Minimally invasive surgery of the kidney a problem-oriented approach
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Philadelphia [u.a.]
Saunders
2000
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| Schriftenreihe: | The urologic clinics of North America
27,4 |
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Datensatz im Suchindex
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CONTENTS
Preface xv
Stevan B. Streem and Inderbir S. Gill
Color Plate xvii
Renal Anatomy: Endourologic Considerations 585
Francisco J. B. Sampaio
The general anatomy of the kidney as applied to minimally invasive
surgery is described. The kidney morphometry, the spatial planes, and
the perirenal coverings are presented. The kidney s relationship with the
diaphragm, ribs, pleura, liver, spleen, and colon is described in importance
of intrarenal access. The intrarenal anatomy is also described, based on a
large series of three dimensional endocasts. The anatomic relationships of
the intrarenal vessels (arteries and veins) with the kidney collecting system
are presented and discussed with respect to intrarenal access by puncture,
for endopyelotomy and for nephron sparing operations.
Renal Physiology: Laparoscopic Considerations 609
Matthew D. Dunn and Elspeth M. McDougall
The pneumoperitoneum used for laparoscopic surgery is associated with
a myriad of physiologic changes. An understanding of the effect of ele¬
vated intra abdominal pressure on cardiopulmonary, vascular, and renal
functions is important as the complexity of the laparoscopic urologic
procedures continues to increase. Oliguria and anuria are well recognized
clinical signs of elevated intra abdominal pressure. The etiology is multi
factorial, emanating from vascular and parenchymal compression, and
associated with systemic hormonal effects. It is important for the entire
operative team to have an understanding of the physiologic effects of
CO2 insufflation to provide appropriate intraoperative monitoring and
management and minimize intraoperative and postoperative complica¬
tions.
UROLOGIC CLINICS OF NORTH AMERICA
VOLUME 27 • NUMBER 4 • NOVEMBER 2000 vii
Renal Calculi
Renal Calculi: Percutaneous Management 617
Sanjay Ramakumar and Joseph W. Segura
There are patients whose renal stones are best treated through percutane¬
ous methods. These indications as well as improvements in selection
criteria are reviewed. The advantages and disadvantages of modifications
to the original technique are discussed. Percutaneous management of renal
calculi provides safe and cost effective treatment for renal stones.
Ureteropyeloscopic Treatment of Ureteral and Intrarenal Calculi 623
Michael Grasso
Retrograde endoscopic treatment of upper urinary tract calculi has pro¬
gressed based on improvements in fiberoptic endoscopes, powerful and
precise endoscopic lithotrites, and incremental advances in surgical tech¬
nique. Where once only distal ureteral stones were addressed ureteroscopi
cally, today stones throughout the upper urinary tract of all sizes and
compositions can be treated ureteroscopically. The indications for retro¬
grade endoscopic lithotripsy, current instrumentation, and progressive
techniques will be presented in this article.
Calyceal Diverticula and Renal Cystic Disease
Percutaneous Management of Caliceal Diverticula 635
Bradley F. Schwartz, and Marshall L. Stoller
Calyceal diverticula are often best managed by a percutaneous approach.
The therapeutic goals for these abnormalities include removal of calculi,
obliteration of the diverticulum using electrocautery fulguration, and tem¬
porary percutaneous nephrostomy drainage. The authors present the indi¬
cations and techniques for approaching calyceal diverticula percutane
ously.
Calyceal Diverticula: Ureteroscopic Management 647
Tsung Wen Chong, Mathew H.T. Bui, and Gerhard J. Fuchs
Calyceal diverticula are usually asymptomatic intrarenal anatomical aber¬
rations, unless they become a source of recurrent hematuria or manifest
as pain related to stones within. Various treatment options exist, ranging
from noninvasive shock wave lithotripsy (SWL) to percutaneous or laparo
scopic procedures. Ureter renoscopic retrograde techniques, in selected
cases, offer the efficacy of intracorporeal lithotripsy and also address the
primary anatomical problem, while having less morbidity than percutane¬
ous or laparoscopic approaches.
Calyceal Diverticulum and Hydrocalyx: Laparoscopic
Management 655
J. Stuart Wolf, Jr
Laparoscopic ablation of calyceal diverticula or hydrocalyces is different
than other minimally invasive options for these lesions (shock wave litho¬
tripsy and ureteroscopic and percutaneous nephroscopy) in that it incorpo¬
rates complete obliteration of both the cavity and its connection with the
collecting system. Laparoscopic ablation provides definitive management
similar to that achieved with open surgery, but with less patient morbidity.
