HOW I DO IT

• Use of blunt right angles to aid in intussusception of a Bricker ileal conduit

  Strigenz E. Michael , Uhlman A. Matthew , Brown A. James, MD University of Iowa, Iowa City, Iowa, USA

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  The Bricker ileal conduit has been the most popular urinary diversion technique following a radical cystectomy since the 1950s. The procedure typically provides a high quality of life for patients. However, stomal complications occur in 16%-65% of ileal conduit cases. We describe an easy technique to aid in the intussusception of a Bricker ileal conduit. This technique produces stomas with a height of 2 cm-3 cm consistently. In our experience, we have had excellent results when using this technique.

  Keywords: surgical techniques, ileal conduit, surgical stoma, urinary bladder neoplasms, cystectomy,

  Feb 2014 (Vol. 21, Issue 1 , Page 7171)
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• Robot assisted radical prostatectomy: how I do it. Part II: surgical technique

  Valdivieso F. Roger , Hueber Pierre-Alain , Zorn C. Kevin, MD Hopital St. Luc Montreal, Quebec, Canada

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  The introduction of the "da Vinci Robotic Surgical System" (Intuitive Surgical, Sunnyvale, CA, USA) has been an important step towards a minimally invasive approach to radical prostatectomy. Technologic peculiarities, such as three-dimensional vision, wristed instrumentation with seven degrees of freedom of motion, lack of tremor, a 10x-magnification and a comfortable seated position for the surgeon has added value to the procedure for the surgeon and the patient. In this article, we describe the 9 step surgical technique for robot assisted radical prostatectomy (RARP) that is currently used in our institution (University of Montreal Hospital Center (CHUM) - Hopital St-Luc). We use the four-arm da Vinci Surgical System. Our experience with RARP is now over 250 cases with the senior surgeon having performed over 1200 RARPs and we have continually refined our technique to improve patient outcomes.

  Keywords: surgical techniques, prostate cancer, robot assisted radical prostatectomy,

  Dec 2013 (Vol. 20, Issue 6 , Page 7073)
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• Robot assisted radical prostatectomy: how I do it. Part I: patient preparation and positioning

  Valdivieso F. Roger , Hueber Pierre-Alain , Zorn C. Kevin, MD University of Montreal Hospital Center (CHUM)-Hopital St. Luc, Montreal, Quebec, Canada

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  Radical prostatectomy remains the standard treatment for long term cure of clinically localized prostate cancer, offering excellent oncologic outcomes, with cancer-specific survival approaching 95% at 15 years after surgery. The introduction of the `da Vinci Robotic Surgical System` (Intuitive Surgical, Sunnyvale, CA, USA) has been another important step toward a minimally invasive approach to radical prostatectomy. Technologic peculiarities, such as three-dimensional vision, wristed instrumentation with seven degrees of freedom of motion, lack of tremor, a 10x-magnification and a comfortable seated position for the surgeon has added value to the surgeon and patient. In this first part of a two article series, we describe preoperative patient preparation and positioning protocols for robot assisted radical prostatectomy (RARP) that are currently used in our institution (University of Montreal Hospital Center (CHUM) – Hopital St-Luc). We use the four-arm da Vinci Si Surgical System. Our experience with RARP is now over 250 cases with the senior surgeon having performed over 1200 RARPs and we have continually refined our technique to improve patient outcomes.

  Keywords: surgical techniques, prostate cancer, robot assisted radical prostatectomy,

  Oct 2013 (Vol. 20, Issue 5 , Page 6957)
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• 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

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  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)
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