Extraperitoneal robot-assisted laparoscopic radical prostatectomy through single incision: Establishment and application of a modified channel / 中华男科学杂志

Objective@#To assess the feasibility and validity of the establishment of a modified channel for extraperitoneal robot-assisted laparoscopic radical prostatectomy (RARP) through single incision.@*METHODS@#From November 2020 to January 2021, 35 cases of localized PCa were treated by extraperitoneal RARP through single incision in our center. All the operations were performed by the same surgeon, none via the multichannel port for the establishment of the channel. We recorded and analyzed the intra- and postoperative parameters, operation cost, complications, pathological findings and follow-up data.@*RESULTS@#All the operations were successfully completed, without conversion to open surgery or additional channels, or serious postoperative complications, the time for establishing the extraperitoneal space averaging 25.4 (20.0－45.0) min, the operation time 67.3 (35.0－125.0) min, intraoperative blood loss 75.5 (60.0－150.0) ml, time to first postoperative anal exhaust 26 (8－48) h, and postoperative hospital stay 7.89 (7－10) d. Postoperative pathology showed adenocarcinoma in all the cases, with Gleason score (GS) 3+3 in 9 (25.7%), GS 3+4 in 9 (25.7%), GS 4+3 in 8 (22.9%), and GS ≥ 8 in 9 (25.7%) of the cases, 23 (65.7%) in the

Treatment of degenerative lumbar spine stenosis by modified unilateral approach for bilateral decompression under microendoscope / 中国脊柱脊髓杂志

Objective:To evaluate the feasibility and clinical efficacy of the treatment of lumbar spine steno-sis by modified unilateral approach for bilateral decompression under microendoscope.Method:217 cases with degenerative lumbar spine stenosis from September 2003 to December 2008 were treated by modified unilater-al approach for bilateral decompression of central spinal canal and nerve root canal under microendoscope.A-mong them laminectomy of one segment was done in 163 cases,two segments were done in 54 cases.After surgery,the routine radiograph were carried out and the Nakai criterion was used for assessment.Result:The mean operative time was 48±13min (range,25 to 95min),the average blood loss was 37±9ml (range,25 to 180ml),the average skin incision length was 2.2±0.2cm(1.8 to 2.4cm).2 cases had dural matter tearing,which healed after filling with gelatin foam and 2 weeks bed rest,after that no cerebrospinal fluid leakage was noted after surgery.Mislocation was noted in 1 case.No nerve inury and postoperative infection oceurred.Postoperative CT scan demonstrated complete decompression of the central spinal canal and nerve root canal.All patients were followed-up for an average of 14 months (range,3 months to 24 months).The Nakai criterion at final follow-up showed clinical excellent in 134 cases,good in 63 cases,fair in 16 cases and worse in 4 cases, with the excellent and good rate of 90.8%.No lumbar spine instability was noted.Conclusion:Treatment of de-generative lumbar spine stenosis by modified unilateral approach for bilateral decompression under mieroendo-scope has the merit of minimal invasive,less complications and reliable therapeutical effect.