Laparoscopic treatment of calyceal diverticula or hydrocalyces is an excel
Viii CONTENTS
lent choice for anterior cavities without significant overlying renal paren¬
chyma that are large or have an endoscopically inaccessible neck and
either a narrow neck or large stone burden.
Renal Cystic Disease: Laparoscopic Management 661
Margaret S. Pearle, Olivier Traxer, and Jeffrey A. Cadeddu
Traditionally, symptomatic or indeterminate renal cysts were managed
with open exploration and cyst decortication—procedures associated with
significant morbidity. The introduction of percutaneous and endoscopic
techniques enabled diagnostic and therapeutic modalities for cyst evalua¬
tion and management. However, for cysts that fail percutaneous or endo¬
scopic maneuvers, or for the numerous cysts associated with autosomal
dominant polycystic kidney disease, laparoscopy offers a safe and effective
alternative for management of symptomatic patients. Likewise, for end
stage kidneys due to renal cystic disease, laparoscopic nephrectomy, while
technically challenging, offers a less morbid alternative to open nephrec¬
tomy.
Ureteropelvic Junction Obstruction
Ureteropelvic Junction Obstruction: Retrograde Endopyelotomy 677
Stephen Y. Nakada and Matthew Johnson
Current treatment of urteropelvic junction obstruction (UJO) with retro¬
grade endopyelotomy continues to evolve as experience and knowledge
progress. Use of the straight lateral incision and selective use of spiral CT
angiogram have refined treatment decisions with retrograde endopyelo¬
tomy further. The authors decision oriented approach offers guidelines
for the practicing urologist. Ultimately, it is up to the urologist and the
patient to select the best approach for each clinical scenario.
Percutaneous Endopyelotomy 685
Stevan B. Streem
Percutaneous endopyelotomy, introduced over 15 years ago, is a well
established alternative to open operative pyeloplasty for management of
ureteropelvic junction (UPJ) obstruction. Although several variations of
the technique have been described, the goal in all cases is to develop a
full thickness incision though the obstructing proximal uretra that extends
out to the peripyeloureteral fat and heals over an internal stent. Though a
percutaneous endopyelotomy can be considered for almost any patient
with primary or secondary UPJ obstruction, it is particularly valuable in
the setting of upper tract stones that can then be managed simultaneously.
This article reviews the indications, techniques, and outcomes of percuta¬
neous endopyelotomy.
Laparoscopic Pyeloplasty 695
Gunter Janetschek, Reinhard Peschel, and Ferdinand Franscher
The results of laparoscopic pyeloplasty are equal to those of open surgery,
but laparoscopy is superior in terms of morbidity. Retrograde endopyelo¬
tomy carries the least morbidity, but if there are crossing vessels at the
ureteropelvic junction (UPJ) the results are far inferior to those of other
techniques. Laparoscopic dismembered pyeloplasty is technically feasible,
but difficult. We, therefore, prefer the nondismembered technique for
laparoscopy, which is technically much easier and achieves equally good
results.
CONTENTS ix
Renal Cell Carcinoma: Laparoscopic Management
Laparoscopic Radical Nephrectomy for Cancer 707
Inderbir S. Gill
Laparoscopic radical nephrectomy is a rapidly emerging technique for the
treatment of renal cell carcinoma. Surgeons at multiple institutions have
reported excellent technical results with this procedure, with encouraging
safety and efficacy data and low complication rates comparable with the
rates of open radical nephrectomy. Although debate continues regarding
the pros and cons of the transperitoneal versus retroperitoneal approach
and regarding morcellation versus intact specimen extraction, laparoscopic
radical nephrectomy is beginning to approach standard of care status at
select institutions for tumors less than 8 cm in size.
Laparoscopic Partial Nephrectomy:
The European Experience 721
Jens J. Rassweiler, Claude Abbou, Giinter Janetsheck,
and Klaus Jeschke
This article summarizes the experience of four European centers with
laparoscopic partial nephrectomy for small renal tumors. Fifty three tu¬
mors have been treated, of which 37 histologically were renal cell carci¬
noma. The procedure is technically demanding; adequate hemostasis dur¬
ing the excision of the tumor still represents the major problem. However,
laparoscopic partial nephrectomy has proved to be oncologically effective,
offering the advantage of minimally invasive access for the patients.
