Urology
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Comparative Study
Improvement of hemostasis in open and laparoscopically performed partial nephrectomy using a gelatin matrix-thrombin tissue sealant (FloSeal).
Long-term follow-up studies have demonstrated that effective local tumor control and long-term tumor-free progression rates can be achieved by nephron-sparing surgery. However, hemostasis is a major issue, and the lack of effective means of hemostasis has limited the wider use of the laparoscopic approach to nephron-sparing surgery. ⋯ The two-component tissue sealant FloSeal provided immediate and durable hemostasis in open and laparoscopically performed partial nephrectomies. The tissue sealant may provide a tool to expand the possibilities of laparoscopic nephron-sparing surgery.
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To describe the technique of transperitoneal laparoscopic bilateral synchronous partial adrenalectomy in a patient with bilateral adrenal pheochromocytoma. ⋯ Laparoscopic partial adrenalectomy for pheochromocytoma is safe and technically feasible. Intraoperative ultrasonography is helpful to accurately plan resection of the tumor. If tumor location permits, the main adrenal vein should be preserved to ensure adequate vascularity for the adrenal remnant.
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Remote robotic telemanipulators have been recently used in performing laparoscopic urologic procedures, both in the laboratory and in clinical practice. We present, to our knowledge, the initial 2 cases of robotic-assisted laparoscopic adrenalectomy in humans. ⋯ Robotic-assisted laparoscopic adrenalectomy is technically feasible. With increasing experience and refinement in the technology, the role of robotics in urologic laparoscopy is likely to expand.