Denis Rey

Laparoscopic adenectomy: a novel technique for managing benign prostatic hyperplasia.

The prostatic capsule is opened 3–4 cm transversally according to prostate size. Haemostatic sutures are placed at the 5 and 7 o’clock positions. Coagulation is obtained by bipolar diathermy. For the first three patients the right index finger was introduced through a 2-cm suprapubic incision into the capsule, permitting enucleation of the adenoma as with the open technique (Fig. 3). After closing the incision, CO 2 was again insufflated to control the section of the adenoma at the apex, which is always visible with the laparoscope. For the last two patients, enucleation was entirely under laparoscopic control without using the finger. The specimen was then placed in the lateral prostatic fossa to await removal. A 22 F irrigation catheter is then introduced (Fig. 4) and a running suture of 2–0 polyglactin used to close the prostatic capsule (Fig. 5). A suction drain is placed in the Retzius space by a lateral trocar. The bladder is irrigated as before with a saline solution. At the end of the procedure, the specimen is placed in a laparoscopic bag and extracted through the enlarged umbilical incision.

Laparoscopic and robot-assisted continent urinary diversions (Mitrofanoff and Yang-Monti conduits) in a consecutive series of 15 adult patients: The Saint Augustin technique

To present a series of 15 laparoscopic and robot‐assisted Mitrofanoff and Yang‐Monti vesicostomies in an adult population, and to assess the feasibility and safety of these minimally invasive approaches.

Laparoscopic treatment of benign prostatic hyperplasia (BPH): overview of the current techniques.

TURP has been the ‘gold-standard’ surgical treatment for BPH over the past 30 years. However, its role in treating large prostates is limited mainly due to intraoperative and postoperative morbidities such as bleeding (with need for transfusion), TUR syndrome, urethral strictures as well as frequent need for re-operation [3]. The operative morbidity of TURP increases when it is performed for prostatic adenomas > 45 g, in procedures lasting > 90 min, or in patients aged > 80 years or with a history of acute urinary retention [4,5].

Feasibility of robotic double Yang-Monti ileal conduit with bladder augmentation: surgical technique.

OBJECTIVE To report the feasibility of a novel robotic technique for intracorporeal construction of a double Yang-Monti ileal conduit with bladder augmentation in an adult patient. METHODS The Yang-Monti procedure can be considered as an alternative to Mitrofanoff appendicovesicostomy when the appendix is not available or in obese patients. To date, the robotic approach has not been described. We have described all the steps of our surgery, performed on a 35-year-old obese patient with post-traumatic paraplegia and a neurogenic bladder. We focused on the technical tips and highlighted all the differences with the standard open technique. RESULTS Our technique provided satisfactory results. No intraoperative complications occurred. The operative time was 250 minutes, and the intraoperative blood loss was 200 mL. The clinical course was uneventful. CONCLUSION We have shown that robotic intracorporeal realization of a double Yang-Monti ileal conduit with bladder augmentation is feasible, extending the potential indications of robot-assisted surgery. The evaluation of more cases is advised.

The First Case of Robotic Pudendal Nerve Decompression in Pudendal Nerve Entrapment Syndrome

OBJECTIVE To report the first case of robotic pudendal nerve (PN) decompression for bilateral PN entrapment (PNE). PN decompression is a safe and effective treatment for PNE and can be accomplished laparoscopically with a better exploration of the sacral roots and of the PN. MATERIALS AND METHODS We describe in detail all the steps of our surgery, performed on a 38-year-old female patient suffering from PNE. All the anatomic landmarks are clearly shown. RESULTS Our technique was successful, and the patients postoperative course was uneventful. Six months after surgery, the pain had completely resolved, and the patient was drug-free. CONCLUSIONS We showed the feasibility and effectiveness of robotic PN decompression, with surgical advantages that could potentially extend the indications of robot-assisted surgery.

Faisibilité de dérivations urinaires continentes de type Mitrofanoff et Yang-Monti par voie robotique : technique opératoire

de reprises chirurgicales. La troisieme etape durait en moyenne 102mn (36—223) (Tableau 1). Sur l’ensemble de notre serie, nous n’avons constate aucune necrose ayant entrainee la perte du lambeau. 95 % des patients furent satisfaits de l’apparence de leur neo phallus. 80 % desmalades etaient satisfaits de leur vie sexuelle apres la chirurgie contre 35% avant. 69 % des malades presentaient des orgasmes reguliers apres chirurgie, contre 43% avant. Conclusion.— Notre technique de phalloplastie par lambeau pedicule de peau sus pubienne est une technique reproductible, peu morbide, esthetique repondant a l’attente des patients transsexuels.

Laparoscopic treatment of benign prostatic hyperplasia (BPH): overview of the current techniques: SURGERY ILLUSTRATED

TURP has been the ‘gold-standard’ surgical treatment for BPH over the past 30 years. However, its role in treating large prostates is limited mainly due to intraoperative and postoperative morbidities such as bleeding (with need for transfusion), TUR syndrome, urethral strictures as well as frequent need for re-operation [3]. The operative morbidity of TURP increases when it is performed for prostatic adenomas > 45 g, in procedures lasting > 90 min, or in patients aged > 80 years or with a history of acute urinary retention [4,5].

Surgery Illustrated ― Surgical Atlas Laparoscopic treatment of benign prostatic hyperplasia (BPH): overview of the current techniques

TURP has been the ‘gold-standard’ surgical treatment for BPH over the past 30 years. However, its role in treating large prostates is limited mainly due to intraoperative and postoperative morbidities such as bleeding (with need for transfusion), TUR syndrome, urethral strictures as well as frequent need for re-operation [3]. The operative morbidity of TURP increases when it is performed for prostatic adenomas > 45 g, in procedures lasting > 90 min, or in patients aged > 80 years or with a history of acute urinary retention [4,5].