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Eugene Cho

Publications and source records attributed to Eugene Cho.

5 recordsLinked to original sources
PubMed2004

Laparoscopic donor nephrectomy: the University of Maryland 6-year experience.

PURPOSE: We determined whether the results of laparoscopic donor nephrectomy warranted expansion of the availability of the technique. MATERIALS AND METHODS: Donor and recipient charts for 738 consecutive laparoscopic living donor nephrectomies have been reviewed. RESULTS: Renal donors were 69% white race and 57% female. Age range was 18 to 74 years. Neither age nor obesity alone were exclusionary criteria. Nephrectomy was left sided in 96%. Donors with body mass index greater than 33 had longer operative times. The extraction site changed from umbilical to suprapubic during the series. Warm ischemia time was 169 seconds. Conversion to open nephrectomy occurred in 1.6% of cases and blood transfusion was required in 1.2%. Major intraoperative complications occurred in 6.8% and major postoperative complications occurred in 17.1% of cases. Hospitalization lasted 64.4 hours. Postoperative donor creatinine was 1.5 times the preoperative level. Recipient serum creatinine averaged 2.0 mg% at 1 week and 1.6 mg% at 1 year. Delayed graft function occurred in 2.6%. However, 9.1% of recipients did not achieve a serum creatinine less than 3.0 mg% within 7 days. The endovascular stapler also created 37 extra arteries for implantation. CONCLUSIONS: Risks of laparoscopic donor nephrectomy to the donor must not be minimized. Rapid conversion to open surgery to control bleeding may be necessary. Nonvascular intraoperative injuries require recognition. Slow bowel function recovery prolongs hospitalization and may indicate unrecognized pancreatitis or small bowel herniation. Surgical technique and complication management have improved. Laparoscopic donor nephrectomy is now routine but still requires an intense level of attention to prevention of complications.

Adolescent↗
PubMed2004

Minimally invasive surgery via laparoscopy for intra-abdominal biopsy in obese rhesus macaques (Macaca mulatta).

PURPOSE: To determine the safety and effectiveness of laparoscopy for repeated intra-abdominal biopsy of liver and omental adipose tissue (AT) in obese rhesus monkeys (Macaca mulatta). METHODS: Nine obese rhesus monkeys were studied by use of 18 laparoscopic procedures (two procedures each, approx. six weeks apart). Time-sensitive liver and omental AT specimens were obtained from monkeys under general anesthesia, using a three-port approach with a roticulating endoscopic stapler/divider and a monopolar electrosurgery for hemostasis. RESULTS: All subjects tolerated the initial and repeat laparoscopic procedures well. Liver specimens weighed a mean +/- SEM of 3.8 +/- 0.5 g, and omental AT specimens weighed 16.6 +/- 0.8 g. Compared with previous studies of conventional laparotomy with liver wedge resection, the monkeys experienced faster postoperative recovery via laparoscopy, with rapid return to normal food intake and activity. Minimal to no adhesions were observed by use of the repeat procedure in all monkeys, with no major complications. CONCLUSIONS: Laparoscopy in obese rhesus monkey (ranging from young to older-aged), with repeated intra-abdominal liver and omental AT biopsy, was an excellent minimally invasive surgical method. In contrast to laparotomy with wedge resection, this approach greatly decreases operative time and stress, provides generous tissue specimens in a time-efficient manner, and facilitates rapid and full recovery of the nonhuman primate.

Adipose Tissue↗
PubMedDate not supplied

Laparoscopic donor nephrectomy: why not?

OBJECTIVES: Laparoscopic donor nephrectomy has undergone explosive worldwide growth as the method of choice for removal of living donor kidneys. However, the method does have some distinct disadvantages as well. The objective is to define real and potential difficulties with the generalized uncritical acceptance of this surgical technique. METHODS: The literature and personal experience at the largest laparoscopic donor program were reviewed and consolidated. Critical areas of technique and management were analyzed. RESULTS: Laparoscopic living donor nephrectomy has increased the pool of willing potential renal donors. In experienced has the recipient renal function results are equivalent to open nephrectomy. CONCLUSIONS: There are risks in performing the operation to the donor and to the allograft. These risks are potentially catastrophic and mitigate against any casual attitudes about embarking on a laparoscopic donor nephrectomy program.

Clinical Competence↗
PubMedDate not supplied

A ten-year, single institution experience with laparoscopic splenectomy.

BACKGROUND AND OBJECTIVES: Laparoscopic splenectomy (LS) is now widely performed and is considered the standard of care for the treatment of certain diseases of the spleen. Although multiple studies have documented the safety and feasibility of laparoscopic splenectomy, little long-term data are available. We present a 10-year, single institution experience with laparoscopic splenectomy to determine trends in procedural outcome data. METHODS: Laparoscopic splenectomy was performed in 109 consecutive, unselected patients with benign or malignant hematological diseases from March 1992 to November 2001. A prospective, longitudinal database, medical record review, and patient interviews were used for data acquisition. During the last 10-years, the annual number of laparoscopic splenectomy was relatively constant. Therefore, patients were divided into 2 cohorts, comparing the first 55 consecutive patients (Group I) with the subsequent 54 patients (Group II) who underwent LS. Data were analyzed using the unpaired Student t test, with values of P < 0.05 considered significant. RESULTS: Mean patient age was 39 years (range, 6 to 79) in Group I and 45 years (range, 13 to 77) in Group II. Total operative time was 151 minutes in Group I and 159 minutes in Group II (NS), estimated blood loss averaged 544 mm in Group I and 308mm in Group II (P = 0.015). The mean specimen weight of the spleen was 288 g in Group I and 512 g in Group II (P = 0.03). Morbidity occurred in 7 of the first 55 patients (13%) and 5 of the next 54 patients (9%). Additionally, 7 conversions to an open operation were necessary in Group I (13%) versus only 1 conversion in Group II (2%). CONCLUSION: A decade of experience with LS shows that it can be performed safely for a wide variety of indications. Over the last 10 years, the average spleen size has increased, yet a significant reduction in blood loss and conversion rate has been achieved.

Adolescent↗