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Biomedical subjects

D Potempa

Publications and source records attributed to D Potempa.

7 recordsLinked to original sources
PubMed1996

[Retroperitoneoscopy. Technique and experiences with the first 100 patients].

Retroperitoneoscopic procedures were already being performed in the late 1970s. The clinical breakthrough of retroperitoneoscopy, however, was initiated in 1992 by the balloon-dissecting technique of Gaur, together with the experience gained with transperitoneal laparoscopic procedures in the upper retroperitoneum. We have modified the balloon-dissecting technique into a hydraulic video-optically controlled balloon dissection of the retroperitoneal space, and this procedure was recently further simplified. From December 1992 to December 1995 we performed 100 retroperitoneoscopic procedures in 98 patients (aged 4-82 years). Twenty-two patients had undergone previous abdominal surgery, 16 patients had been operated on for kidney and ureter problems. We performed 28 simple procedures (6 renal biopsies, 17 renal cyst resections, 4 ureterocutaneostomies, 1 foreign body retrieval), 65 difficult operations (47 nephrectomies, 5 nephroureterectomies, 5 nephropexies, 4 ureterolithotomies, 2x ureterolysis). There were also 9 complicated cases (5 heminephrectomies, 2 tumor nephrectomies, 2 dismembered pyeloplasties). Operating time, complications and conversion rate to open surgery mainly depended on the difficulty of the procedure and the personal learning curve, resulting in 50-90 min, 0% and 3.8%, respectively, for an easy retroperitoneoscopy, 90-210 min, 12% and 9.2% respectively for a difficult operation, and 180-390 min, 22% and 11%, respectively, for a very difficult procedure. Excluding the 17 patients with complications or conversion (unclear anatomy, extremely difficult dissection), the mean postoperative need for analgesics was 0.7 vials, and the mean hospital stay was 4.7 days. We have now passed most of our learning curve, and retroperitoneoscopy has become a standardized procedure that is a part of the training program for the experienced urologist.

Biopsy↗
PubMed1993

[Pelviscopic ovarian surgery: a new method of safe organ preserving surgery].

For pelviscopic removal of ovarian tumours, a puncture or morcellation of the tumour used to be necessary, frequently causing the peritoneal cavity to be contaminated with contents of cysts or tumourous material. This contamination can be avoided safely by placing the intact tumour into a bag, provided that the tumour has been dissected completely. The intact tumour is put into a bag and both are completely removed at the same time through the abdominal wall. This method increases the safety of pelviscopic ovarian surgery, and its indication for use can be broadened.

Female↗
PubMed1993

Correction of distal hypospadias: ventral adaption of the prepuce and meatal advancement.

In distal hypospadias without chordee, surgical correction has a purely cosmetic character. In contrast to standard techniques focusing on meatal position, parents often regard the redundant dorsal prepuce and its missing ventral fusion as the essential constituent of this malformation. The operative technique, presented in detail, emphasizes on foreskin reconstruction. The ventral adaption of the prepuce (VAP procedure) results in a penis with normal appearance. Complications presented reveal the importance of proper patient selection.

Child↗
PubMed1993

[Antegrade-retrograde urethrotomy in therapy of high degree urethral stricture].

In the case of urethral stricture which is non-passable by conventional "cold knife" urethrotomy, open urethroplasty can be avoided by combined antegrade-retrograde urethrotomy (ARUT). A rigid cystoscope is guided, through a dilated, suprapubic cystostomy channel, to the stricture in the membranous or bulbular urethra. A urethrotome is inserted in the retrograde direction and the "cut to the light" procedure is adopted. Using the ARUT method, successful realignment was achieved in 9 patients; 4 strictures were trauma- or urethritis-induced and 5 were the result of transurethral management. Recurrent stricture in 4 out of 7 cases (57%) required further urethrotomy. There was no recurrence in 4 out of 7 patients for at least 5 months subsequent to the last treatment. All patients were spared open surgery. The antegrade-retrograde technique exists since 1978. Up to date, 63 cases have been mentioned in the literature. The primary therapy success rate is 25%. Successful retreatment following recurrence was observed in 65%. We recommend ARUT as first-choice treatment for severe strictures of the bulbular and membranous urethra.

Adult↗
PubMedDate not supplied

[Modulit SL-20. Its development and clinical trial].

Modulit SZ-20 represents the third lithotriptor generation comprising the advantages of high disintegration efficacy, operation without anesthesia, combined system of ultrasonic and fluoroscopic localization of the concrements, provision with multifunctional platform. The impulse is generated by a cylindrical electromagnetic spiral with a paraboloid reflector. The waves go through a water cushion and impedance-adapted layer in which the patient is placed. Localization of the concrements is conducted by a special ultrasonic detector operating on-line, or fluoroscopically by an integrated arm C of the x-ray unit. In vitro and animal experiments have given evidence for high efficacy of the above lithotriptor, make it possible to evaluate dose-related and reversible renal trauma, to compare similar traumas induced by other lithotriptors. Since 1988 Modulit-SZ-20 has been tested for localization of nephroliths and ureteroliths. Then the attention of the designers was focused on concrement disintegration. After improving the X-ray guidance, the voltage of the generator, analysis of the experience gained, the percentage of disintegration has risen to 94. The authors achieved completed disappearance of the stones in 88% of their patients. SZ-20 Modulit proved effective against choleliths and stones in the biliary ducts as well. This device is recommended as high effective stone-crushing modality of the third generation.

Animals↗
PubMedDate not supplied

Modulith SL20--development and clinical experience.

A third generation lithotripter was developed incorporating the advantages of high disintegrative efficacy, anaesthesia-free treatment, combined sonographic and fluoroscopic localization system as well as a multifunctional table for interdisciplinary use. The shock wave generator consists of a cylindrical-shaped electromagnetic coil with a paraboloid reflector. The waves are coupled by means of a water cushion and an impedance adapted foil in which the patient is comfortably positioned. Stones are localized by an in-line ultrasound probe or fluoroscopically by the integrated C-arm. Preclinical trials using the in-vitro stone model demonstrated the superior disintegrative capacity. The in-vivo animal studies evaluated the dose-dependent and reversible kidney trauma, which was comparable to that induced by other lithotripters. The clinical evaluation of the Modulith SL since 1988 was divided into three phases with different technical equipment. It was indicated that sonographic stone localization enables treatment of nearly all kidney stones and 12% of the ureteric calculi. As preference was given to in situ disintegration of all ureteral stones, X-ray targeting became necessary. By increasing the generator voltage in the third phase together with advanced experience, the disintegration rate (94%) was improved. The number of auxiliary measures after ESWL (11%) and treatment time (average 39 min) was decreased. Eighty-eight percent of our patients were stone-free at follow-up. The experience demonstrated that this lithotripter is also easy to handle for gallbladder stones and highly effective (82%) in treatment of endoscopically non-extractable bile duct stones.

Animals↗