Biomedical subjects
W G Bowsher
Publications and source records attributed to W G Bowsher.
Radiotherapy as a treatment for bladder cancer.
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Laparoscopic pelvic lymph node dissection for carcinoma of the prostate and bladder.
Improvements in instruments and camera systems have allowed the development of operative techniques for laparoscopic pelvic lymph node dissection. A series of dissections in 20 patients is reported. The mean operation time was 1 h and 40 min. When the nodes appeared malignant, a node biopsy was sent for frozen section. If this was positive, the dissection went no further. In three patients it was necessary to complete the operation by open surgery. A mean number of five lymph nodes was dissected per side. After laparoscopic dissection, all patients were discharged the morning after surgery. The operation is possible without making great demands on hospital bed occupancy and the patient has a comfortable and speedy return to normal activity. Using laparoscopic techniques, node dissection becomes a more appealing option as an investigation and staging procedure.
Radiation protection in percutaneous renal surgery.
Two British centres have published the radiation doses received during percutaneous nephrolithotomy (PCNL). Their results were disparate. This study was performed to establish the likely exposure of the eyes and fingers of an experienced urological surgeon who creates the track into the kidney and also performs the endoscopic operation. In addition, some radioprotective gloves were evaluated. Provided that specific precautions, including a judicious use of screening, are taken, the current dose limits are unlikely to be exceeded. However, a 30% reduction in the dose limits is probable. Wearing routine radiation badges under a lead apron is an inadequate method of monitoring exposure: urologists should press for more active assistance from radiation protection officers in the monitoring of procedures in theatre and the use of ultrasound should be encouraged.
Laser ablation of the prostate in patients with benign prostatic hypertrophy.
Seventeen patients with bladder neck obstruction due to benign prostatic hypertrophy have been treated with the Neodymium: YAG laser. We review our experience since the first patient was treated in September 1990. Using a prototype deflecting gold alloy tip on a quartz laser fibre (Lateralase TM), we ablated obstructing prostatic adenoma and constricting bladder neck tissue. Experience with this technique has enabled a patient population to be defined in whom laser therapy for prostatic obstruction may be effective. The treatment is relatively simple, speedy and attended by virtually no blood loss. Laser ablation therapy may offer some advantages over conventional transurethral resection of the prostate (TURP) in a selected subgroup of patients. The advent of new delivery systems may make laser ablation therapy a practical alternative to TURP.
Laparoscopic pelvic lymph node dissection.
The infiltration of pelvic lymph nodes by carcinoma of the prostate or carcinoma of the bladder is an important factor in disease staging. Until now, this could be accurately assessed only by means of open surgery, an undesirable option as an investigation. Recent advances in laparoscopic instruments and camera systems have allowed the performance of laparoscopic pelvic lymph node dissection. A series of dissections in 14 patients is reported.
Prediction of response to lithotripsy--the use of scanning electron microscopy and X-ray energy dispersive spectroscopy.
A single urine sample was obtained from each of 38 patients before and immediately after treatment with a Wolf Piezolith 2300. Each sample was analysed for crystals using scanning electron microscopy and X-ray energy dispersive spectroscopy. In all cases it was possible to make a stone diagnosis prior to treatment and there was 100% correlation between the pre- and post-treatment diagnosis. All stones smaller than 90 mm2 on plain X-ray cleared with piezoelectric lithotripsy alone, regardless of composition. Larger stones composed of calcium oxalate were all successfully fragmented, but 5 of 15 mixed or phosphate stones failed to respond.
Single urine sample diagnosis. A new concept in stone analysis.
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