The Experts below are selected from a list of 303 Experts worldwide ranked by ideXlab platform
Chao Xu - One of the best experts on this subject based on the ideXlab platform.
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Interventional therapy for renal artery pseudoaneurysms.
Asian Pacific Journal of Cancer Prevention, 2012Co-Authors: Wen-bin Ji, Wei-zheng Wang, Yu-cheng Mi, Qiong Xu, Yi-er Chen, Wei Xu, Song Yang, Chao XuAbstract:The aim of this study was to explore the angiographic diagnosis and embolization therapy for renal artery pseudoaneurysms due to acute urinary tract hemorrhage after conservative medical management failed. Seven out of ten cases had fever symptoms after the Kidney Surgery. The pseudoaneurysms were treated with gelatin sponge and (or) spring coil and the majority demonstrated rapid blockage of hemorrhage. Angiography diagnosis and trans catheter embolization are rapid, safe and effective methods for diagnosis and treatment of renal artery pseudoaneurysms.
Jihad H. Kaouk - One of the best experts on this subject based on the ideXlab platform.
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Minimally invasive partial nephrectomy in the age of the 'trifecta'.
BJU international, 2015Co-Authors: Homayoun Zargar, Riccardo Autorino, Humberto Laydner, Oktay Akca, Luis Felipe Brandao, Jihad H. KaoukAbstract:In a recent meta-analysis reported in BJUI, Zhang et al. [1] looked at the peri-operative outcomes of robot-assisted partial nephrectomy (RAPN) vs those of laparoscopic partial nephrectomy (LPN). Their study represents the third metaanalysis carried out over the last year [1–3], which is testament to the growing interest on this topic that is driven by the rapid spread of robot-assisted Kidney Surgery.
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Robotic single-site Kidney Surgery: evaluation of second-generation instruments in a cadaver model.
Urology, 2012Co-Authors: Jihad H. Kaouk, Riccardo Autorino, Humberto Laydner, Shahab Hillyer, Rachid Yakoubi, Wahib Isac, Ahmad Kassab, Emad Rizkala, Robert J. SteinAbstract:Objective To evaluate the second generation of single-site instruments for robotic laparoendoscopic single-site Surgery (R-LESS) for Kidney procedures in a cadaver model. Methods Three procedures, including 1 pyeloplasty, 1 partial nephrectomy, and 1 nephrectomy, were conducted in a female cadaver model. A da Vinci Si system (Intuitive Surgical, Sunnyvale, CA) and the second generation of single-site instruments, specifically designed for R-LESS, were used. Results All the procedures were completed successfully without the addition of extra ports. Time to set up the port and instruments was 40 minutes. In the pyeloplasty, time to complete the anastomosis was 39 minutes. In the partial nephrectomy, simulated ischemia time was 21 minutes. In the nephrectomy, time to complete the resection was 13 minutes. No significant gas leak was noticed during the procedures. There were no injuries to intraabdominal organs or vessels. Conclusion Robotic single-site renal Surgery using a second generation of specifically designed instruments was feasible in a cadaver model, obviating many limitations of LESS. Lack of articulation at the tip of the instruments represents the main disadvantage of this novel instrumentation, especially in case of reconstructive procedures.
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Immediate impact of a robotic Kidney Surgery course on attendees practice patterns.
The international journal of medical robotics + computer assisted surgery : MRCAS, 2011Co-Authors: Fatih Altunrende, Riccardo Autorino, Georges-pascal Haber, Humberto Laydner, Michael A. White, Rakesh Khanna, Robert J. Stein, Jihad H. KaoukAbstract:Background The object of this study was to evaluate the immediate impact of a robotic Kidney Surgery course on the practice patterns of participating urologists. Methods Two surveys were administered to the participants of the International Symposium on Robotic Kidney and Adrenal Surgery held at the Cleveland Clinic on October 2009. Returned responses were entered into a database. Results were reviewed and analyzed. Results Twenty-seven participants (60% of total registered) completed the end-of-course questionnaire. Mean age was 44 years (range 33–65). Mean time from completion of residency was 14 years (range 1–30). The majority of the attendees (78%) had familiarity with both laparoscopy and robotics, but only 22% of them had completed a formal fellowship or mini-residency training in laparoscopy or robotics. All course components received a mean score above 4.5. 92% of the participants planned to perform a ‘new’ procedure in their practice immediately after the course. Of the 27 participants contacted, 12 (44.4%) returned the 3-month questionnaire. All of them (100%) had performed robotic surgical procedures after the course. Overall, there was an increase of 56% in the robotic cases in the surgical practice of the participants. The actual impact of attending the course on starting or implementing robotic Surgery practice was positively rated by the participants (mean score 4.7 ± 0.45 on scale 1–5). Conclusions A course including lectures, video analysis, live Surgery and hands-on session with both simulators and an animal laboratory is an effective educational model for immediately spreading robotic skills. Copyright © 2011 John Wiley & Sons, Ltd.
