- Internal hernia from the interureteric space after robot-assisted radical cystectomy and urinary diversion: Two case reports. [Case Reports]Medicine (Baltimore) 2019; 98(41):e17222M
- CONCLUSIONS: The incidence of internal herniation may increase by the growing use of RARC. Suitable stoma position, appropriate length of ureter dissection, and retroperitonealization can help prevent this complication.
- Ureteral endometriosis in patients with deep infiltrating endometriosis: characteristics and management from a single-center retrospective study. [Journal Article]Arch Gynecol Obstet 2019; 300(4):967-973AG
- CONCLUSIONS: The variables of rAFS stage IV, USL DIE lesion ≥ 3 cm in diameter and previous surgery for endometriosis significantly increased the risk of UE. Laparoscopic ureterolysis and ureteroneocystostomy are feasible and safe procedures with low complication and recurrence rates.
- Impact of prior hysterectomy on surgical outcomes for laparoscopic adnexal surgery. [Journal Article]Surg Endosc 2019SE
- CONCLUSIONS: Patients with prior hysterectomy were 70% more likely to have a complication at the time of laparoscopic adnexal surgery than patients without hysterectomy. Increased risk of complications in subsequent adnexal surgery may influence the informed consent process or decisions regarding ovarian conservation. Awareness of potential need for additional surgical procedures may guide availability of equipment, choice of operating site, or referral to an advanced pelvic surgeon.
- Comparison of Laparoscopic Hysterectomy in Patients with Endometriosis with and without an Obliterated Cul-de-sac. [Journal Article]J Minim Invasive Gynecol 2019JM
- CONCLUSIONS: Patients with stage IV endometriosis and an obliterated cul-de-sac required laparoscopic modified radical hysterectomy and various other intraoperative procedures more than patients with stage IV endometriosis without obliteration and stages I through III. Patients with obliterated cul-de-sacs who are identified intraoperatively should be referred to minimally invasive gynecologic specialists because of the difficult nature of these procedures and extra training required to perform them safely with limited morbidity.
- Ureteric inguinal herniation with obstructing bladder tumour. [Case Reports]Urol Case Rep 2019; 26:100924UC
- While ureteric orifice obstruction by bladder tumour is common, an inguinal hernia containing ureter is rare. The simultaneous occurrence of both has not previously been reported and made management both challenging and unique. We present the case of a 75-year-old man who presented with a symptomatic right inguinal hernia, which was found on imaging to include the right ureter. Cystoscopy to perf…
While ureteric orifice obstruction by bladder tumour is common, an inguinal hernia containing ureter is rare. The simultaneous occurrence of both has not previously been reported and made management both challenging and unique. We present the case of a 75-year-old man who presented with a symptomatic right inguinal hernia, which was found on imaging to include the right ureter. Cystoscopy to perform right ureteric stent insertion revealed bladder tumour obstructing the ipsilateral ureteric orifice. A multi-disciplinary approach involving urology, general surgery and interventional radiology was successful in achieving tumour resection, ureterolysis with preservation of ureter and inguinal hernia repair.
- Bilateral laparoscopic ureterolysis using hydrodissection in retroperitoneal fibrosis: a new application of an old technique. [Journal Article]Res Rep Urol 2019; 11:131-135RR
- CONCLUSIONS: Hydrodissection of the ureter in retroperitoneal fibrosis is a new application in the upper urinary tract laparoscopic approach that has not been described in literature before. It seems to offer excellent midterm outcomes. The use of ERBEJET 2 device seems to simplify the procedure and make it feasible and safe (less trauma to the ureter and more conservation of its blood supply). We believe that comparative studies are needed to assess the role of hydrodissection in ureterolysis for retroperitoneal fibrosis.
- Gross and Histologic Anatomy of the Pelvic Ureter: Clinical Applications to Pelvic Surgery. [Journal Article]Obstet Gynecol 2019; 133(5):896-904OG
- CONCLUSIONS: Proximity of the ureter to the uterine isthmus and lateral anterior vagina mandates careful surgical technique and identification. The intricacy of tissue surrounding the distal ureter within the parametrium and the increased nerve density along the posterior distal ureter emphasizes the importance of avoiding extensive ureterolysis in this region.
- Intraoperative ICG-fluorescence imaging for robotic-assisted urologic surgery: current status and review of literature. [Review]Int Urol Nephrol 2019; 51(5):765-771IU
- CONCLUSIONS: Although it is not necessary to utilize fluorescence-enhanced surgery in all cases, the authors find the utilization of ICG-NIRF in complex and highly technical surgeries useful.
- Laparoscopic Removal of an Abdominal Pregnancy in the Pelvic Sidewall. [Journal Article]J Minim Invasive Gynecol 2019 Sep - Oct; 26(6):1007-1008JM
- CONCLUSIONS: Abdominal pregnancy is a rare type of ectopic pregnancy with a reported incidence of 1:10,000 to 1:30,000 pregnancies, and accounts for approximately 1% of ectopic pregnancies . It carries a high risk for maternal morbidity and mortality. Many different locations at different gestational ages have been reported in the literature, including the pouch of Douglas, pelvic sidewall, bowel, broad ligament, omentum, and spleen [2-4]. These varied locations and the rarity of this type of pregnancy make diagnosis and treatment challenging. The location of the growing fetal tissue may endanger the patient's life if it impinges on vital anatomic structures. In the present case, the gestational sac was very close to the right ureter, and we opted to surgically excise the gestational sac in its entirety.
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- A rare indication of robot-assisted uretero-ureterostomy: ovarian vein syndrome. [Journal Article]J Robot Surg 2019; 13(5):703-705JR
- Ovarian vein syndrome is a rare cause of ureteral obstruction. Most of these cases occur during pregnancy likely from the gravid uterus causing ovarian vein dilatation and valvular incompetence. Hormonal changes associated with pregnancy also affect the muscular wall of ureter, causing decrease in tone and may facilitate compression as well. There is a predilection for right side and in thin fema…
Ovarian vein syndrome is a rare cause of ureteral obstruction. Most of these cases occur during pregnancy likely from the gravid uterus causing ovarian vein dilatation and valvular incompetence. Hormonal changes associated with pregnancy also affect the muscular wall of ureter, causing decrease in tone and may facilitate compression as well. There is a predilection for right side and in thin females. The traditional treatment has been the ligation of ovarian vein and ureterolysis. We report a case of ovarian vein syndrome in a young female which was managed by robot-assisted laparoscopic ovarian vein ligation, resection of stenosed ureteric segment and end-to-end ureterostomy.