Patel Robotic Urologic Surgery

1. Auflage 2008
ISBN: 978-1-84628-704-6
Verlag: Springer
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 222 Seiten

Robotic Urologic Surgery is a technical manual for various robotic approaches to surgical procedures, with helpful hints for avoiding pitfalls. The book shows how to develop a successful robotics program, learn the various techniques, and improve outcomes. Leading robotic urologic surgeons worldwide contribute chapters. The body of available data is reviewed in table format and supported by schematic diagrams and anatomic photographs to illustrate the concept being discussed. An accompanying DVD gives instructional content. This book is essential reading for all urologists as a reference to establish a robotics program, refine their surgical technique and provide information to patients.

Vipul Patel, MD, is director of Robotic and Minimally Invasive Urologic Surgery, associate clinical professor of Urology and Bioinformatics at The Ohio State University. He serves as an attending physician at OSU Medical Center and is a member of the OSU James Cancer Hospital prostate cancer treatment team. Patel also is director of the minimally invasive laparoscopic surgery fellowship training program at OSU. Dr. Patel is an internationally recognized expert in minimally invasive laparoscopic and robotic urologic surgery. His clinical interests involve urologic cancer and laparoscopic reconstruction with special emphasis on the care of patients with prostate and kidney cancer. He has performed more than 1,500 open, laparoscopic and robotic surgeries. His experience of almost 1,000 robotic surgeries is one of the largest in the world. He has served on the Board of the American Cancer Society and has led a prostate cancer support group called 'Man to Man.' This group serves to provide individualized support to patients and the families of men with prostate cancer. Yearly they have an event to raise awareness of prostate cancer called Relay For Life. Dr. Patel is a member of several professional societies including American Urological Association, Society of Laparoscopic Surgeons, Robotic Surgery Society and the American College of Surgeons. He is a reviewer for the professional journal Urology and has received numerous awards for his expertise in laparoscopy and patient care. He has published several articles on urologic cancer, urology and robotics.

Autoren/Hrsg.

Patel, Vipul R.

