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Biomedical subjects

Patrick Davol

Publications and source records attributed to Patrick Davol.

6 recordsLinked to original sources

Robotic-assisted laparoscopic retroperitoneal lymph node dissection.

Minimally invasive laparoscopic techniques have been applied to the staging and treatment of testicular cancer during the performance of retroperitoneal lymph node dissection. The da Vinci Surgical System potentially improves the safety and accuracy of this approach. We present what we believe to be the first published description of robotic-assisted retroperitoneal lymph node dissection, which was performed in an 18-year-old man with a mixed germ cell tumor. This case demonstrates the technical feasibility, safety, and accuracy of robotic-assisted retroperitoneal lymph node dissection and expands the role of minimally invasive techniques in urologic oncology.

Adolescent↗

Percutaneous ultrasound-guided cryoablation of renal tumors using the CIVCO assist positioning system.

Cryoablation is emerging as an accepted treatment for small renal tumors. Percutaneous placement of cryoprobes using ultrasound guidance is an attractive option for patients with tumors easily seen with transabdominal ultrasonography; however, the placement of probes using hand-held devices is technically challenging. To improve the accuracy and ease of cryoprobe placement during percutaneous renal cryoablation, we describe the novel application of the CIVCO Assist positioning arm system during these complex procedures.

Cryosurgery↗

Henoch-Schönlein purpura presenting with orchitis: a case report and review of the literature.

Henoch-Schönlein purpura (HSP) is the most common cause of nonthrombocytopenic purpura in children. The clinical picture is classically a cutaneous purpuric eruption of the legs and buttocks and infrequently the upper torso and extremities. Arthritis, gastrointestinal tract symptoms, and nephritis are other common findings typically associated with the cutaneous findings. We present an unusual case of HSP with scrotal swelling and orchitis.

Child↗

Testicular torsion in a 68-year-old man.

Testicular torsion is a rare, yet often underrecognized, cause of scrotal pain in adult men. Few reports have commented on testicular torsion in the geriatric population. We report a case of a 68-year-old man initially diagnosed with epididymo-orchitis, who, on surgical exploration, was found to have intravaginal testicular torsion. The diagnosis in this patient population is often delayed, leading to poor salvage rates. The use of color Doppler ultrasonography should be strongly considered if the history and physical examination is suggestive of testicular torsion, regardless of patient age.

Aged↗

Priapism associated with routine use of quetiapine: case report and review of the literature.

We report a case of priapism occurring in a patient taking a standard daily dose of the atypical antipsychotic quetiapine (Seroquel). To our knowledge, this represents the second published report associating quetiapine with priapism, and the first to associate priapism with routine dosing of the drug. Previously published studies have suggested that alpha-adrenergic blockade may be the mechanism of action for this side effect. We report successful management in this case with cavernosal aspiration followed by intracavernosal injection of phenylephrine.

Antipsychotic Agents↗

Computerized tomography with 3-dimensional reconstruction for the evaluation of renal size and arterial anatomy in the living kidney donor.

PURPOSE: Computerized tomography (CT) with 3-dimensional (3-D) reconstruction has gained acceptance as an imaging study to evaluate living renal donors. We report our experience with this technique in 199 consecutive patients to validate its predictions of arterial anatomy and kidney volumes. MATERIALS AND METHODS: Between January 1997 and March 2002, 199 living donor nephrectomies were performed at our institution using an open technique. During the operation arterial anatomy was recorded as well as kidney weight in 98 patients and displacement volume in 27. Each donor had been evaluated preoperatively by CT angiography with 3-D reconstruction. Arterial anatomy described by a staff radiologist was compared with intraoperative findings. CT estimated volumes were reported. Linear correlation graphs were generated to assess the reliability of CT volume predictions. RESULTS: The accuracy of CT angiography for predicting arterial anatomy was 90.5%. However, as the number of renal arteries increased, predictive accuracy decreased. The ability of CT to predict multiple arteries remained high with a positive predictive value of 95.2%. Calculated CT volume and kidney weight significantly correlated (0.654). However, the coefficient of variation index (how much average CT volume differed from measured intraoperative volume) was 17.8%. CONCLUSIONS: CT angiography with 3-D reconstruction accurately predicts arterial vasculature in more than 90% of patients and it can be used to compare renal volumes. However, accuracy decreases with multiple renal arteries and volume comparisons may be inaccurate when the difference in kidney volumes is within 17.8%.

Adult↗