Robert L. Galloway - One of the best experts on this subject based on the ideXlab platform.
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A novel method for texture-mapping conoscopic surfaces for minimally invasive image-guided Kidney Surgery.
International journal of computer assisted radiology and surgery, 2016Co-Authors: Rowena E. Ong, Courtenay L. Glisson, Amber L. Simpson, Michael I. Miga, Jessica Burgner-kahrs, Andrei Danilchenko, Ray A. Lathrop, S. Duke Herrell, Robert J. Webster, Robert L. GallowayAbstract:Purpose Organ-level registration is critical to image-guided therapy in soft tissue. This is especially important in organs such as the Kidney which can freely move. We have developed a method for registration that combines three-dimensional locations from a holographic conoscope with an endoscopically obtained textured surface. By combining these data sources clear decisions as to the tissue from which the points arise can be made.
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Comparison and assessment of semi-automatic image segmentation in computed tomography scans for image-guided Kidney Surgery
Medical physics, 2011Co-Authors: Courtenay L. Glisson, Hernan O. Altamar, Peter E. Clark, S. Duke Herrell, Robert L. GallowayAbstract:Purpose: Image segmentation is integral to implementing intraoperative guidance for Kidneytumor resection. Results seen in computed tomography(CT) data are affected by target organphysiology as well as by the segmentation algorithm used. This work studies variables involved in using level set methods found in the Insight Toolkit to segment Kidneys from CT scans and applies the results to an image guidance setting. Methods: A composite algorithm drawing on the strengths of multiple level set approaches was built using the Insight Toolkit. This algorithm requires imagecontrast state and seed points to be identified as input, and functions independently thereafter, selecting and altering method and variable choice as needed. Results: Semi-automatic results were compared to expert hand segmentation results directly and by the use of the resultant surfaces for registration of intraoperative data. Direct comparison using the Dice metric showed average agreement of 0.93 between semi-automatic and hand segmentation results. Use of the segmented surfaces in closest point registration of intraoperative laser range scan data yielded average closest point distances of approximately 1 mm. Application of both inverse registration transforms from the previous step to all hand segmented image space points revealed that the distance variability introduced by registering to the semi-automatically segmented surface versus the hand segmented surface was typically less than 3 mm both near the tumor target and at distal points, including subsurface points. Conclusions: Use of the algorithm shortened user interaction time and provided results which were comparable to the gold standard of hand segmentation. Further, the use of the algorithm’s resultant surfaces in image registration provided comparable transformations to surfaces produced by hand segmentation. These data support the applicability and utility of such an algorithm as part of an image guidance workflow.
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Medical Imaging: Image-Guided Procedures - The use of virtual fiducials in image-guided Kidney Surgery
Medical Imaging 2011: Visualization Image-Guided Procedures and Modeling, 2011Co-Authors: Courtenay L. Glisson, Rowena E. Ong, Peter E. Clark, S. Duke Herrell, Amber L. Simpson, Robert L. GallowayAbstract:The alignment of image-space to physical-space lies at the heart of all image-guided procedures. In intracranial Surgery, point-based registrations can be used with either skin-affixed or bone-implanted extrinsic objects called fiducial markers. The advantages of point-based registration techniques are that they are robust, fast, and have a well developed mathematical foundation for the assessment of registration quality. In abdominal image-guided procedures such techniques have not been successful. It is difficult to accurately locate sufficient homologous intrinsic points in imagespace and physical-space, and the implantation of extrinsic fiducial markers would constitute "Surgery before the Surgery." Image-space to physical-space registration for abdominal organs has therefore been dominated by surfacebased registration techniques which are iterative, prone to local minima, sensitive to initial pose, and sensitive to percentage coverage of the physical surface. In our work in image-guided Kidney Surgery we have developed a composite approach using "virtual fiducials." In an open Kidney Surgery, the perirenal fat is removed and the surface of the Kidney is dotted using a surgical marker. A laser range scanner (LRS) is used to obtain a surface representation and matching high definition photograph. A surface to surface registration is performed using a modified iterative closest point (ICP) algorithm. The dots are extracted from the high definition image and assigned the three dimensional values from the LRS pixels over which they lie. As the Surgery proceeds, we can then use point-based registrations to re-register the spaces and track deformations due to vascular clamping and surgical tractions.
