ABSTRACT
Three-dimensional, high-definition images, small instruments with endowrist technology, ergonomic position and the easiness to teach, are possibly the main reasons why robotic surgery will continue to gain ground to others forms of surgery. The current applications of robotics in functional urology are: the correction of pelvic organ prolapse, the correction of female stress urinary incontinence (artificial urinary sphincter) and the treatment of chronic pelvic pain (pudendal nerveneurolysis). In this paper, we explain our robotic techniques in these three scenarios, as well as, provide the most updated data of our series.
Las imagen tridimensional de alta definición,los instrumentos pequeños con tecnología "endowrist"(endo-muñeca), la posición ergonómica y lafacilidad para enseñar son posiblemente las razonesprincipales por las que la cirugía robótica continuaráganando terreno sobre otras formas de cirugía. Las aplicacionesactuales de la robótica en urología funcionalson: la corrección del prolapso de órganos pélvicos, lacorrección de la incontinencia urinaria de esfuerzo (esfínterurinario artificial) y el tratamiento del dolor pélvicocrónico (neurolisis del nervio pudendo). En este artículoexplicamos nuestras técnicas robóticas en estos tres escenariosy también presentamos los datos más actualizadosde nuestras series.
Subject(s)
Pelvic Organ Prolapse , Robotic Surgical Procedures , Robotics , Urinary Incontinence, Stress , Urology , Female , Humans , Urinary Incontinence, Stress/surgery , Urologic Surgical ProceduresABSTRACT
Three-dimensional, high-definition images, small instruments with endowrist technology, ergonomic position and the easiness to teach, are possibly the main reasons why robotic surgery will continue to gain ground to others forms of surgery. The current applications of robotics in functional urology are: the correction of pelvic organ prolapse, the correction of female stress urinary incontinence (artificial urinary sphincter) and the treatment of chronic pelvic pain (pudendal nerve neurolysis). In this paper, we explain our robotic techniques in these three scenarios, as well as, provide the most updated data of our series
Las imagen tridimensional de alta definición, los instrumentos pequeños con tecnología "endowrist" (endo-muñeca), la posición ergonómica y la facilidad para enseñar son posiblemente las razones principales por las que la cirugía robótica continuará ganando terreno sobre otras formas de cirugía. Las aplicaciones actuales de la robótica en urología funcional son: la corrección del prolapso de órganos pélvicos, la corrección de la incontinencia urinaria de esfuerzo (esfínter urinario artificial) y el tratamiento del dolor pélvico crónico (neurolisis del nervio pudendo). En este artículo explicamos nuestras técnicas robóticas en estos tres escenarios y también presentamos los datos más actualizados de nuestras series
Subject(s)
Humans , Female , Pelvic Organ Prolapse , Robotic Surgical Procedures , Urinary Incontinence, Stress/surgery , Urologic Surgical Procedures/methodsABSTRACT
OBJECTIVES: The routine diagnostic method for assessment of renal graft dysfunction is Doppler ultrasound. However, contrast-enhanced ultrasound (CEUS) may provide more information about parenchymal flow and vascular status of kidney allografts. The aim of the study was to assess the effectiveness of CEUS in the immediate post-transplant period, focusing on acute vascular complications. A brief review of available literature and a report of our initial experience is made. MATERIAL AND METHODS: 15 kidney transplant (KT) cases with clinical suspicion of acute surgical complication were assessed with CEUS and conventional Doppler ultrasound (US). In addition, bibliographic review was conducted through PubMed, Embase, and ClinicalKey databases. RESULTS: 10% of KT underwent CEUS, useful for detecting vascular complication or cortical necrosis in 4 (26%) and exclude them in 74%. Grafts with acute vascular complications have a delayed contrast-enhancement with peak intensity lower than normal kidneys. Perfusion defects can be clearly observed and the imaging of cortical necrosis is pathognomonic. CONCLUSIONS: CEUS is a useful tool in the characterization of renal graft dysfunction with special interest on acute vascular complications after renal transplant. It is a feasible technique for quantitative analysis of kidney perfusion, which provides information on renal tissue microcirculation and regional parenchymal flow. Exploration could be done by a urologist at the patient's bedside while avoiding iodinated contrast.
