ABSTRACT
ABSTRACT Introduction Several techniques of robotic-assisted radical prostatectomy (RARP) using the da Vinci SP (SP) have been described since its clearance by the FDA (Food and Drug Administration) in 2018 ( 1 , 2 ). Even with the expanding literature about this robot, the SP technology has been restricted to a few centers in the US and Asia due to the recent release of this robot in the marked.3 In this scenario, we provided, in this video compilation, a consensus of SP referral centers describing the current approaches and techniques of da Vinci SP Radical prostatectomy (SP-RARP). Surgical Technique We have illustrated five different techniques, including transperitoneal, extraperitoneal, Retzius-sparing, transvesical, and transperineal ( 4 - 6 ). Each surgery demonstrated crucial steps from the trocar placement until anastomosis. All approaches follow anatomic concepts and landmarks to minimize positive surgical margins, optimize oncological outcomes and promote optimal functional recovery. The trocar placement and the use of an assistant port were selected according to the operative technique of each institution. None of these surgeries had intra- or postoperative complications, and the pain management until discharge was controlled without using narcotics. All patients were discharged in less than 16 hours of surgery. Conclusion Robotic-assisted radical prostatectomy performed with the da Vinci SP is feasible and safe with optimal perioperative outcomes. Five different approaches were described in this video compilation, and we believe that the technical details provided by this multicentric collaboration are crucial for centers willing to initiate the SP approach to radical prostatectomy.
ABSTRACT
ABSTRACT Background The da Vinci SP robot consists of an innovative single port trocar that houses a flexible camera and three biarticulated arms, which minimizes the number of incisions to assess the surgical site, allowing a less invasive procedure. However, due to its recent release in the market, the current literature reporting SP-RARP is still restricted to a few centers. In this scenario, after performing a literature search with all available techniques of SP-RARP, our objective is to report a multicentric opinion of referral centers on different techniques to approach SP-RARP. Results The SP literature is provided by only a few centers due to the limited number of this new console in the market. Five different approaches are available: transperitoneal, extraperitoneal, Retzius-Sparing, transperineal and transvesical. None of the current studies describe long-term functional or oncological outcomes. However, all approaches had satisfactory operative performance with minimum complication rates. Conclusions Several techniques of SP-RARP have been reported in the literature. We performed a multicentric collaboration describing and illustrating the most challenging steps of this surgery. We believe that the details provided in this article are useful teaching material for new centers willing to adopt the SP technology.
ABSTRACT
Aim: Infections with Hepatitis B virus (HBV) and Hepatitis C virus (HCV) cause serious morbidity and mortality. This study was designed to determine the prevalence of Hepatitis B and C infections and their co-infections among blood donors in Minia governorate, Egypt. Study Design: A cross-sectional study. Place and Duration of Study: The study was conducted over a period of 6 months starting from May 2011 till December 2011 and it included 5410 samples from blood donors at the Regional Blood Transfusion Center in Minia governorate. Methodology: Both HBsAg and antibodies to HCV were detected by EIA in 5410 blood samples from potentially healthy asymptomatic blood donors. Detection of HBV DNA and HCV RNA was carried out by real-time PCR (RT-PCR). Results: Most individuals were males (4305; 79.6%) and were from rural areas (3695; 68.3%). The sero-prevalence of infections was 0.9% (48 cases) for HBV and 6% (322 cases) for HCV, and 0.1% (7 cases) for co-infection. Out of 7 samples with co-infection, only one (14.3%) was positive for HBV DNA and HCV RNA. The mean age of HCV-antibody positive donors (33.2 ±9.41 years) was significantly higher than that of the HBV-positive donors (27.3± 6.06 years) and co-infection (29.9± 10.21 years) (P<0.05). Prevalence of HBV and HCV was higher in males (1% and 6.6% respectively) while HCV was higher in rural areas (6.8%) unlike HBV which did not show any difference in residential distribution (0.9% for both rural and urban areas). Conclusion: The prevalence of both viruses is low and that of the dual infection is lower than any of the two viruses alone.
ABSTRACT
This study included 40 male patients with end stage renal disease [ESRD] on hemodialysis [HD] for more than six months, three times/week and 20 healthy subjects as controls. All of them were subjected to laboratory investigations, resting ECG, Holter ECG monitor and echocardiographic examination for the assessment of cardiovascular disorders and its risk factors. Arrhythmia and other ECG changes were found in all patients and in only two of the controls. Patients developed arrhythmia and ischemia during HD sessions, which was improved after dialysis. All patients showed structural changes in the myocardium, which were explained by the presence of anemia, increased serum uric acid, hyperparathyroidism and hypertension