Upper Tract Transitional Cell Carcinoma
Primary Percutaneous Approach to Upper Urinary Tract
Transitional Cell Carcinoma 739
Michel E. Jabbour and Arthur D. Smith
With the evolution of ureteronephroscopes, a primary endoscopic ap¬
proach to upper urinary tract filling defect has become possible with a
strategy similar to that used for bladder tumors. Endcscopic resection can
provide the histologic proof as well as the grade and the stage of the
tumor without exposing the patient to additional cancer related risks.
Invasive tumors can be treated with an immediate nephroureterectomy.
With a rigorous follow up, superficial transitional cell carcinoma (TCC) of
the upper tract with low and moderate grades can be treated endourologi
cally, even in the presence of a normal contralateral kidney, with low
morbidity and a long term efficiency comparable to that of nephroureterec¬
tomy.
Ureteroscopic Management of Patients with Upper Tract
Transitional Cell Carcinoma 751
Dean G. Assimos, M. Craig Hall, and Jeffrey H. Martin
Endoscopic therapy for the management of upper urinary tract TCC is
mainly indicated for patients with an anatomically or functionally solitary
kidney, renal insufficiency, bilateral tumors, or severe medical comorbidity.
It may be a reasonable alternative to distal ureterectomy with bladder cuff
resection in individuals with low grade superficial distal ureteral tumors.
Although use of this approach has been suggested for treating standard
patients with low grade, low stage collecting system tumors, this recom¬
mendation should not be embraced until more supporting evidence is
generated.
X CONTENTS
Laparoscopic Nephroureterectomy:
A New Standard for the Surgical Treatment of
Upper Tract Transitional Cell Carcinoma 761
Arieh L. Shalhav, Andrew J. Portis, Elsepth M. McDougall,
Manoj Patel, and Ralph V. dayman
Laparoscopic nephroureterectomy for upper tract transitional cell cancer
has been in a slow process of evolution since its inception in 1991. Given
the rarity of this condition, there are presently reported only a few series
containing relatively small numbers of patients with brief follow up. Also,
valid concerns remain about the method of treatment of the distal ureter
among these patients.
Renal Transplantation
Renal Transplantation: Laparoscopic Live Donor Nephrectomy 777
Fernando J. Kim, Lloyd E. Ratner, and Louis R. Kavoussi
Live donor renal transplantation has many advantages compared to kid¬
neys obtained from cadavers, including greater patient and graft survival.
In an effort to decrease disincentives to donors, a laparoscopic approach
to renal donation was developed. This surgical route provides donors with
less postoperative pain, an optimal cosmetic result and quicker convales¬
cence compared to traditional open removal. Moreover, experience has
demonstrated that these gains have been achieved without compromise to
the allograft. This article describes our latest techniques and reviews re¬
sults obtained with laparoscopic donation.
Renal Transplant Complications:
Minimally Invasive Management 787
Michael G. Hobart, Stevan B. Streem, and Inderbir S. Gill
The therapeutic goal of managing renal transplant complications is to
ensure optimal recipient and graft outcomes, while minimizing recipient
morbidity and potential secondary complications. Dense peri transplant
scar tissue may hamper open surgical correction of renal transplant com¬
plications, and correction may require complex reconstructive procedures.
More recently, principles derived from endourology, laparoscopy and in
terventional radiology have been applied to renal transplant complications
with encouraging results. In carefully selected patients, minimally invasive
management plans can be offered as reasonable alternatives to, and in
some cases as superior approaches to conventionally open surgical repair,
though clearly not all complications are amenable or appropriate for this
form of management.
Renal Surgery in the 21st Century
Renal Surgery in the New Millennium 801
Fernando C. Delvecchio and Glenn M. Preminger
The development and application of new technologies to the field of
minimally invasive surgery will surely transform the standards of medical
practice as we understand them today. Advances in video imaging technol¬
ogy, virtual reality, diagnostic modalities, telemedicine, needlescopic ac¬
cess, robotics, tissue welding, and tissue ablation will all impact on the
performance of renal surgery over the next two decades. This paper
reviews recent progress in these fields and speculates on the potential
impact of these innovative technologies.
CONTENTS Xi
The Craft of Urologic Surgery
Laparoscopic Cryoablation of Renal Masses 813
Roland N. Chen, Andrew C. Novick, and Inderbir S. Gill
Laparoscopic cryoablation seems to be an effective treatment modality for
small peripheral renal tumors. The technique is minimally invasive, has a
rapid learning curve, results in minimal blood loss and morbidity, and, to
date, has demonstrated precise reliable ablation of small renal neoplasms.
