Refinement Surgical Technique, and Perioperative and Functional Outcomes in Patients With Robotic Intracorporeal Hautmann Orthotopic Neobladder

Zheng, Jing; He, Peng; Zheng, Jun; Li, Xuemei; Lang, Lang; Zhou, Zhansong; Chen, Zhiwen

doi:10.1016/j.urology.2020.01.025

Cited by 10 publications

(19 citation statements)

References 32 publications

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“…Uroflowmetry data also showed mostly unobstructed maximum urinary flow ( Q max > 10 ml/s) with low PVR in most of the patients, suggesting satisfactory bladder emptying. There were some patients who need clean intermittent-self catheterization as compared to other reports with the rate ranging from 0 to 20% [ 27 – 32 ], but most of these patients had their urodynamic evaluation at 12 months, suggesting possible improvement of neobladder voiding over time. Interestingly, some patients in our series had neobladder wall over-activity during the cystometry filling phase, potentially causing transitory high internal pressure.…”

Section: Discussionmentioning

confidence: 90%

Comparison of the Y-pouch orthotopic neobladder and the Studer technique after radical cystectomy: surgical and functional outcomes from a single-center series

2023

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Background To explore a method of constructing an orthotopic ileal neobladder (ONB) in the Y-pouch configuration. We describe the steps followed to create the Y-pouch ileal orthotopic neobladder (ONB) and compared the perioperative, functional, and urodynamics outcomes with the Studer neobladder technique. Methods A retrospective cohort study of 90 bladder cancer patients, who received open radical cystectomy with the ONB performed at a hospital from June 2009 to May 2020. These patients were divided into two groups—the Y-pouch and the Studer neobladder groups. Perioperative, functional outcome, complication, renal function data outcomes, and pressure–volume study were used to evaluate the treatment outcomes after a radical cystectomy. Results Ninety patients (54 Studer and 36 Y-pouch neobladder) were enrolled. The median patient age was 62.6 (± 11) years. The mean operative time for the Studer technique was 290 (242.5–350) min, and the Y-pouch technique was 300 (271.2–335) min) (p = 0.826). At 30 days postoperatively, the Clavien-Dindo classification of surgical complications revealed grade-2 urinary infections in two patients (5.6%) and six patients (11.1%) for the Y-pouch and Studer techniques, respectively. Intermediate complications (30–90 days) were reported in 4 (11.1%) and 18 patients (44.4%) in the Y-pouch and the Studer techniques, respectively (p = 0.062). In the urodynamics study (UDS), the Y-pouch group had a mean postvoid residual volume of 20 mL and Studer of 40 ml (p = 0.06). A mean capacity of 462 (380–600) mL compares to the Studer neobladder group with 495 (400–628) mL. The average mean compliance of the Studer group was 35.5 (28–52) ml/cm H2O and 33 (30–43) ml/cm H2O for Y pouch, and most patients had > 30 ml/cm H2O compliance (80/90 patients). Conclusions The Y-pouch neobladder technique in an RC with an orthotopic neobladder provides perioperative and functional outcomes compared to those of the Studer orthotopic neobladder resulting in similar intermediate-term. Therefore, the Y-pouch ileal neobladder is both feasible and safe to be used as a standard neobladder technique for urinary diversion in patients with bladder cancer undergoing radical cystectomy and needs confirmation with long-term results.

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Section: Discussionmentioning

confidence: 90%

Comparison of the Y-pouch orthotopic neobladder and the Studer technique after radical cystectomy: surgical and functional outcomes from a single-center series

2023

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“…Table 3 shows the reconstruction techniques for ICNB reconstruction and the hybrid approach [ 9 , 13 , 17 , 18 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ]. We also demonstrate the direction in which the posterior plate is folded intracorporeally.…”

