial nephrectomy. Int Braz J Urol 2017; 42:623-5. [PMID: 27286131 PMCID: PMC4920585 DOI: 10.1590/s1677-5538.ibju.2015.0282] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Accepted: 07/07/2015] [Indexed: 11/22/2022] Open
Affiliation(s)
- Hiury S Andrade
- Center for Robotic and Image Guided Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Homayoun Zargar
- Center for Robotic and Image Guided Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Peter A Caputo
- Center for Robotic and Image Guided Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Oktay Akca
- Center for Robotic and Image Guided Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Daniel Ramirez
- Center for Robotic and Image Guided Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Onder Kara
- Center for Robotic and Image Guided Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Robert J Stein
- Center for Robotic and Image Guided Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jihad H Kaouk
- Center for Robotic and Image Guided Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
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Jensen PH, Berg KD, Azawi NH. Robot-assisted pyeloplasty and pyelolithotomy in patients with ureteropelvic junction stenosis. Scand J Urol 2017; 51:323-328. [PMID: 28398101 DOI: 10.1080/21681805.2017.1300188] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Approximately one in five patients with ureteropelvic junction stenosis (UPJS) also present with renal or ureteral stones. For patients with UPJS, the European Association of Urology guidelines currently recommend that robot-assisted pyeloplasty (RAP) and pyelolithotomy are performed as two separate procedures. The aim of the present study was to evaluate the feasibility and safety of RAP with concomitant pyelolithotomy (RAP + P) in patients diagnosed with UPJS and renal stones. MATERIALS AND METHODS In total, 56 RAP procedures and 18 RAP + P procedures were performed between December 2012 and January 2014. Patient records were retrospectively reviewed for operation time (OT), estimated blood loss (EBL), length of hospital stay (LOS), complications, stone burden and stone-free rates at 1, 3 and 6 months following surgery. RESULTS A significant difference in the OT was demonstrated between RAP and RAP + P, with a median of 120 min [interquartile range (IQR) 100-134 min] and 151 min (IQR 128-185 min), respectively (p < 0.0001). In contrast, no difference in LOS [median 2 days (IQR 2-3 days) vs 3 days (2-4 days), p = 0.50) or EBL [median 0 ml (IQR 0-50 ml) vs 20 ml (0-50 ml), p = 0.64] was observed between RAP and RAP + P. The median total stone burden was 1.5 cm (IQR 1.0-4.3 cm; range 1-10 cm). The stone-free rate at 1, 3 and 6 months was 94%, 83% and 72%, respectively. No grade 3-5 complications were observed in the RAP + P group. CONCLUSIONS RAP + P can safely be offered to patients with UPJS and renal stones, with an acceptable stone-free rate.
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Affiliation(s)
| | - Kasper Drimer Berg
- a Department of Urology , Zealand University Hospital , Roskilde , Denmark
| | - Nessn H Azawi
- a Department of Urology , Zealand University Hospital , Roskilde , Denmark
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Hernandez DJ. Editorial Comment: Laparoscopic - assisted transpyelic rigid nephroscopy - simple alternative when flexible ureteroscopy is not available. Int Braz J Urol 2016; 42:855. [PMID: 27564305 PMCID: PMC5006790 DOI: 10.1590/s1677-5538.ibju.2014.0588.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- David J Hernandez
- USF Urology Clinic South Urologic Malignancies, USA.,Department of Urology, Tampa General Hospital, Tampa, FL, USA
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Stravodimos KG, Giannakopoulos S, Tyritzis SI, Alevizopoulos A, Papadoukakis S, Touloupidis S, Constantinides CA. Simultaneous laparoscopic management of ureteropelvic junction obstruction and renal lithiasis: the combined experience of two academic centers and review of the literature. Res Rep Urol 2014; 6:43-50. [PMID: 24892032 PMCID: PMC4036597 DOI: 10.2147/rru.s59444] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Introduction Approximately one out of five patients with ureteropelvic junction obstruction (UPJO) present lithiasis in the same setting. We present our outcomes of simultaneous laparoscopic management of UPJO and pelvic or calyceal lithiasis and review the current literature. Methods Thirteen patients, with a mean age of 42.8±13.3 years were diagnosed with UPJO and pelvic or calyceal lithiasis. All patients were subjected to laparoscopic dismembered Hynes–Anderson pyeloplasty along with removal of single or multiple stones, using a combination of laparoscopic graspers, irrigation, and flexible nephroscopy with nitinol baskets. Results The mean operative time was 218.8±66 minutes. In two cases, transposition of the ureter due to crossing vessels was performed. The mean diameter of the largest stone was 0.87±0.25 cm and the mean number of stones retrieved was 8.2 (1–32). Eleven out of 13 patients (84.6%) were rendered stone-free. Complications included prolonged urine output from the drain in one case (Clavien grade I) and urinoma formation requiring drainage in another case (Clavien grade IIIa). The mean postoperative follow-up was 30.2 (7–51) months. No patient has experienced stone or UPJO recurrence. Conclusion Laparoscopy for the management of UPJO along with renal stone removal seems a very appealing treatment, with all the advantages of minimally invasive surgery. Concomitant renal stones do not affect the outcome of laparoscopic pyeloplasty, at least in the midterm. According to our results and the latest literature data, we advocate laparoscopic management as the treatment of choice for these cases.
