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Biomedical subjects

E J Sacknoff

Publications and source records attributed to E J Sacknoff.

7 recordsLinked to original sources
PubMed1995

Laser prostatectomy with a TURPETTE: evolution with right-angle technique.

Fifty-five patients with symptomatic bladder outlet obstruction were treated with laser ablation of the prostate using right-angle fibers to deliver Nd:YAG laser energy. Dosimetry ranged between 60 and 80 W power in a noncontact mode to achieve both coagulation and vaporization of adenomatous prostate tissue. Most patients were followed for > 1 year. Efficacy of treatment was assessed with American Urological Association (AUA) symptom scores, uroflow studies, need for revision procedures, and catheterization. Perioperative morbidity and complications demonstrate results comparable to published statistics for transurethral resection of the prostate (TURP). Because patients with glands larger than 40 cm3 showed more postoperative symptoms of irritation and obstruction, 18 patients had visual laser ablation of the prostate (VLAP) alone and 37 patients were treated with a limited TURP, or TURPETTE, which includes removal of the coagulated tissue immediately after lasing to facilitate earlier voiding with minimal bleeding. The evolution of this combined technique in those patients with larger glands encourages more rapid urinary flow by providing an immediate channel, reducing acute swelling, and shortening the duration of necrotic slough. Eighty-six percent of patients voided with improved flow and reduced AUA symptom score. Fourteen percent required a revision procedure due to obstruction or bleeding. Modification in surgical technique and improved optical characteristics of fiber technology will determine the future of laser application to prostate surgery.

Aged↗
PubMed1993

Laser advances in urology.

This paper reviews the current use of lasers in urology--CO 2, Nd:YAG, KTP/532, Diode, pulsed dye--and describes the most common procedures performed with them. It discusses surgical techniques of lasers that are expected to be useful to urologists in the future and concludes that lasers are important tools for this specialty.

Forecasting↗
PubMed1988

Percutaneous ablation of canine prostate using transrectal ultrasound guidance. Absolute ethanol and Nd:YAG laser.

Percutaneous absolute ethanol injections and Nd:YAG laser ablations were performed bilaterally in canine prostates (N = 13) using transrectal ultrasound guidance. Seventy-one percent (10/14) of the ethanol injections produced an intraglandular focus of hemorrhagic necrosis. Associated morbidity of ethanol injections included necrosis of the external prostatic sphincter and mucosa of the urethra and bladder. Ninety-two percent (11/12) of the laser ablations produced intraglandular foci of thermal tissue damage, which had distinct margins of transition between necrotic and viable cells. The areas of ablation were well visualized by ultrasound and had minimal associated morbidity. The results of this study demonstrate the technical feasibility and low potential morbidity of transrectal ultrasound guided Nd:YAG laser ablations in the canine prostate.

Animals↗
PubMed1980

Primary leiomyosarcoma of ureter.

The tenth case of primary leiomyosarcoma of the ureter is reported, and previous cases are summarized. It is the first example studied by percutaneous pyelography and ultrasonography. The former was more informative than retrograde ureterography. The ultrasonic study suggested a cystic lesion rather than the solid tumor encountered. Nephroureterectomy, selective para-aortic node dissection, and radiotherapy were used, but distant metastasis and death ensured fifteen months later.

Aged↗
PubMed1980

Direct vision cold knife urethrotomy.

During a 3-year period urethral strictures in 75 patients were treated by cold knife urethrotomy. Analysis of the etiology, diagnosis, surgical technique, complications and postoperative management is described. Satisfactory results were achieved in 71 per cent of the cases. The over-all morbidity rate was 9 per cent. Patients with strictures more than 2 cm. long had unsatisfactory results, while those managed with a silicone catheter postoperative for less than 7 days had better results. Direct vision cold knife urethrotomy is a safe technique that should be exercised as a therapeutic trial before a final decision is made to perform definitive urethroplasty.

Humans↗
PubMedDate not supplied

Instrumentation for urologic laser surgery.

Carbon dioxide, neodymium:yttrium-aluminum-garnet, ruby, and argon lasers are the only commercially available lasers with wavelengths suitable for laser surgery. Consequently, researchers have attempted to make the tool fit the clinical need. A pediatric #6 bronchoscope was fitted to a carbon dioxide laser endoscopic coupler to form a modified cystoscopic laser delivery system. This instrument was able to vaporize small condylomata of the distal male urethra. However, the restricted visibility of this crude adaptation represents an inferior solution compared with the endless possibilities of sophisticated fiberoptic technology. Future prospects in infrared optical fiber technology portend a breakthrough for transurethral carbon dioxide laser surgery. Adapting the Nd:YAG laser for urologic surgery is attractive because it can be easily incorporated into conventional cystoscopes. The argon laser's capacity to absorb blood and traverse water suggests future importance for transurethral surgery. Investigation is needed to develop a surgical laser adaptable to both open and transurethral urologic surgery.

Argon↗