Bruno Graça

Nefrectomia Parcial Robótica de Tumor Endofítico: Técnica e Resultado

Robotic surgery allows complex oncological renal surgery with at least equivalent safety and outcomes profiles when comparing to open and laparoscopic approach. We describe a robotic partial nephrectomy of an endophytic tumor with intraoperative ultrasound support and 10th month follow-up outcome.

Inflammatory Myofibroblastic Tumor of the Bladder: 2 Rare Cases Managed with Laparoscopic Partial Cystectomy.

Two cases of inflammatory myofibroblastic tumor (IMT) of the bladder are reported here. Both patients were male and presented with macroscopic hematuria; in the first case terminal hematuria was associated with irritative voiding symptoms. The second case was a smoker with hematuria unresponsive to medical treatment and anemia. Clinical presentation, pathological features, treatment, and prognosis are discussed. Due to rarity of this pathological condition, there are no guidelines concerning treatment and follow-up. We present our follow-up scheme and highlight the use of laparoscopic partial cystectomy as a successful treatment approach.

Radical Retropubic Prostatectomy

In recent years, surgical technique for radical retropubic prostatectomy (RRP) has evolved with increasing attention to preservation of anatomic structures and its impact on outcome and quality of life. Technical aspects of nerve-sparing RRP are described. A careful and thorough technique has impact on erectile function and urinary continence and should be performed in all patients. For successful nerve preservation we advocate a lateral approach to the prostate, improvising visualization and simplifying the dissection of the neurovascular bundles from the dorsolateral prostatic capsule. Control of bleeding in the ligation and incision of the Santorini’s plexus ensures the success of the remaining steps. Meticulous apical dissection with preservation of a maximal urethral length and bladder neck are other important factors for the optimal surgery outcomes.

Giant nephrothoracic abscess: a misleading disease, a surgical challenge, and an unexpected complication.

A rare case of perinephric abscess with unilateral secondary pulmonary involvement that was further complicated by spillover of purulent content into the contralateral lung is reported here. Its diagnosis, treatment, and evolution are described and discussed along with certain features of nephropulmonary fistulas. The diagnosis of these abscesses is difficult, largely because of the paucity of primary symptoms and the frequent presence of misleading secondary symptoms. Deceptive cases like this one highlight the importance of its contemplation in every physicians differential diagnosis.