RESUMO
OBJECTIVE: For novice surgeons, successful laparoscopic radical nephrectomy depends on the treatment of the renal vessels, and the use of computed tomography assists in navigation during the surgery. METHODS: To navigate during surgery, three-dimensional volume-rendered images of the renal vessels, kidneys, and surrounding organs were created intraoperatively by the surgeon using an image-processing application. A surgeon adjusted the angle of view and the size of the images according to surgical views during the operation, using a wireless mouse enclosed in a sterilized bag. These images were simultaneously fused onto live video using image-capture software. RESULTS: Novice surgeons easily constructed the augmented reality images intraoperatively and were able to successfully treat the renal vessels. CONCLUSION: The combination of three-dimensional computed tomography volume-rendered images with live video is a valuable navigation system for use intraoperatively.
Assuntos
Processamento de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/métodos , Cuidados Intraoperatórios/métodos , Cirurgia Assistida por Computador/métodos , Tomografia Computadorizada por Raios X/métodos , Gravação de Videoteipe/métodos , Humanos , Resultado do TratamentoRESUMO
Between July 1986 and March 2006, 102 patients underwent an operation for acute scrotum. Median age was 12.0 years old (range 0-51). Post-operative diagnosis revealed 50 cases (49%) of spermatic cord torsion, 29 cases (28%) of epididymal appendix torsion, and 13 cases (13%) of acute epididymitis. Spermatic cord torsion was most frequent in the age between 0 and 5, and 11 and 20, while epididymal appendix torsion was most frequent between 6 and 10. Moreover, acute epididymitis was most frequently seen in the age over 20. There were no apparent differences in the clinical symptoms such as scrotal pain, scrotal swelling, and abdominal pain. In the physical examinations, pyuria was the only finding to indicate acute epididymitis. In case of spermatic cord torsion, 'golden time' is defined as the time from onset to operation when testicular function can be expected for preservation. In this study golden time was defined as 8 hours because the testes was preserved in all 23 patients receiving the operation within 8 hours, but in only 10 (37%) out of 27 patients receiving the operation after 8 hours. Moreover, the operation within 24 hours saved the testes in approximately 90% of the patients. In patients with acute scrotum, emergency operation should be performed as speedily as possible for preservation of testicular function.
Assuntos
Doenças dos Genitais Masculinos/etiologia , Doenças dos Genitais Masculinos/cirurgia , Escroto , Doença Aguda , Adolescente , Adulto , Criança , Pré-Escolar , Diagnóstico Diferencial , Epididimo , Epididimite/complicações , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Torção do Cordão Espermático/complicações , Fatores de Tempo , Anormalidade Torcional/complicações , Anormalidade Torcional/diagnósticoRESUMO
Venous air embolism is a rare complication during transurethral resection of the prostate (TURP). We report a case of air embolism during TURP under general anesthesia in a 56-year-old man. Incorrect assembly of the resectoscope-drain aspiration system caused rapid entrainment of air into the vein of the prostate bed. Rapid recognition of the condition and prompt treatment are required.
Assuntos
Embolia Aérea/etiologia , Ressecção Transuretral da Próstata/efeitos adversos , Ressecção Transuretral da Próstata/instrumentação , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Orbital metastasis caused by prostate cancer is rare. We report a case of prostate cancer diagnosed from the initial ocular signs with complaints of decreased vision and exophthalmos. The orbital tumor was surgically removed and endocrine therapy was performed subsequently. Metastatic carcinoma of the prostate should be considered in the elderly male with exophthalmos.
