The Experts below are selected from a list of 45921 Experts worldwide ranked by ideXlab platform

Anders F Mellgren - One of the best experts on this subject based on the ideXlab platform.

Neil Hyman - One of the best experts on this subject based on the ideXlab platform.

Joaquim Gamarodrigues - One of the best experts on this subject based on the ideXlab platform.

  • transanal endoscopic Microsurgery for residual rectal cancer ypt0 2 following neoadjuvant chemoradiation therapy another word of caution
    Diseases of The Colon & Rectum, 2013
    Co-Authors: Rodrigo Oliva Perez, Angelita Habrgama, Patricio B Lynn, Guilherme Pagin Sao Juliao, Romina Bianchi, Igor Proscurshim, Joaquim Gamarodrigues
    Abstract:

    Background Significant tumor downstaging among patients with rectal cancer following neoadjuvant chemoradiation has raised the issue of offering patients with small residual cancers restricted to the bowel wall an alternative treatment strategy to total mesorectal excision. Transanal endoscopic Microsurgery may allow proper primary tumor resection with promising oncological outcomes, less postoperative morbidity, and minimal long-term sexual, urinary, and fecal continence disorders in comparison with radical resection. Objective The aim of this study was to determine the oncological outcomes of patients with residual rectal cancers restricted to the rectal wall (ypT0-2) following neoadjuvant chemoradiation and transanal endoscopic Microsurgery. Design This study considered a prospective cohort of patients with residual rectal cancers following neoadjuvant chemoradiation treated by transanal endoscopic Microsurgery and no additional systemic therapy. Settings This study was a single-institution experience. Patients Patients with adenocarcinoma of the rectum located no more than 7 cm from the anal verge and endorectal ultrasound- or magnetic resonance-staged cT2-4N0-2M0 treated by neoadjuvant chemoradiation (50.4-54 Gy and 5-fluorouracil-based chemotherapy) were eligible for the study. Patients with small residual tumors (≤3 cm) radiologically staged ycT0-2N0 were treated by transanal endoscopic Microsurgery. Interventions Transanal endoscopic Microsurgery was performed. Main outcome measures The primary outcome measured was local recurrence. Results Of the 27 patients treated by transanal endoscopic Microsurgery, 3 had ypT0, 6 had ypT1, and 18 had ypT2 cancers. All patients underwent R0 transanal endoscopic Microsurgery excision. Local recurrence was observed in 4 (15%) patients after a median follow-up of 15 months. Only lymphovascular invasion was an independent predictive factor for local failure (p = 0.04). Tumor size, ypT status, T-status downstaging, lateral/radial margins, and tumor regression grade were not predictors of local failure. Limitations This study was limited by the small sample size and limited follow-up. Conclusions A local failure rate of 15% after transanal endoscopic Microsurgery for patients with residual rectal cancers restricted to the bowel wall (ypT0-2) may limit the indication of this procedure to highly selected patients as an alternative to standard radical total mesorectal excision.

Ben M Tsai - One of the best experts on this subject based on the ideXlab platform.

Sijo J. Parekattil - One of the best experts on this subject based on the ideXlab platform.

  • Robot-assisted Microsurgery for chronic orchialgia.
    Translational andrology and urology, 2017
    Co-Authors: Parviz Kavoussi, Jamin Brahmbhatt, Nahomy Calixte, Sijo J. Parekattil
    Abstract:

    Chronic orchialgia is one of the most common complaints seen in the urologists office and has traditionally been considered a very difficult diagnostic and therapeutic challenge for the clinician. First line management of chronic orchialgia is conservative treatment; however, in men who fail conservative therapy, surgical intervention may be indicated. Microsurgery has been the mainstay for surgical treatment of chronic orchialgia, but the implementation of robotics to Microsurgery lends itself particularly to surgical treatment of chronic orchialgia. PubMed was used to perform a current literature search on chronic orchialgia with robotic Microsurgery, robotic spermatic cord denervation, robotic varicocelectomy, and robotic vasectomy reversal. Although conservative therapy is considered the first line treatment for chronic orchialgia, reported outcomes are moderate to poor, with the need to proceed to surgical intervention in select cases. Current surgical therapies in which robot assistance have been applied to Microsurgery include microsurgical denervation of the spermatic cord, varicocelectomy, and vasectomy reversal. As further studies have assisted in the understanding of surgical treatment of chronic orchialgia, the application of robot assistance to this level of Microsurgery has been shown to be feasible and safe with comparable outcomes to traditional Microsurgery and may provide potential advantages.

  • Robot-Assisted Microsurgery in Male Infertility and Andrology
    Urologic Clinics of North America, 2014
    Co-Authors: Ahmet Gudeloglu, Jamin Brahmbhatt, Sijo J. Parekattil
    Abstract:

    Use of the operative microscope marked a new era for Microsurgery in male infertility and andrology in the 1970s. More than a decade has passed since the initial description of the first robotic-assisted microsurgical vasovasostomy. Large single-center series have recently been published on robotic-assisted Microsurgery for vasectomy reversal, especially in the past few years. Multicenter studies are also beginning to be reported, and the potential for this new platform for Microsurgery is starting to become more apparent. This article describes the basic technical details of robotic-assisted Microsurgery in male infertility and andrology, and reviews the latest literature.

  • Robotic Microsurgery Optimization
    Archives of Plastic Surgery, 2014
    Co-Authors: Jamin Brahmbhatt, Ahmet Gudeloglu, Philippe Liverneaux, Sijo J. Parekattil
    Abstract:

    The increased application of the da Vinci robotic platform (Intuitive Surgical Inc.) for Microsurgery has led to the development of new adjunctive surgical instrumentation. In Microsurgery, the robotic platform can provide high definition 12×-15× digital magnification, broader range of motion, fine instrument handling with decreased tremor, reduced surgeon fatigue, and improved surgical productivity. This paper presents novel adjunctive tools that provide enhanced optical magnification, micro-Doppler sensing of vessels down to a 1-mm size, vein mapping capabilities, hydro-dissection, micro-ablation technology (with minimal thermal spread-CO2 laser technology), and confocal microscopy to provide imaging at a cellular level. Microsurgical outcomes from the use of these tools in the management of patients with infertility and chronic groin and testicular pain are reviewed. All these instruments have been adapted for the robotic console and enhance the robot-assisted Microsurgery experience. As the popularity of robot-assisted Microsurgery grows, so will its breadth of instrumentation.