ABSTRACT
OBJECTIVE: To assess perioperative, clinical, and functional outcomes following completely robotic ileal ureter. METHODS: We retrospectively reviewed 7 consecutive patients undergoing completely intracorporeal ileal ureteric replacement between November 2015 and May 2017. One patient had a solitary kidney. A 4-arm technique was used. In 5 patients, additional psoas hitch procedure was performed. Patients had retrograde filling and removal of the ileal stent and transurethral catheter at an average of 14 days postoperatively. Renal ultrasonography, serum analysis, and diuretic renography were performed at follow-up 3 months postoperatively. RESULTS: Mean operative time was 328 ± 66.3 minutes and median estimated blood loss was 100 mL (range 50-200); mean length of the ileal substitute was 20.4 cm (range 18-24). No case was converted to open surgery. In 1 patient, there was a prolonged insufficiency of the pyeloileal anastomosis, requiring prolonged stenting. Apart from that, there were no major complications and no open surgical or endoscopic reinterventions. On 3-month follow-up, all patients presented symptom-free, with no signs of obstruction on ultrasound and significantly improved glomerular filtration rate, creatinine levels, and differential renal function (P = .02, 0.03, and 0.046, respectively). Five patients had a diuretic halftime <10 minutes, 2 had a halftime between 10 and 20 minutes. CONCLUSION: Completely intracorporeal robotic ileal ureteric replacement results in full functional restoration of the upper tract in cases of long defects of the mid and upper ureter.
Subject(s)
Ileum/transplantation , Plastic Surgery Procedures/methods , Robotic Surgical Procedures/methods , Ureter/surgery , Ureteral Obstruction/surgery , Adult , Aged , Blood Loss, Surgical , Female , Follow-Up Studies , Humans , Male , Middle Aged , Operative Time , Retrospective Studies , Stents , Urologic Surgical Procedures/methodsABSTRACT
Surface magnetoelastic waves are coupled elastic and magnetic excitations that propagate along the surface of a magnetic material. Ultrafast optical techniques allow for a non-contact excitation and detection scheme while providing the ability to measure both elastic and magnetic components individually. Here we describe a simple setup suitable for excitation and time resolved measurements of high frequency magnetoelastic waves, which is based on the transient grating technique. The elastic dynamics are measured by diffracting a probe laser pulse from the long-wavelength spatially periodic structural deformation. Simultaneously, a magnetooptical measurement, either Faraday or Kerr effect, is sensitive to the out-of-plane magnetization component. The correspondence in the response of the two channels probes the resonant interaction between the two degrees of freedom and reveals their intimate coupling. Unraveling the observed dynamics requires a detailed understanding of the spatio-temporal evolution of temperature, magnetization and thermo-elastic strain in the ferromagnet. Numerical solution of thermal diffusion in two dimensions provides the basis on which to understand the sensitivity in the magnetooptic detection.
ABSTRACT
Time resolved optical spectroscopy is used to elucidate the dynamics of photodoped spin-aligned carriers in the presence of an underlying magnetic lattice in the multiferroic compound TbMnO(3). The transient responses while probing d-d intersite transitions show marked differences along different crystallographic directions, which are discussed in terms of the interplay between the processes of hopping of the photo-injected electrons and the magnetic order in the material.
