Hand-assisted laparoscopic autoaugmentation gastrocystoplasty

Specht, Michelle C.; Pareek, Gyan; Lin, D.D.; Bleustein, Clifford B.; Fahey, Thomas J.; Felsen, Diane; Poppas, Dix P.

doi:10.1007/s00464-001-8210-y

Cited by 3 publications

(4 citation statements)

References 13 publications

(22 reference statements)

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“…Handassisted laparoscopy may benefit those already versed in laparoscopy by allowing them to accomplish even the most challenging surgical procedures. Recent reports of advanced hand-assisted urologic procedures include simultaneous multiple organ ablative surgery [18,19], donor nephrectomy in morbidly obese patients [20], radical nephrectomy with inferior vena caval thrombus [21•], radical cystectomy with ileal conduit urinary diversion [22•], autoaugmentation gastrocystoplasty (animal model) [23], removal of large renal specimens [24••], retroperitoneoscopic nephrectomy, donor nephrectomy, and nephroureterectomy [25][26][27]28••].…”

Section: Other Applicationsmentioning

confidence: 99%

The advantages of hand-assisted laparoscopy

Munver¹,

Pizzo²,

Sosa

2004

Curr Urol Rep

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The technical challenges of performing laparoscopic renal surgery require fellowship training and are associated with a steep learning curve. For the established urologist in practice, fellowship training is not a reality. As a result of these obstacles, in the late 1990s, laparoscopic renal surgery was entering the domain of the general surgeons who had a large number of laparoscopic procedures at their disposal to develop laparoscopic skills. Hand-assisted laparoscopic renal surgery is a hybrid procedure combining the most salient features of open renal surgery and laparoscopic renal surgery. By allowing the surgeons to place their non-dominant hand into the abdominal cavity, palpation and spatial orientation became possible, lessening the learning curve for laparoscopic surgery. Moreover, hand-assisted laparoscopic surgery could be applied to a variety of renal surgeries, extirpative and reconstructive, with results similar to those already achieved by standard laparoscopy. Throughout the past 5 years, hand-assisted laparoscopy has allowed urologists to incorporate laparoscopic renal surgery into their practices to the benefit of their patients and of their specialty. This review article offers a historical review of the development of hand-assisted laparoscopy and describes the procedures commonly performed today using this technique.

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Section: Other Applicationsmentioning

confidence: 99%

The advantages of hand-assisted laparoscopy

Munver¹,

Pizzo²,

Sosa

2004

Curr Urol Rep

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“…Recently, many laparoscopic studies have been performed, in an attempt to minimize the distress of urinary reconstruction, avoiding large incisions and their destructive psychological and physical consequences (7)(8)(9)(10)(11). These reports showed the feasibility of bladder augmentation through laparoscopic approach, improving cosmesis and decreasing postoperative morbidity.…”

Section: Introductionmentioning

confidence: 99%

“…Since then, the laparoscopic approach has been increasingly used to perform either augmentation or total replacement of the bladder (8)(9)(10)(11). The objectives have been to reduce the morbidity of these complex procedures and to expand laparoscopic reconstructive surgery in both pediatric and adult urology (8)(9)(10)(11)(12)(13).…”

Section: Commentsmentioning

confidence: 99%

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Total laparoscopic gastrocystoplasty: experimental technique in a porcine model

et al. 2007

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Objective: Describe a unique simplified experimental technique for total laparoscopic gastrocystoplasty in a porcine model. Material and methods:We performed laparoscopic gastrocystoplasty on 10 animals. The gastroepiploic arch was identified and carefully mobilized from its origin at the pylorus to the beginning of the previously demarcated gastric wedge. The gastric segment was resected with sharp dissection. Both gastric suturing and gastrovesical anastomosis were performed with absorbable running sutures. The complete procedure and stages of gastric dissection, gastric closure, and gastrovesical anastomosis were separately timed for each laparoscopic gastrocystoplasty. The end-result of the gastric suturing and the bladder augmentation were evaluated by fluoroscopy or endoscopy. Results: Mean total operative time was 5.2 (range 3.5 -8) hours: 84.5 (range 62 -110) minutes for the gastric dissection, 56 (range 28 -80) minutes for the gastric suturing, and 170.6 (range 70 to 200) minutes for the gastrovesical anastomosis. A cystogram showed a small leakage from the vesical anastomosis in the first two cases. No extravasation from gastric closure was observed in the postoperative gastrogram. Conclusions: Total laparoscopic gastrocystoplasty is a feasible but complex procedure that currently has limited clinical application. With the increasing use of laparoscopy in reconstructive surgery of the lower urinary tract, gastrocystoplasty may become an attractive option because of its potential advantages over techniques using small and large bowel segments.

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