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Affiliation(s)
| | | | - Stavros I Tyritzis
- Department of Urology, Athens University Medical School, Laiko Hospital, Athens, Greece
| | | | - Stefanos Papadoukakis
- Department of Urology, Athens University Medical School, Laiko Hospital, Athens, Greece
| | - Stavros Touloupidis
- Department of Urology, Democritus University of Thrace, Alexandroupolis, Greece
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Thiel DD. Navigating the difficult robotic assisted pyeloplasty. ISRN UROLOGY 2012; 2012:291235. [PMID: 23213571 PMCID: PMC3503323 DOI: 10.5402/2012/291235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Accepted: 10/09/2012] [Indexed: 12/29/2022]
Abstract
Pyeloplasty is the gold standard therapy for ureteropelvic junction obstruction. Robotic assisted pyeloplasty has been widely adopted by urologists with and without prior laparoscopic pyeloplasty experience. However, difficult situations encountered during robotic assisted pyeloplasty can significantly add to the difficulty of the operation. This paper provides tips for patient positioning, port placement, robot docking, and intraoperative dissection and repair in patients with the difficult situations of obesity, large floppy liver, difficult to reflect colon (transmesenteric pyeloplasty), crossing vessels, large calculi, and previous attempts at ureteropelvic junction repair. Techniques presented in this paper may aid in the successful completion of robotic assisted pyeloplasty in the face of the difficult situations noted above.
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Affiliation(s)
- David D Thiel
- Department of Urology, Mayo Clinic, 3 East Urology, 4500 San Pablo Road, Jacksonville, FL 32224, USA
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Ganpule AP, Prashant J, Desai MR. Laparoscopic and robot-assisted surgery in the management of urinary lithiasis. Arab J Urol 2012; 10:32-9. [PMID: 26558002 PMCID: PMC4442910 DOI: 10.1016/j.aju.2011.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 12/07/2011] [Accepted: 12/07/2011] [Indexed: 01/19/2023] Open
Abstract
Objectives To review the current role of laparoscopy and robot-assisted laparoscopy for managing urinary lithiasis. Results The contemporary indications for laparoscopic stone management are: anatomical variations in location or shape of the kidney (pelvic kidney, horseshoe kidney and malrotated kidney); coexisting pathologies, e.g. pelvi-ureteric junction obstruction; and stones in a renal unit with lower ureteric obstruction. The laparoscopic approach allows the simultaneous management of both the pathologies. Symptomatic stones in diverticula not amenable to endourological intervention can be treated with laparoscopy. Large impacted pelvic and ureteric calculi with a functioning renal unit are an indication for laparoscopic ureterolithotomy or pyelolithotomy. This review of current reports suggests that in a selected group of patients with complex stone disease the laparoscopic approach offers good success rates with minimal complications. There are few reports of robotic procedures in stone disease but existing data suggest that it is feasible. Conclusion Laparoscopic surgery is effective for complex renal stones and offers excellent stone clearance rates with minimal morbidity. Laparoscopic surgery is complementary in managing these stones. Robot-assisted laparoscopic technique of urinary tract stone management is in its early stage of implementation and randomised trials that compare robot assisted outcomes with other minimally invasive techniques are needed.
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Affiliation(s)
| | - Jain Prashant
- Muljibhai Patel Urological Hospital, Nadiad, Gujarat, India
| | - Mahesh R Desai
- Muljibhai Patel Urological Hospital, Nadiad, Gujarat, India
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Role of Robotic-Assisted Surgery in the Management of Urolithiasis. Urolithiasis 2012. [DOI: 10.1007/978-1-4471-4387-1_63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Babbar P, Hemal AK. Robot-assisted urologic surgery in 2010 - Advancements and future outlook. Urol Ann 2011; 3:1-7. [PMID: 21346825 PMCID: PMC3036993 DOI: 10.4103/0974-7796.75853] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2010] [Accepted: 12/01/2010] [Indexed: 11/04/2022] Open
Abstract
Robotic surgery is a cutting edge and minimally invasive procedure, which has generated a great deal of excitement in the urologic community. While there has been much advancement in this emerging technology, it is safe to say that robotic urologic surgery holds tremendous potential for progress in the near future. Hence, it is paramount that urologists stay up-to-date regarding new developments in the realm of robotics with respect to novel applications, limitations and opportunities for incorporation into their practice. Robot-assisted surgery provides an enhanced 3D view, increased magnification of the surgical field, better manual dexterity, relatively bloodless field, elimination of surgeon's tremor, reduction in a surgeon's fatigue and mitigation of scattered light. All these factors translate into greater precision of surgical dissection, which is imperative in providing better intraoperative and postoperative outcomes. Pioneering work assessing the feasibility of robotic surgery in urology began in the early 2000's with robot-assisted radical prostatectomy and has since expanded to procedures such as robot-assisted radical cystectomy, robot-assisted partial nephrectomy, robot-assisted nephroureterectomy and robot-assisted pyeloplasty. A MEDLINE search was used to identify recent articles (within the last two years) and publications of specific importance, which highlighted the recent developments and future direction of robotics. This review will use the aforementioned urologic surgeries as vehicles to evaluate the current status and future role of robotics in the advancement of the field of urology.
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Affiliation(s)
- Paurush Babbar
- Department of Urology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Current world literature. Curr Opin Urol 2011; 21:166-72. [PMID: 21285721 DOI: 10.1097/mou.0b013e328344100a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Current world literature. Curr Opin Urol 2010; 21:84-91. [PMID: 21127406 DOI: 10.1097/mou.0b013e328341a1a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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