Section: Discussionmentioning

confidence: 99%

“…We used a 45 cm detubularization tube and a 10 cm afferent limb. In the urethra–enteric anastomosis part, an opening is often created at the antimesenteric site of the ileum before detubularization, and a urethral anastomosis is performed [ 13 , 20 , 21 , 22 , 23 , 24 , 26 , 27 , 31 , 32 , 35 , 36 ]. Alternatively, a circumferential urethra–ileal anastomosis is performed after detubularization [ 9 , 17 , 18 ], or an opening is created after detubularization, and a urethral anastomosis is performed [ 28 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, if the ureter is short, it may be better to anastomose the ureter directly into the NB. Pruthi et al [25] Sim et al [26] Asimakopoulos et al [27] Koie et al [28] Tan et al [29] Butt et al [30] Zhou et al [31] Whelan et al [32] Dal Moro et al [ The procedure for ECNB reconstruction generally utilizes an infraumbilical midline incision of approximately 7 cm [38]. This position is the optimal location for manipulating the ileum and the ureter.…”

Section: Discussionmentioning

confidence: 99%

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Robot-Assisted Radical Cystectomy with Modified Vesica Ileale Padovana (VIP) Neobladder Configuration Using a Hybrid Approach: Initial Experience

Shimizu

Muto

Kitamura

et al. 2023

JPM

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Purpose: We developed a new technique to fold a neobladder (NB) simply by using a modified Vesica Ileale Padovana (VIP) with a hybrid approach. We provide a step-by-step description of our technique as it was used in this initial experience. Methods: A total of 10 male patients with a median age of 66 years underwent robot-assisted radical cystectomy (RARC) with an orthotopic NB via a hybrid approach from March 2022 to February 2023. After the isolation of the bladder and bilateral pelvic lymphadenectomy, Wallace plate creation was performed, and the robot was undocked. We extracorporeally performed the removal of the specimen and a side-to-side ileoileal anastomosis, and then the VIP NB posterior plate was rotated 90 degrees counterclockwise using a 45 cm detubularized ileum. The robot was redocked; then, circumferential urethra–ileal anastomosis, side-to-middle anterior wall closure, and ureteric afferent limb anastomosis were performed. Results: The median estimated blood loss was 524 mL, and the mean operative time was 496 min. Patients had a high continence rate, and no high-grade complications were observed. Conclusion: The NB configuration using the modified VIP method for a hybrid approach is a feasible surgical technique to minimize the movement of robotic forceps. In particular, it may be more useful in Asian individuals with narrow pelvises.

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“…e combination of strengths and advanced technology can make our work more effective and will be icing on the cake [6].…”

Section: Introductionmentioning

confidence: 99%

The Validity of Digital Media Communication of Platforms

Bao-ying

Hai-gang

2022

Mobile Information Systems

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The status of Politics and Ideology curriculum is becoming more and more important in university education. The Politics and Ideology curriculum is closely related to both the development of the country and the nation and the quality of university students. Due to the progress of technology, new media has become an important information collection channel for college students, which has an important impact on college students’ thoughts and life. Situation, problems, environment, politics, and ideology work need to deal with new challenges. It also brings new perspectives, new ideas, and new models. This study focuses on how new media technology affects the college students’ Politics and Ideology learning, studies the timeliness of new media on political education, and analyzes the path and countermeasures to improve the new media communication with the theoretical basis of communication, Politics and Ideology curriculum, and other disciplines. The AIDMA model of the validity of new media communication is constructed and the validity of the digital media communication is studied by means of literature research and questionnaire survey. The results show that the use of new media to attract archive users is clearly feasible and has advantages that the traditional media technology cannot achieve. The fast and effective speed of information dissemination can affect the behavior of profile users in the model. In the political education of colleges and universities, the influence of digital media is used to continuously improve the quality of educators, improve the literacy of students in using new media, optimize educational content, innovate educational carriers, optimize educational environment, and improve the new media management mechanism, etc.

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Refinement Surgical Technique, and Perioperative and Functional Outcomes in Patients With Robotic Intracorporeal Hautmann Orthotopic Neobladder

Cited by 10 publications

References 32 publications

Comparison of the Y-pouch orthotopic neobladder and the Studer technique after radical cystectomy: surgical and functional outcomes from a single-center series

Comparison of the Y-pouch orthotopic neobladder and the Studer technique after radical cystectomy: surgical and functional outcomes from a single-center series

Robot-Assisted Radical Cystectomy with Modified Vesica Ileale Padovana (VIP) Neobladder Configuration Using a Hybrid Approach: Initial Experience

The Validity of Digital Media Communication of Platforms

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