Biomedical subjects

Daniel Vanuno

Publications and source records attributed to Daniel Vanuno.

3 recordsLinked to original sources

PubMed2002

Robotic-assisted laparoscopic donor nephrectomy for kidney transplantation.

BACKGROUND: Minimally invasive laparoscopic nephrectomy is a well-established alternative to open surgery in living donors for kidney transplantation. Donor mortality and morbidity rates as well as recipient outcome are comparable to the open approach. Furthermore, the procedure is associated with reduced donor discomfort, faster recovery, and improved cosmetic results. Recently, an advanced robotic system for laparoscopic surgery was approved for use in the United States. This system allows a greater freedom of movement and recreates the hand-eye coordination and three-dimensional vision that is lost in standard laparoscopic procedures. METHODS: We report the first 12 successful cases of robotic-assisted laparoscopic living donor nephrectomy performed using the da Vinci Surgical System (Intuitive Surgical, Mountain View, CA). RESULTS: Our initial experience has shown that the system allows the performance of donor nephrectomy in a safe and accurate fashion. CONCLUSIONS: As technology continues to evolve, robotic-assisted surgery has the potential to become a widely used attractive alternative to standard laparoscopic donor nephrectomy.

Adult↗

PubMed2002

Outcome of laparoscopic ventral hernia repair in correlation with obesity, type of hernia, and hernia size.

BACKGROUND: The morbidity and overall recovery time of ventral hernia repair can vary significantly depending on the hernia type or size and on other factors, such as the body mass index (BMI). The purpose of our study was to investigate the effects of type of hernia, hernia size, and BMI on the outcome of laparoscopic ventral hernia repair. METHODS: Fifty patients who underwent laparoscopic ventral hernia repair were retrospectively reviewed and stratified according to hernia type (incisional, IVH/primary, PVH), hernia size, and BMI. These subgroups were compared in regard to operative time, resumption of diet, hospital stay, pain control, and complication rate. RESULTS: Laparoscopic IVH repair was associated with a longer operative time (143 vs. 98 minutes, p = .02) and length of stay (2.2 vs. 0.6 days, p = .03) than PVH repair. The narcotic requirements were higher in the IVH group, but the difference did not reach statistical significance. Larger hernias were associated with a longer operative time (p = .04) and increased narcotic requirement (p = .03). The morbidity of the laparoscopic repair was not significantly affected by the hernia type or size. The BMI did not significantly alter any of the parameters examined. CONCLUSIONS: Laparoscopic repair of incisional and larger hernias is a technically demanding procedure that requires a longer operative time. In contrast to PVH repair, laparoscopic IVH repair usually cannot be performed on an outpatient basis. Surgeons need not be discouraged from recommending the laparoscopic approach for patients with large IVHs or with severe obesity because the morbidity remains low.

Body Mass Index↗

PubMed2002

Early experience with robotically assisted laparoscopic donor nephrectomy.

The da Vinci robotic system became available at our institution in late August 2000. We decided to use this system to perform robotically assisted laparoscopic donor nephrectomies. A prospective study was conducted of 10 consecutive patients who underwent robotically assisted laparoscopic donor nephrectomy between January and May 2001. The mean operative time was 166 minutes. The mean hospital stay was 1.8 days. The need for parenteral pain medication was limited to the first postoperative day. All kidneys were transplanted successfully; no rejections occurred. This early experience suggests that the results of robotically assisted laparoscopic donor nephrectomy are similar to those of laparoscopic donor nephrectomy. We believe that robotic surgery, which enables regaining of the hand-eye coordination and three-dimensional view lost in laparoscopic surgery, allows us to perform the donor nephrectomy with greater precision, confidence, and comfort.

Adult↗