[Does robotics improve laparoscopic radical prostatectomy in complex surgical cases?]. / Le robot améliore-t-il la prostatectomie totale laparoscopique dans les cas complexes?

UNLABELLED: The radical prostatectomy is the main treatment prostate cancer in young men. However in difficult cases, another therapeutic option is often suggested. OBJECTIVE: Evaluation of the quality of the anastomosis in complex surgical cases by comparing laparoscopic radical prostatectomy (LRP) to robotic assisted radical prostatectomy (RLRP). MATERIAL: From March 2004 to August 2009, 397 patients underwent radical prostatectomy: 176 LRP and 221 RLRP consecutively by the same surgeon. Antecedents that might have complicated dissection were analyzed: prostatic volume over 80 cc, previous inguinal hernia repair with mesh, previous pelvic surgery, body mass index over 30 and previous trans-urethral resection of prostate. RESULTS: In a preoperative mode, there was no significant difference between the two groups. A multivariable analysis of the quality of the anastomosis turned to the advantage of the robot (OR=2.56 [95 %CI: 1.28-5.25]), specifically for difficult cases (Odd Ratio=7.736 [95 %CI: 2.689-22.254]). CONCLUSION: The use of the robot improved the quality of the anastomosis for patients that might have raised technical issues.

[Role of percutaneous arterial embolization in renal pathology]. / Place de l'embolisation artérielle percutanée en pathologie rénale.

Therapeutic embolization in renal pathology is used for various conditions in cancerology, traumatology, urology, nephrology and for iatrogenic complications of percutaneous manoeuvers. Any department of vascular radiology may be requested to use this technique, especially in emergent traumatology or palliative cancerology. The authors study the various conditions that may benefit from these procedures and give the highlights of the main indications and the main types of embolic agents used. Complications, side effects and the major precautions are also reviewed.

Modified shoelace technique for delayed primary closure of the thigh after acute compartment syndrome.

The authors report a case of acute compartment syndrome in the thigh in a 19-year-old man with multiple injuries including fracture of the femoral diaphysis. Decompressive fasciotomy was performed emergently. Complete progressive closure of the wound without split-thickness skin grafting was achieved using a modified shoelace technique: sutures were run inside wide drains placed in contact with the muscles and were then tightened over the skin. These drains enlarged the contact area between sutures and muscles, preventing damage to muscles.