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Kidney Deformation and Intraprocedural Registration: A Study of Elements of Image-Guided Kidney Surgery
Journal of endourology, 2010Co-Authors: Hernan O. Altamar, Rowena E. Ong, Courtenay L. Glisson, Davis P. Viprakasit, S. Duke Herrell, Michael I. Miga, Robert L. GallowayAbstract:Abstract Introduction: Central to any image-guided surgical procedure is the alignment of image and physical coordinate spaces, or registration. We explored the task of registration in the Kidney through in vivo and ex vivo porcine animal models and a human study of minimally invasive Kidney Surgery. Methods: A set of (n = 6) ex vivo porcine Kidney models was utilized to study the effect of perfusion and loss of turgor caused by incision. Computed tomography (CT) and laser range scanner localizations of the porcine Kidneys were performed before and after renal vessel clamping and after capsular incision. The da Vinci™ robotic Surgery system was used for Kidney surface acquisition and registration during robot-assisted laparoscopic partial nephrectomy. The surgeon acquired the physical surface data points with a tracked robotic instrument. These data points were aligned to preoperative CT for surface-based registrations. In addition, two biomechanical elastic computer models (isotropic and anisotropic) wer...
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Intraprocedural Registration for Image-Guided Kidney Surgery
IEEE ASME Transactions on Mechatronics, 2010Co-Authors: Rowena E. Ong, Courtenay L. Glisson, Hernan O. Altamar, Davis P. Viprakasit, Peter E. Clark, S. Duke Herrell, Robert L. GallowayAbstract:This paper reviews the process of using surface-based registration techniques for image-guided Kidney Surgery and presents data for both open and minimally invasive Kidney Surgery either by robot or by hand.
Daniel Eun - One of the best experts on this subject based on the ideXlab platform.
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V7-10 ROBOTIC TRAPDOOR PARTIAL NEPHRECTOMY FOR COMPLETELY ENDOPHYTIC TUMORS
The Journal of Urology, 2014Co-Authors: Blake W. Moore, Ziho Lee, Lindsey A. Parkes, Mudhukar Patel, Jack H. Mydlo, Daniel EunAbstract:both cases, extensive adhesions were found around the Kidney, making anatomical identification and dissection difficult. Intra-operative ultrasound and a doppler probe were used to facilitate identification of anatomical structures. The fourth robotic arm and robotic hook were used to help mobilize the Kidney and expose important structures. RESULTS: The results of the two cases are presented in Table 1. Both cases were completed robotically with no intraoperative complications. Post-operative course was uneventful and both the patients were discharged on day three. CONCLUSIONS: Salvage robotic Kidney Surgery for complications of robotic partial nephrectomy is rare but challenging. Intraoperative ultrasound, intraoperative doppler, the fourth robotic arm, and robotic hook canall beuseful todefineanatomyand facilitatedissection indifficult cases.
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Retroperitoneal robotic renal Surgery: technique and early results
Journal of Robotic Surgery, 2009Co-Authors: Manish N. Patel, Mani Menon, Daniel Eun, Sanjeev A. Kaul, Rajesh Laungani, Mahendra Bhandari, Craig G. RogersAbstract:We describe a robotic retroperitoneal approach to renal Surgery, optimized in porcine and cadaveric models, and applied to human patients. A retroperitoneal approach for robotic Kidney Surgery was developed in nonsurvival porcine and a fresh cadaver models, and then utilized in ten patients (three partial nephrectomy, three radical nephrectomy, two simple nephrectomy, one pyeloplasty, one cryoablation). Retroperitoneal access was successfully achieved for robotic renal procedures in six pigs and a human cadaver. Ten human patients (mean age 56 years, range 36–72 years) then underwent a successful retroperitoneal approach for robotic renal Surgery. Mean console time was 166 (120–300) min. Mean blood loss was 82 (50–100) ml and average hospital stay was 2.6 (1–5) days. Pathology demonstrated clear cell renal cell carcinoma (four), papillary renal cell carcinoma (two), and xanthogranulomatous pyelonephritis (two). One patient with xanthogranulomatous pyelonephritis required open conversion for failure to progress due to dense adhesions. A retroperitoneal approach is a safe and feasible alternative to a transperitoneal approach for robotic renal Surgery, including radical nephrectomy, partial nephrectomy, pyeloplasty, and cryoablation.
Wen-bin Ji - One of the best experts on this subject based on the ideXlab platform.
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Interventional therapy for renal artery pseudoaneurysms.
Asian Pacific Journal of Cancer Prevention, 2012Co-Authors: Wen-bin Ji, Wei-zheng Wang, Yu-cheng Mi, Qiong Xu, Yi-er Chen, Wei Xu, Song Yang, Chao XuAbstract:The aim of this study was to explore the angiographic diagnosis and embolization therapy for renal artery pseudoaneurysms due to acute urinary tract hemorrhage after conservative medical management failed. Seven out of ten cases had fever symptoms after the Kidney Surgery. The pseudoaneurysms were treated with gelatin sponge and (or) spring coil and the majority demonstrated rapid blockage of hemorrhage. Angiography diagnosis and trans catheter embolization are rapid, safe and effective methods for diagnosis and treatment of renal artery pseudoaneurysms.
