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UR - Artigos
Lima, E; Rolanda, C; Correia-Pinto, J
Natural Orifice Transluminal Endoscopic Surgery (NOTES) has emerged recently in the experimental surgical field, innovating for the passage of luminal barrier, the absence of scars and reduction of post-operative pain. Among the various ports of access (transvaginal, transgastric, transvesical and transcolonic), this paper is an update on advances & controversies of transvesical port for NOTES Urological applications.
Autorino, R; Martínez-Salamanca, JI; Lima, E
Cicione, A; Autorino, R; Breda, A; De Sio, M; Damiano, R; Fusco, F; Greco, F; Carvalho-Dias, E; Mota, P; Nogueira, C; Pinho, P; Mirone, V; Correia-Pinto, J; Rassweiler, J; Lima, E
OBJECTIVE:
To compare the last generation of 3-dimensional imaging (3D) vs standard 2-dimensional imaging (2D) laparoscopy.
MATERIALS AND METHODS:
A prospective observational study was conducted during the 4th Minimally Invasive Urological Surgical Week Course held in Braga (Portugal) in April 2013. The course participants and faculty were asked to perform standardized tasks in the dry laboratory setting and randomly assigned into 2 study groups; one starting with 3D, the other with 2D laparoscopy. The 5 tasks of the European Training in Basic Laparoscopic Urological Skills were performed. Time to complete each task and errors made were recorded and analyzed. An end-of-study questionnaire was...
Tomada, N; Tomada, I; Botelho, F; Pacheco-Figueiredo, L; Lopes, T; Negrão, R; Pestana, M; Cruz, F
Erectile dysfunction (ED) is a highly prevalent disease whose aetiology is mostly vasculogenic. It is nowadays considered a marker of future cardiovascular events reflecting the underlying endothelial dysfunction, the common link with the metabolic syndrome (MetS). The recent association between MetS, endothelial dysfunction and peripheral artery disease, but not with coronary artery disease (CAD), suggests that the pathophysiologies of CAD and peripheral artery disease may be distinct. Moreover, several recent studies support an emerging role for an imbalance of angiogenic growth factor levels like Angiopoietin 1 and 2 in cardiovascular disease, considering its intimate association with chronic low-grade inflammation. We...
Rolanda, C; Lima, E; Pêgo, JM; Henriques-Coelho, T; Silva, D; Moreira, I; Macedo, G; Carvalho, JL; Correia-Pinto, J
BACKGROUND:
An isolated transgastric port has some limitations in performing transluminal endoscopic cholecystectomy. However, transvesical access to the peritoneal cavity has recently been reported to be feasible and safe.
OBJECTIVE:
To assess the feasibility and the technical benefits of transgastric and transvesical combined approach to overcome the limitations of isolated transgastric ports.
DESIGN:
We created a transgastric and transvesical combined approach to perform cholecystectomy in 7 consecutive anesthetized female pigs. The transgastric access was achieved after perforation and dilation of the gastric wall with a needle knife and with a balloon, respectively. Under cystoscopic control, an ureteral catheter, a guidewire, and a dilator of the...
Bachiller Burgos, J; Alonso Flores, J; Sánchez De La Vega, J; Beltrán Aguilar, V; Salazar Otero, S; Brás Silva, C
Since 2007, various urological procedures have been performed with laparoendoscopic single-site surgery (LESS surgery), including nephrectomy, pyeloplasty, simple prostatectomy and, with the refinement of laparoscopic instrumentation, radical prostatectomy. This paper reports our initial experience in radical prostatectomy using the SILS Port from Covidiem and two lateral 5-mm trocars for triangulation. The SILS Port allows for accurate, simple insertion through a Hadson incision. The flexible port accommodates three 5-mm cannulas or two 5-mm cannulas and a 12-mm port for easier instrument exchange through a single incision. This approach decreases morbidity from bleeding, hernia and/or internal organ damage and improves cosmetic. One-port...
Ribeiro, JC; Rolanda, C; Santos, A
Félix, J; Andreozzi, V; Soares, M; Borrego, P; Gervásio, H; Moreira, A; Costa, L; Marcelo, F; Peralta, F; Furtado, I; Pina, F; Albuquerque, C; Santos, A; Passos-Coelho, JL; Portuguese Group for the Study of Bone Metastases
BACKGROUND:
Skeletal-related events (SREs) occur frequently in patients with bone metastases as a result of breast (BC) and prostate (PC) cancers. They increase both morbidity and mortality and lead to extensive health-care resource utilization.
METHODS:
Health care resource utilization by BC/PC patients with at least one SRE during the preceding 12 months was assessed through retrospective chart review. SRE-treatment costs were estimated using the Portuguese Ministry of Health cost database and analyzed using generalized linear models.
RESULTS:
This study included 152 patients from nine hospitals. The mean (SD) annual SRE-treatment cost per patient was €5963 (€3646) and €5711 (€4347), for BC (n=121) and PC (n=31)...
Lima, E; Branco, F; Parente, J; Autorino, R; Correia-Pinto, J
Study Type - Therapy (case series) Level of Evidence 4. What's known on the subject? and What does the study add? Until now, the transvaginal approach has been the only method of removing larger specimens from the abdominal cavity using natural orifice transluminal endoscopic surgery. There has been no means of extracting larger specimens in men and the means are restricted even in women, particularly in young women. The present study shows that the difficulty of large specimen retrieval can be overcome, irrespective of the diameter of the chosen port, through natural orifices using morcellation.
OBJECTIVE:
To show, in a porcine model,...
Lima, E; Autorino, R; Correia-Pinto, J
Natural orifice transluminal endoscopic surgery (NOTES) generated a huge hope among surgeons because it promised scarless surgery and eventually less pain and surgical stress. However, serious limitations regarding reliable visceral closing methods remain unsolved. This article provides an update in development and future applications of transvesical access in the field of surgery.
