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Laparoscopic Renal Cryoablation: The Video
VIDEO REVIEWS
ureteroscope. The incision is performed electrosurgically or with the holmium laser. The pertinent points are presented at length. Finally, the stenting, insertion and type of stents are well described. The indwelling catheter is left for 8 to 10 weeks. This video well presents all of the steps and advantages of this technique, and will be a useful adjunct to urologists planning to use it.
Endoscopic Management of Upper Tract Transitional Cell Tumors M. ESHGHI AND HIROSHI TAZAKI, Valhalla, New York This video illustrates the experience of the authors with the management of transitional cell carcinoma of the upper tract in the last 11 years. They summarize the approach for these tumors using dedicated instrumentation and nicely illustrate the comments with clinical cases. These techniques are used usually in a select group of patients, whose criteria include solitary kidney, poor renal function, small and superficial lesion, large lesion in a solitary kidney as a temporary measure and, rarely, patient preference. The authors also describe the technical considerations, which must not be forgotten. The final diagnosis and procedure for 46 cases are enumerated. Concerns about multicentricity of these lesions and the use of bacillus Calmette-Guerin in the management of the upper tract tumors are emphasized. Claude Trudel, M.D. 300 East Concorde Blvd. Duverney, Laval, Canada Laparoscopic Renal Cryoablation:The Video A. MATAMOROS, I. S. GILL,T. G. HEFFRON, M. E. FIDLER, R. J. TAYLOR, C. D. MILLER AND M. T. GRUNE, Omaha, Nebraska The porcine model has been used to investigate the technical feasibility of performing laparoscopic cryoablation of renal lesions. Although this idea is investigational in nature, it is novel, and certainly needs further animal and clinical trials. The use of color Doppler sonography enhances the safety factors. Several issues, such as possible indications, technical nuances (hypothermia), entry of the iceball into the collection system, postoperative course and complications (delayed bleeding) and so forth, remain to be addressed. Stage Adjusted Operative Strategy for Hypospadias Repair M. FISCH,J. FICHTNER,D. AS AND R. HOHENFELLNER, Mainz, Germany There is no need really to bring the meatus all the way to the tip is the message of this video. The concept is based on the following steps, including meatoplasty with meatotomy/glanuloplasty,dissection of chordee with the Nesbit procedure and urethral reconstruction using buccal mucosa as onlay graft. The 4 take home messages include keeping the aesthetics as the main goal, positioning the neomeatus at the coronal or glandular level, using buccal mucosa because of high compatibility and using onlay grafts, which decrease the rate of stricture at the proximal anastomosis. Raju Thomas, M.D. Department of Urology Tulane University Medical School New Orleans, h u i s a n a Videolaparoscopic Adrenalectomy L. N. CESTILHO, A. 1. M m ,A. M. LUCON, J. L. CHAMBER AND S. ARAP, Sao Paulo, Brazil This technique orientated video illustrates the laparoscopic surgical technique of anterior transperitoneal adrenalectomy in a brief, clear and concise manner. The technical quality is good with accurate left anatomical correlation and description of operative techniques. This video would serve as a good preoperative review for left transperitoneal laparoscopic adrenalectomy.
Bulbar Urethroplasty Using a Dorsal Onlay Graft G. D. WEBSTER AND L. K. CARR, Durham, North Carolina This video reviews the management of bulbar urethral strictures. The authors nicely demonstrate the technique of dorsal onlay urethroplasty. The demonstration is thorough, beginning with patient positioning and review of urethral exposure, intraoperative technique, graft harvest, postoperative management and followup studies. The distinguishing characteristics of this technique include the dorsal position of the free full-thickness skin graft. By fixation of the graft to the overlying corpora cavernosa the posterior repair is well supported and vascularized, allowing less shrinkage and sacculation. The authors caution against this complication in the pendulous urethra because of possible chordee. Mark Austenfeld, M.D. 4321 Washington 5300 Kansas City, Missouri All videos are available from the Ortho-McNeiYAmerican Urological Association Video Library, and can be ordered by calling 1-800-608-0096.
