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Enhancing Care With Robotic Prostatectomy

Enhancing Care With Robotic Prostatectomy

During the last decade, the number of robot-assisted prostatectomies performed in the United States has risen steadily throughout the country. Several factors have led to more complex patients being offered surgery for organ-confined prostate cancer, including refined surgical techniques, a better understanding of anatomy, and more experience. Robot-assisted procedures help surgeons better visualize anatomy and control bleeding with the added benefit of increased dexterity. This has enabled surgeons to treat prostate cancers more effectively with fewer complications than was previously possible with traditional open surgery. Although rare, several studies have reported on complication rates associated with robot-assisted prostatectomy. However, few data exist when evaluating ureteral injuries that are sustained during these procedures. Further complicating matters is that there is no standardized universal criteria for reporting and grading of complications. “Identifying patient characteristics that may forewarn surgeons of such damage may further improve our ability to reduce complications,” says Jay K. Jhaveri, MD, MPH. Low Rates Observed In the Journal of Endourology, Dr. Jhaveri and colleagues had a study published that focused on 6,442 patients who underwent robotic prostatectomy by one of five surgeons over a 12-year period. Under the guidance of Mani Menon, MD, and James Peabody, MD, the study team found that three patients—operated on by two of the five surgeons—sustained complete transection of the ureter. One of the patients required readmission for further treatment. The study authors identified several risk factors that predisposed these patients to ureteral injury, including a history of: • Infection. • Abdominal surgery. • Radiation treatment. • Enlarged prostate glands. • Prior transurethral prostatic resection. Overall, the study group found a 0.046% rate...

Surgery in Space: I Foresee Problems

The astronauts are halfway to Mars when suddenly one of them develops abdominal pain and requires surgery. What will they do? According to NASA, a miniature robot capable of assisting in surgery has been developed, tested in pigs, and is soon to be trialed in a weightless environment. The robot, which weighs less than 1 pound, can be inserted into the abdomen via the umbilicus and controlled remotely. The press release from NASA said types of operations that the robot would be capable of performing were “emergency appendectomies, emergency cholecystectomies, emergency perforation of gastric ulcers [sic], and intra-abdominal bleeding due to trauma.” NASA meant to say “repair of perforated gastric ulcers.” Not surprisingly, many science reporters for media outlets, for example, SFGate and WiredUK, did not notice the error. New Scientist also missed it, but at least published a later correction. However, even the famous da Vinci robot is incapable of performing surgery on its own. The original idea was that a surgeon on the ground would direct the robot’s movements, but that will not be possible for two reasons. In deep space, the time lag between the earthbound surgeon’s actions and the robot’s response would be too long, and a recent article about remote-controlled drone crashes highlighted the problems that can occur when links are lost or computers malfunction. The plan is to train the astronauts to perform minimally invasive robotic surgery on each other. What could go wrong? A lot. If they are only going to train on simulators and then have to do real surgery in space, they will be completely lost, robot or not. I...
2014 VEITH Symposium

2014 VEITH Symposium

New research is being presented at the 2014 VEITH Symposium, the 41st Annual Symposium on Vascular and Endovascular Issues, from November 18 to 22 in New York City.    Conference Highlights Gender Differences in EVAR: A 20-Year Look Age, Urgency, & TEVAR Iliac Vein Stenting in the Elderly Open Vs Endovascular RAAA Repair ltrasound-Accelerated, Catheter-Directed Thrombolysis for DVT   News From the Meeting Two-Year PYTHAGORAS Data Presented for Lombard Medical’s Aorfix Device Initial Data Presented From EVAS FORWARD–Global Registry for Endologix’ Nellix Device Innovation + Investment Roundtable At VEITHsymposium Scheduled for Friday, Nov. 21, Gramercy Suite West, 2nd Floor.  Details Include Schedule of Presentations Lower Extremity Disease Treatment Presentations at VEITHsymposium: Stents, Drug-Eluting Balloons and Trial Updates Management Options, Diagnosis and Treatment for Pulmonary Embolism Topics to be Presented Final 5-Year Results of RCT Comparing Heparin Bonded PTFE Propaten Grafts vs. Standard PTFE Grafts in Fem-Pop and Fem-Fem Bypasses Durability to be Presented A Review of Endovascular vs. Open Surgery for Critical Limb Ischemia Innovation and Roundtable Session at VEITHsymposium:  Medical Devices, Pharmaceutical and Diagnostic Companies On-Hand To Showcase Products The INSTEAD Trials May Not Be Enough to Justify TEVAR for All Uncomplicated TBADs: Experts State More Trials May be Needed While Other’s Disagree The Future of Carotid Stenting Is Bright  CAS Will Emerge as an Effective and Justifiable Mainstream Treatment With a Bright Future To Help Patients Further Studies to Document that Promise Are in Order Multiple Sclerosis and CCSVI Discussions Heat Up At the 41st Annual VEITHsymposium   More From the Meeting General Information Program Faculty Register Introduction to Academic Surgery Hemodialysis Access Endovenous Management Wound Care...
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