Biomedical subjects

David B Samadi

Publications and source records attributed to David B Samadi.

4 recordsLinked to original sources

PubMed2006

High body mass index in muscular patients and flank position are risk factors for rhabdomyolysis: case report after laparoscopic live-donor nephrectomy.

BACKGROUND AND PURPOSE: Rhabdomyolysis is well known after traumatic crush injuries or ischemia involving muscles. Postoperatively, it most likely is secondary to surgical positioning and patient muscle mass. We report a case after laparoscopic live-donor nephrectomy. CASE REPORT: A muscular 35-year-old man underwent elective left laparoscopic live-donor nephrectomy in a 70 degrees flank position with four ports. He was in the right-side lying position with hip flexion (flank position) for approximately 4 hours. A kidney bridge had been placed between the iliac crest and the rib cage. Postoperatively, the patient had light-pinkish urine and low urine output. There was marked induration of the buttocks and significant pedal and scrotal edema. With judicious use of alkalinization and diuretics, the patient did not require dialysis, and renal function returned to base level by postoperative day 20. The recipient of the kidney had a normal postoperative course. CONCLUSION: Rhabdomyolysis is a syndrome of muscle necrosis and release of intracellular components into the circulation. Acute renal failure secondary to myoglobinuria is a common complication. We currently use little flexion of the table during donor nephrectomy and bring the table to a neutral position immediately after kidney retrieval. Postoperatively, one needs a high index of suspicion for rhabdomyolysis to avoid or at least promptly recognize this rare but potentially serious condition after any operation lasting >or=4 hours.

Acute Kidney Injury↗

PubMed2002

Laparoscopic radical prostatectomy.

Laparoscopy has become an integral part of urologic surgery. Its indications have been progressively extended to the most advanced oncologic and reconstructive procedures. Within this frame, radical prostatectomy is of major interest, especially considering the incidence and clinical significance of prostate cancer. The procedure comprises several steps of challenging dissection in which the preservation of delicate nerve and muscular structures should be conciliated with safe tumor excision. The intervention ends with vesicourethral anastomosis, which is considered the most difficult reconstructive procedure in urologic laparoscopy. Laparoscopic radical prostatectomy has gradually become a wholly standardized procedure, and it is now routinely performed in several centers throughout the world.

Humans↗

PubMed2002

Laparoscopic radical prostatectomy: published series.

Next to the retropubic and perineal approaches, laparoscopic radical prostatectomy has become the third most common technique in the surgical treatment of localized prostate cancer. Although long-term oncologic data are still lacking, based on several contemporary series, it seems likely that oncologic results will fulfill expectations. Over the past decade, quality-of-life issues have come into the spotlight in oncologic surgery in particular. In this regard, the aim of the laparoscopic technique is to become the best in terms of operative stress, postoperative morbidity, catheterization time, and return to normal activities. The unique intraoperative visibility and magnification of the operative field allow ultraprecise dissection and suturing of vital neural and sphincteric structures. Will the use of this new kind of surgery translate into better functional results? The goal of this review is to analyze the published results of laparoscopic radical prostatectomy in the context of its rapidly evolving open surgical counterpart.

Erectile Dysfunction↗

PubMed2002

Robotic assisted kidney transplantation: an initial experience.

PURPOSE: The use of robotics is a recent innovation in surgery. In addition to dexterity enhancement and motion scaling, this new technology opens the horizon of remote surgery. This latter advancement has potential use during surgery involving a high risk of patient-to-professional or professional-to-patient virus transmission. We investigated the feasibility of robotic assisted kidney transplantation. MATERIALS AND METHODS: A right cadaveric kidney was transplanted into a 26-year-old male patient who has been on hemodialysis for 11 years. Surgery was done with the help of the da Vinci robot (Intuitive Surgical, Inc., Mountain View, California) by a remote surgeon, who completely performed vascular dissection and anastomosis as well as ureterovesical anastomosis. The role of the assistant by the side of the patient was limited to access creation, exposure, hemostasis and maintaining traction on the running sutures performed by the robot. RESULTS: Operative time was 178 minutes. Robotic assistance made anastomosis possible by its unique ability of stereoscopic magnification and ultra-precise suturing techniques due to the flexibility of the robotic wristed instruments. Renal perfusion was excellent with immediate diuresis. Postoperative acute tubular necrosis started to resolve after 1 week. CONCLUSIONS: This study demonstrates that robotic assisted kidney transplantation is feasible. Currently technical and cost hindrances limit the routine use of robots. However, with ongoing improvement and future availability of this technology the prevention of patient-to-professional and professional-to-patient viral transmission may become a potential field of application.

Adult↗