Inhaltsverzeichnis

1;Foreword;7
2;Preface;9
3;Contents;11
4;Contributors;15
5;Robotic Urologic Surgery: An Introduction and Vision for the Future;19
5.1;1.1. Definition;19
5.2;1.2. A Brief History of Robotics;19
5.3;1.3. Instrumentation;20
5.4;1.4. Optics;20
5.5;1.5. Robotic Arm Design;21
5.6;1.6. Console Design;21
5.7;1.7. Telecommunications;21
5.8;1.8. Tactile Feedback;21
5.9;1.9. Access;21
5.10;1.10. Miniaturization;22
5.11;1.11. Autonomy;22
5.12;1.12. Conclusion;22
6;Robotic Surgical Systems;23
6.1;2.1. Introduction;23
6.2;2.2. Robotics in Surgery;23
6.3;2.3. AESOP System;24
6.4;2.4. Telerobotic Surgery;25
6.5;2.5. Zeus System;25
6.6;2.6. da Vinci® Surgical System;26
6.7;2.7. Advantages of Robotic Technology;29
6.8;2.8. Telepresence Surgery;29
6.9;2.9. Future Designs;30
6.10;2.10. Conclusion;30
7;Multispeciality Applications of Robotic Technology;33
7.1;3.1. Cardiothoracic Surgery;33
7.2;3.2. General Surgery;35
7.3;3.3. Neurosurgery;37
7.4;3.4. Orthopedic Surgery;38
7.5;3.5. Conclusion;38
8;An Overview of Adult Robotic Urologic Surgery;41
8.1;4.1. Introduction;41
8.2;4.2. General Applications of Robotics in Adult Urologic Surgery;41
8.3;4.3. Conclusion;43
9;Essential Elements of Building a Robotics Program;46
9.1;5.1. Introduction;46
9.2;5.2. Establishment of a Robotic Prostatectomy Team;47
9.3;5.3. Training of the Robotic Prostatectomy Team;48
9.4;5.4. Operating Room Requirements;48
9.5;5.5. Patient Selection;49
9.6;5.6. Outcomes Measurement;50
9.7;5.7. Financial Considerations;50
9.8;5.8. Marketing Strategy;51
9.9;5.9. Conclusion;51
10;Principles and Lessons in a Transition from Open to Robotic-Assisted Laparoscopic Prostatectomy;52
10.1;6.1. Technical Differences in Surgical Technique;52
10.2;6.2. Patient Selection;54
10.3;6.3. Comparative Results;55
10.4;6.4. Conclusion;58
11;Training: Preparing the Robotics Team for Their First Case;59
11.1;7.1. The Current Standard;60
11.2;7.2. The Decision to Start a Robotic Prostatectomy Program;60
11.3;7.3. The Robotic Team;60
11.4;7.4. Preparation Before the First Case;61
11.5;7.5. Patient Selection;62
11.6;7.6. The First Case and the Mentor/ Proctor;63
11.7;7.7. Review of Reported Results;63
11.8;7.8. Other Thoughts;63
12;Patient Selection and Perioperative Management;65
12.1;8.1. Preoperative Period;65
12.2;8.2. Intraoperative Considerations;65
12.3;8.3. Robotic Radical Prostatectomy;66
12.4;8.4. Robotic Radical Cystectomy;69
12.5;8.5. Robotic Distal Ureterectomy with Reimplantation;70
13;Anesthetic Considerations and Management;72
13.1;9.1. Patient Population;72
13.2;9.2. Laparoscopic Considerations;74
13.3;9.3. Robotic/ Positioning Considerations;75
13.4;9.4. Recovery/ Pain Control Issues;76
13.5;9.5. Conclusion;77
14;Patient Positioning for Robotic Urologic Procedures;79
14.1;10.1. Robotic-Assisted Laparoscopic Prostatectomy;79
14.2;10.2 Robotic-Assisted Laparoscopic Ureterovesical Reimplant;81
14.3;10.3. Kidney Surgery;82
14.4;10.4. Conclusion;84
15;Transperitoneal Trocar Placement;85
15.1;11.1. General Considerations;85
15.2;11.2. Pelvic Operations ( Radical Prostatectomy, Cystectomy, Sacrocolpopexy);87
15.3;11.3. Renal Operations;91
15.4;11.4. Special Considerations ;92
15.5;11.5. Conclusion;92
16;Extraperitoneal Access;94
16.1;12.1. Introduction;94
16.2;12.2. Published Series;96
16.3;12.3. Comment;96
16.4;12.4. Conclusion;97
17;Robotic Radical Prostatectomy: A Step- by- Step Approach;99
17.1;13.1. Robot-Assisted Prostatectomy: A Step- by- Step Approach;99
17.2;13.2. Steps of the Robotic Prostatectomy;99
17.3;13.3. Evolving Role of Robotic Prostatectomy in Urology Practice;107
18;Clinical Pearls: The Approach to the Management of Difficult Anatomy and Common Operative and Postoperative Problems;109
18.1;14.1. The Obese Patient;109
18.2;14.2. Postinguinal Hernia Repair;111
18.3;14.3. The Bladder Neck Dissection;112
18.4;14.4. Posttransurethral Resection of the Prostate;112
18.5;14.5. Median Lobe;113
18.6;14.6. The Large Prostate;115
18.7;14.7. The Vesicourethral Anastomosis;115
18.8;14.8. Immediately Increased Postoperative Drain Output;116
18.9;14.9. Postoperative Urinary Retention and Nonunion of the Vesicourethral Anastomosis;117
