[Robot-assisted urologic and general telesurgery].
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Biomedical subjects
Publications and source records attributed to Lars Henning Olsen.
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OBJECTIVE: Retrospectively we evaluated the outcome of all primary hypospadia operations done at Skejby Sygehus, Aarhus University Hospital, in the period May 1999 to March 2001. In that period the concept of treating hypospadias was changed from mainly the Mathiau operation and the preputial skin tube (Duckett) to the method of Barcat (and Koyanagi). MATERIAL AND METHODS: During the study period 101 boys consecutively underwent treatment of hypospadias using mainly the techniques of Koyanagi, Barcat and the Glanular Approximation Procedure (GAP). RESULTS: Cosmetic and functional outcome were excellent. Complications consisted of 12% urethrocutaneous fistula of which the majorities were seen in the first year after taken up the new techniques. There were 3% meatal stenosis and no urethral diverticula. CONCLUSION: The short-term results of the new techniques are superior in cosmetic and functional outcome. The fistula rate was a little high in the start of the period after introducing the new techniques but have fallen to a level comparable to other centres results. The level of fistula is comparable to other centres results.
To assess the feasibility of a new variant of laparoscopic Cohen cross-trigonal ureter reimplantation in vesico-ureteral reflux (VUR) using telesurgical equipment. VUR was induced in 8 female pigs by transurethral unroofing of the ureteric orifices. Three months later the reflux was verified by a cystography. A cross-trigonal ureter reimplantation a.m. Cohen was performed by laparoscopic access to the bladder using the da Vinci telesurgical system. The 12 mm camera port was placed below the umbilicus, two 8 mm working ports for the robotic system were placed lateral to the rectus muscles and an additional port for assistance between camera and right working port. The outcome was assessed 3 months later by a new cystography. The operative time for a single reimplantation varied from 45 to 90 minutes. In all pigs the reflux disappeared after the procedure, which was complicated by a postoperative port hernia in two animals. Laparoscopic transvesical ureter reimplantation using telesurgical equipment is a feasible method in the few cases this procedure is indicated. The advantage of the robotic equipment is the better access to submucosal tunneling of the ureter and the intravesical suturing of the anastomosis indicated by shorter operative time and success rates similar to the open procedure.