Case report: pure robot-assisted psoas hitch ureteral reimplantation for distal-ureteral stenosis.

Robot-assisted procedures are slowly invading minimally invasive urologic surgery. When superior visibility, meticulous dissection, or complex reconstruction is needed, robotic surgery may offer benefits over conventional laparoscopy. We report the use of the da Vinci robotic system for laparoscopic psoas hitch-supported ureteral reimplantation. We believe this procedure was facilitated technically compared with conventional laparoscopy.

[A man stuck to a drain]. / Een man met een vastzittende drain.

A 54-year-old man underwent a robot assisted laparoscopic prostatectomy (RALP) because of prostate cancer. During surgery an open silicone drain was placed in the abdominal cavity. After a few days we tried to remove the drain, however it was stuck to a bloodclot and to a tissue structure protruding from the abdominal cavity. This proved to be the appendix vermiformis. The drain was safely removed and the appendix was pushed back into the abdominal cavity successfully. The patient suffered no consequences of this complication.

Robot-assisted laparoscopic radical prostatectomy: oncologic and functional results of 184 cases.

OBJECTIVE: To evaluate the initial functional and oncologic results of 184 robot-assisted radical prostatectomies performed at our hospital. METHODS: A retrospective study was made of the first 184 consecutive robot-assisted radical prostatectomies performed at our hospital between February 2003 and December 2005. The procedures were performed by two surgeons who used the da Vinci robot with three robot arms. A transperitoneal approach was used in all patients. All patients had clinically organ-confined prostate cancer (< or =cT2c). The median follow-up was 6 mo. RESULTS: A positive surgical margin was found in 29 of the 184 patients (mean: 15.7%). The percentage positive surgical margins for the organ-confined (pT2) and non-organ-confined prostate cancers (pT3) were 2.5% and 38%, respectively. Ninety-five percent of patients were completely continent or wore one safety liner. Forty-three percent of the continent patients achieved complete continence within 28 d. Eighty-one percent of the patients who were younger than 60 yr and received a nerve-sparing procedure were potent and able to perform sexual intercourse. This percentage dropped to 51% in patients older than 60 yr. No major complications were encountered. CONCLUSIONS: The functional and oncologic results of this minimally invasive procedure seem very promising. Longer follow-up of the data and larger prospective studies are necessary to confirm these promising results.