18.10;14.10. Conclusion;117
19;The French Experience: A Comparison of the Perioperative Outcomes of Laparoscopic and Robot- Assisted Radical Prostatectomy at Montsouris;119
19.1;15A. 1. Robotic-Assisted Laparoscopic Prostatectomy;119
19.2;15A. 2. Conclusion;121
20;The French Experience: The St. Augustin Transition from the Laparoscopic to the Robotic Approach;124
20.1;15B. 1. Introduction;124
20.2;15B. 2. Trocar Position;124
20.3;15B. 3. Dissection of the Neurovascular Bundles;125
20.4;15B.4. The Anastomosis;126
20.5;15B. 5. Conclusion;127
21;The Oncologic Outcomes of Robotic- Assisted Laparoscopic Prostatectomy;128
21.1;16.1. Open Radical Prostatectomy;128
21.2;16.2. Robotic-Assisted Laparoscopic Prostatectomy;129
21.3;16.3. Techniques to Decrease Positive Margins;130
21.4;16.4. Robotic-Assisted Laparoscopic Prostatectomy: Comparison to Open and Laparoscopic Prostatectomies;131
21.5;16.5. Conclusion;131
22;Anatomic Basis of Nerve- Sparing Robotic Prostatectomy;134
22.1;17.1. Pelvic Neuroanatomy;134
22.2;17.2. Nerve- Sparing Technique of Robotic Prostatectomy;137
22.3;17.3. Conclusion;139
23;Alternative Approaches to Nerve Sparing: Techniques and Outcomes;141
23.1;18.1. Introduction;141
23.2;18.2. Nerve-Sparing Techniques and Results;141
23.3;18.3. Conclusion;147
24;Management of Postprostatectomy Erectile Dysfunction;149
24.1;19.1. Introduction;149
24.2;19.2. Approaches to Radical Prostatectomy: Potency Rates;149
24.3;19.3. Concept of Early Penile Intervention;155
24.4;19.4. Pathophysiology of Nerve Injury: Historical Evidence;156
24.5;19.5. Clinical Evidence ( Studies) for Early Intervention;157
24.6;19.6. Evolving Role of Robotic- Assisted Laparoscopic Prostatectomy;162
24.7;19.7. Is There Any Role of Early Penile Rehabilitation Following Robotic- Assisted Laparoscopic Prostatectomy?;163
24.8;19.8. Concept of Chronic Therapy;164
24.9;19.9. Conclusion;166
25;Robotic Pyeloplasty;170
25.1;20.1. Ureteropelvic Junction Obstruction;170
25.2;20.2. Pathophysiology;170
25.3;20.3. Presenting Symptoms;171
25.4;20.4. Diagnosis;171
25.5;20.5. Indications for Treatment;173
25.6;20.6. Therapeutic Options;173
25.7;20.7. Robotic-Assisted Pyeloplasty;173
25.8;20.8. Patient Positioning;174
25.9;20.9. Trocar Placement;174
25.10;20.10. Surgical Technique;175
25.11;20.11. Clinical Outcomes;175
25.12;20.12. Cost;177
25.13;20.13. Conclusion;177
26;Robot- Assisted Radical Cystectomy and Urinary Diversion;179
26.1;21.1. Introduction;179
26.2;21.2. Surgical Technique;180
26.3;21.3. Postoperative Care;183
26.4;21.4. Results;183
26.5;21.5. Comments;183
26.6;21.6. Conclusion;185
27;Complications of Robotic Surgery and How to Prevent Them;187
27.1;22.1. Patient Positioning and Anesthetic Issues;187
27.2;22.2. Complications of Access and Port Placement;190
27.3;22.3. Complications of Robotic- Assisted Laparoscopic Prostatectomy;191
27.4;22.4. Robotic Pyeloplasty;193
27.5;22.5. Mastering the Robotic Surgical System;194
28;Applications of Robotics in Pediatric Urologic Surgery;197
28.1;23.1. Pediatric Urologic Procedures;198
28.2;23.2. Other Procedures;204
28.3;23.3. Conclusion;205
29;Robotics and Infertility;206
29.1;24.1. Current Applications of Robotic Surgery in Reproductive Endocrinology and Infertility;207
29.2;24.2. Conclusion;210
30;Robotic Urogynecologic Surgery;212
30.1;25.1. Robotic-Assisted Laparoscopic Sacrocolpopexy Surgical Technique;213
30.2;25.2. Results;214
30.3;25.3. Complications;214
30.4;25.4. Limitations of Robotic-Assisted Sacrocolpopexy;214
30.5;25.5. Conclusion;215
30.6;25.6. The Future of Robotics in Urogynecology;215
31;The Future of Telerobotic Surgery;217
31.1;26.1. Telementoring;217
31.2;26.2. Telepresence Surgery;219
31.3;26.3. The Operating Room as a Digital Information Platform: Surgery in Information Space;220
31.4;26.4. Surgical Simulation;220
31.5;26.5. Augmented Reality Surgery;221
31.6;26.6. Preoperative and Intraoperative Teleconsulting for Oncologic Surgery;222
31.7;26.7. Surgical Simulation for Surgical Training;222
31.8;26.8. Surgical Simulators and Surgical Skills Competency;223
32;Prostate Images;226
33;Pyeloplasty Images;232
34;Index;235