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ureteroscope. The incision is performed electrosurgically or with the holmium laser. The pertinent points are presented at length. Finally, the stenting, insertion and type of stents are well described. The indwelling catheter is left for 8 to 10 weeks. This video well presents all of the steps and advantages of this technique, and will be a useful adjunct to urologists planning to use it.
Endoscopic Management of Upper Tract Transitional Cell Tumors M. ESHGHI AND HIROSHI TAZAKI, Valhalla, New York This video illustrates the experience of the authors with the management of transitional cell carcinoma of the upper tract in the last 11 years. They summarize the approach for these tumors using dedicated instrumentation and nicely illustrate the comments with clinical cases. These techniques are used usually in a select group of patients, whose criteria include solitary kidney, poor renal function, small and superficial lesion, large lesion in a solitary kidney as a temporary measure and, rarely, patient preference. The authors also describe the technical considerations, which must not be forgotten. The final diagnosis and procedure for 46 cases are enumerated. Concerns about multicentricity of these lesions and the use of bacillus Calmette-Guerin in the management of the upper tract tumors are emphasized. Claude Trudel, M.D. 300 East Concorde Blvd. Duverney, Laval, Canada Laparoscopic Renal Cryoablation:The Video A. MATAMOROS, I. S. GILL,T. G. HEFFRON, M. E. FIDLER, R. J. TAYLOR, C. D. MILLER AND M. T. GRUNE, Omaha, Nebraska The porcine model has been used to investigate the technical feasibility of performing laparoscopic cryoablation of renal lesions. Although this idea is investigational in nature, it is novel, and certainly needs further animal and clinical trials. The use of color Doppler sonography enhances the safety factors. Several issues, such as possible indications, technical nuances (hypothermia), entry of the iceball into the collection system, postoperative course and complications (delayed bleeding) and so forth, remain to be addressed. Stage Adjusted Operative Strategy for Hypospadias Repair M. FISCH,J. FICHTNER,D. AS AND R. HOHENFELLNER, Mainz, Germany There is no need really to bring the meatus all the way to the tip is the message of this video. The concept is based on the following steps, including meatoplasty with meatotomy/glanuloplasty,dissection of chordee with the Nesbit procedure and urethral reconstruction using buccal mucosa as onlay graft. The 4 take home messages include keeping the aesthetics as the main goal, positioning the neomeatus at the coronal or glandular level, using buccal mucosa because of high compatibility and using onlay grafts, which decrease the rate of stricture at the proximal anastomosis. Raju Thomas, M.D. Department of Urology Tulane University Medical School New Orleans, h u i s a n a Videolaparoscopic Adrenalectomy L. N. CESTILHO, A. 1. M m ,A. M. LUCON, J. L. CHAMBER AND S. ARAP, Sao Paulo, Brazil This technique orientated video illustrates the laparoscopic surgical technique of anterior transperitoneal adrenalectomy in a brief, clear and concise manner. The technical quality is good with accurate left anatomical correlation and description of operative techniques. This video would serve as a good preoperative review for left transperitoneal laparoscopic adrenalectomy.
Bulbar Urethroplasty Using a Dorsal Onlay Graft G. D. WEBSTER AND L. K. CARR, Durham, North Carolina This video reviews the management of bulbar urethral strictures. The authors nicely demonstrate the technique of dorsal onlay urethroplasty. The demonstration is thorough, beginning with patient positioning and review of urethral exposure, intraoperative technique, graft harvest, postoperative management and followup studies. The distinguishing characteristics of this technique include the dorsal position of the free full-thickness skin graft. By fixation of the graft to the overlying corpora cavernosa the posterior repair is well supported and vascularized, allowing less shrinkage and sacculation. The authors caution against this complication in the pendulous urethra because of possible chordee. Mark Austenfeld, M.D. 4321 Washington 5300 Kansas City, Missouri All videos are available from the Ortho-McNeiYAmerican Urological Association Video Library, and can be ordered by calling 1-800-608-0096.
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