Lima, E; Autorino, R; Correia-Pinto, J
Natural orifice transluminal endoscopic surgery (NOTES) generated a huge hope among surgeons because it promised scarless surgery and eventually less pain and surgical stress. However, serious limitations regarding reliable visceral closing methods remain unsolved. This article provides an update in development and future applications of transvesical access in the field of surgery.
Autorino, R; White, WM; Gettman, MT; Khalifeh, A; De Sio, M; Lima, E; Kaouk, JH
Evidence relating to the perception and view of patients and physicians on natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS) was scrutinized. A comprehensive literature search was performed through PubMed. A total of 18 studies were included in the analysis. Patients demonstrated interest in scarless surgery, with a preference for LESS over NOTES. Safety and efficacy remain the key factors in the decision-making process of patients. With more information about the safety and reproducibility of LESS and NOTES, and with improved educational efforts, patients and physicians alike may feel more comfortable in widespread application of scarless surgery.
Autorino, R; White, WM; Gettman, MT; Khalifeh, A; De Sio, M; Lima, E; Kaouk, JH
Evidence relating to the perception and view of patients and physicians on natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS) was scrutinized. A comprehensive literature search was performed through PubMed. A total of 18 studies were included in the analysis. Patients demonstrated interest in scarless surgery, with a preference for LESS over NOTES. Safety and efficacy remain the key factors in the decision-making process of patients. With more information about the safety and reproducibility of LESS and NOTES, and with improved educational efforts, patients and physicians alike may feel more comfortable in widespread application of scarless surgery.
Autorino, R; Kim, FJ; Rane, A; De Sio, M; Stein, RJ; Micali, S; Correia-Pinto, J; Kaouk, JH; Lima, E
PURPOSE:
To test different sets of prebent instruments and a new reusable access device for laparoendoscopic single-site (LESS) surgery.
MATERIALS AND METHODS:
Three surgeons with previous experience in LESS performed 12 nephrectomies in six pigs. In all procedures, a multichannel access device (X-CONE) and a 5-mm extra-long telescope were used. Four sets of prebent instruments with different profiles (S-portal) were tested: Standard (one straight scissors and one curved grasper), Cuschieri, Carus, and Leroy set (each of them consisting of two curved instruments with different configurations). Assessment was performed based on both objective (procedure time; time to manage the pedicle; time to free kidney)...
Autorino, R; Kim, FJ; Rane, A; De Sio, M; Stein, RJ; Micali, S; Correia-Pinto, J; Kaouk, JH; Lima, E
PURPOSE:
To test different sets of prebent instruments and a new reusable access device for laparoendoscopic single-site (LESS) surgery.
MATERIALS AND METHODS:
Three surgeons with previous experience in LESS performed 12 nephrectomies in six pigs. In all procedures, a multichannel access device (X-CONE) and a 5-mm extra-long telescope were used. Four sets of prebent instruments with different profiles (S-portal) were tested: Standard (one straight scissors and one curved grasper), Cuschieri, Carus, and Leroy set (each of them consisting of two curved instruments with different configurations). Assessment was performed based on both objective (procedure time; time to manage the pedicle; time to free kidney)...
Autorino, R; Stein, RJ; Lima, E; Damiano, R; Khanna, R; Haber, GP; White, MA; Kaouk, JH
Objective of this study is to provide an evidence-based analysis of the current status and future perspectives of scarless urological surgery. A PubMed search has been performed for all relevant urological literature regarding natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS). In addition, experience with LESS and NOTES at our own institution has been considered. All clinical and investigative reports for LESS and NOTES procedures in the urological literature have been considered. A wide variety of clinical procedures in urology have been successfully completed by using LESS techniques. Thus far, experience with NOTES has largely been investigational,...
Autorino, R; Stein, RJ; Lima, E; Damiano, R; Khanna, R; Haber, GP; White, MA; Kaouk, JH
Objective of this study is to provide an evidence-based analysis of the current status and future perspectives of scarless urological surgery. A PubMed search has been performed for all relevant urological literature regarding natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS). In addition, experience with LESS and NOTES at our own institution has been considered. All clinical and investigative reports for LESS and NOTES procedures in the urological literature have been considered. A wide variety of clinical procedures in urology have been successfully completed by using LESS techniques. Thus far, experience with NOTES has largely been investigational,...
Gettman, MT; Box, G; Averch, T; Cadeddu, JA; Cherullo, E; Clayman, RV; Desai, M; Frank, I; Gill, I; Gupta, M; Georges-Pascal, H; Humphreys, M; Kaouk, J; Landman, J; Lima, E; Ponsky, L
Gettman, MT; Box, G; Averch, T; Cadeddu, JA; Cherullo, E; Clayman, RV; Desai, M; Frank, I; Gill, I; Gupta, M; Georges-Pascal, H; Humphreys, M; Kaouk, J; Landman, J; Lima, E; Ponsky, L
Oliveira, M; Marques, V; Carvalho, AP; Santos, A
LEVEL OF EVIDENCE:
2b. What's known on the subject? and What does the study add? In recent years, several nomograms were developed in an effort to decrease the number of unnecessary prostate biopsies. The European SWOP-PRI and the North American PCPT are among the most popular. However, evidence on the relative predictive accuracy is lacking. A head-to-head comparison on the diagnostic accuracy of two previously validated prostate cancer risk predictors on biopsy confirmed the superiority of these tools over PSA alone. Moreover, in the studied population, the European SWOP-PRI proved to be more accurate than the North American PCPT-CRC.
OBJECTIVE:
To compare the...