Long term follow up is necessary to confirm the absence of local tumor
recurrence or distant or port site metastases.
Cumulative Index 2000 821
Subscription Information Inside back cover
XU CONTENTS
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| spelling | Minimally invasive surgery of the kidney a problem-oriented approach Stevan B. Streem ... guest ed. Surgical craft: laparoscopic cryoablation of renal masses Laparoscopic cryoablation of renal masses Philadelphia [u.a.] Saunders 2000 XII S., S. 585 - 839 zahlr. Ill. txt rdacontent n rdamedia nc rdacarrier The urologic clinics of North America 27,4 Niere (DE-588)4042270-7 gnd rswk-swf Minimal-invasive Chirurgie (DE-588)4327907-7 gnd rswk-swf Nierenkrankheit (DE-588)4075399-2 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Niere (DE-588)4042270-7 s Minimal-invasive Chirurgie (DE-588)4327907-7 s DE-604 Nierenkrankheit (DE-588)4075399-2 s Streem, Stevan B. Sonstige oth Chen, Roland N. (DE-588)1067450254 aut Laparoscopic cryoablation of renal masses Novick, Andrew C. aut Laparoscopic cryoablation of renal masses Gill, Inderbir S. aut Laparoscopic cryoablation of renal masses The urologic clinics of North America 27,4 (DE-604)BV000001584 27,4 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=009196364&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis [Surgical craft: laparoscopic cryoablation of renal masses <<Roland N. Chen, Andrew C. Novick and Inderbir S. Gill>>] |
| spellingShingle | Chen, Roland N. Novick, Andrew C. Gill, Inderbir S. Minimally invasive surgery of the kidney a problem-oriented approach The urologic clinics of North America Niere (DE-588)4042270-7 gnd Minimal-invasive Chirurgie (DE-588)4327907-7 gnd Nierenkrankheit (DE-588)4075399-2 gnd |
| subject_GND | (DE-588)4042270-7 (DE-588)4327907-7 (DE-588)4075399-2 (DE-588)4143413-4 |
| title | Minimally invasive surgery of the kidney a problem-oriented approach |
| title_alt | Surgical craft: laparoscopic cryoablation of renal masses Laparoscopic cryoablation of renal masses |
| title_auth | Minimally invasive surgery of the kidney a problem-oriented approach |
| title_exact_search | Minimally invasive surgery of the kidney a problem-oriented approach |
| title_full | Minimally invasive surgery of the kidney a problem-oriented approach Stevan B. Streem ... guest ed. |
| title_fullStr | Minimally invasive surgery of the kidney a problem-oriented approach Stevan B. Streem ... guest ed. |
| title_full_unstemmed | Minimally invasive surgery of the kidney a problem-oriented approach Stevan B. Streem ... guest ed. |
| title_short | Minimally invasive surgery of the kidney |
| title_sort | minimally invasive surgery of the kidney a problem oriented approach |
| title_sub | a problem-oriented approach |
| topic | Niere (DE-588)4042270-7 gnd Minimal-invasive Chirurgie (DE-588)4327907-7 gnd Nierenkrankheit (DE-588)4075399-2 gnd |
| topic_facet | Niere Minimal-invasive Chirurgie Nierenkrankheit Aufsatzsammlung |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=009196364&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
| volume_link | (DE-604)BV000001584 |
| work_keys_str_mv | AT streemstevanb minimallyinvasivesurgeryofthekidneyaproblemorientedapproach AT chenrolandn minimallyinvasivesurgeryofthekidneyaproblemorientedapproach AT novickandrewc minimallyinvasivesurgeryofthekidneyaproblemorientedapproach AT gillinderbirs minimallyinvasivesurgeryofthekidneyaproblemorientedapproach AT streemstevanb surgicalcraftlaparoscopiccryoablationofrenalmasses AT chenrolandn surgicalcraftlaparoscopiccryoablationofrenalmasses AT novickandrewc surgicalcraftlaparoscopiccryoablationofrenalmasses AT gillinderbirs surgicalcraftlaparoscopiccryoablationofrenalmasses AT streemstevanb laparoscopiccryoablationofrenalmasses AT chenrolandn laparoscopiccryoablationofrenalmasses AT novickandrewc laparoscopiccryoablationofrenalmasses AT gillinderbirs laparoscopiccryoablationofrenalmasses |