HOW I DO IT

• Partial nephrectomy: novel closure technique using bovine pericardium

  Uhlman A. Matthew , Brown A. James, MD Department of Urology, University of Iowa, Iowa City, Iowa, USA

  ---

  Partial nephrectomy (PN) has gained popularity over the past two decades as an alternative to radical nephrectomy (RN) in patients with small renal masses. Morbidity and mortality from PN have been shown to be lower than from RN, while oncologic outcomes have been shown to be equivalent for tumors < 7 cm. PN has become increasingly popular in academic centers, but the general urologic community continues to lag behind. The reason for this is not known, but may be related to the relatively high complication rate, including delayed complications associated with inadequate closure. Here we describe a novel PN closure technique that provides additional strength and hemostasis by incorporating bovine pericardium.

  Keywords: surgical techniques, novel closure, penile carcinoma, laparoscopy, robotics,

  Oct 2012 (Vol. 19, Issue 5 , Page 6485)
  Full Text   |  PDF (866KB)Free
• Functional oncologic and technical outcomes after endoscopic groin dissection for penile carcinoma

  Canter J. Daniel, Dobbs W. Ryan, Jafri Mohammed A. S., Herrel A. Lindsey, Ogan Kenneth, Delman A. Keith, Master A. Viraj, MD Department of Urology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia, USA

  ---

  Penile cancer is a rare cutaneous malignancy that frequently spreads to the regional inguinal lymph nodes with a prolonged locoregional phase. An inguinal lymph node dissection may be both diagnostic and therapeutic, even in the setting of advanced disease. Despite its proven oncologic importance and efficacy, an inguinal lymphadenectomy remains underutilized, even with the publication of guidelines advocating its use. Failure to apply this modality is most likely due to the significant morbidity associated with a traditional open approach, including flap necrosis, wound infection and debilitating lymphedema. The risks and complications associated with an open inguinal lymph node dissection have driven several investigators to develop techniques for performing a minimally invasive endoscopic inguinal lymph node dissection that is oncologically equivalent to the ?gold standard? open approach, while potentially minimizing the complications traditionally seen with the open technique. In this report, we detail our technique for performing a minimally invasive endoscopic groin dissection with inguinal lymphadenectomy for penile carcinoma. We also present preliminary complication and short term oncologic data employing this surgical technique in an initial cohort of patients.

  Keywords: penile carcinoma, laparoscopy,

  Aug 2012 (Vol. 19, Issue 4 , Page 6395)
  Full Text   |  PDF (913.1KB)Free