The Experts below are selected from a list of 2028 Experts worldwide ranked by ideXlab platform
Ralph V Clayman - One of the best experts on this subject based on the ideXlab platform.
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intraoperative Catheter management during laparoscopic excision of a giant bladder diverticulum
Journal of Laparoendoscopic & Advanced Surgical Techniques, 2004Co-Authors: Sepehr Khonsari, David I Lee, Jay Basillote, Elspeth M Mcdougall, Ralph V ClaymanAbstract:Background: Massive bladder diverticula present a technical challenge to the laparoscopic surgeon. We describe a laparoscopic approach to transperitoneal diverticulectomy, using a specific Catheter arrangement to allow excellent control of the various portions of the procedure. Methods: A 49-year-old male with longstanding frequency was diagnosed with a 1000 cc bladder diverticulum and bladder neck outlet obstruction. Laparoscopic transperitoneal diverticulectomy was performed using a triple Catheter arrangement: endoscopic placement of a Councill Catheter in the diverticulum, fluoroscopic positioning of an Occlusion Balloon Catheter in the renal pelvis, and placement of a Cope loop suprapubic tube. Additionally, a transurethral incision of the prostate was performed. Results: The procedure was completed laparoscopically using a four port transperitoneal approach. During the procedure, the diverticulum could be filled and emptied as needed; the Catheter across the diverticular neck facilitated subsequent ...
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sealing percutaneous nephrolithotomy tracts with gelatin matrix hemostatic sealant initial clinical use
The Journal of Urology, 2004Co-Authors: David I Lee, Carlos Uribe, Louis Eichel, Sepehr Khonsari, Jay Basillote, Hyung Keun Park, Elspeth M Mcdougall, Ralph V ClaymanAbstract:ABSTRACTPurpose: Tubeless percutaneous nephrolithotomy (PCNL) has been performed at several centers with good success. However, these cases have been carefully selected with regard to short duration and smaller stone burden to prevent complications associated with the loss of access to the collecting system. We describe the use of gelatin matrix hemostatic sealant (FloSeal Baxter Medical, Fremont, California) as an adjunct to tubeless percutaneous nephrolithotomy to help preclude bleeding complications.Materials and Methods: Two patients were treated with PCNL through a single nephrostomy tract. At the satisfactory conclusion of the cases the tract was occluded retrograde with an Occlusion Balloon Catheter and gelatin matrix hemostatic sealant was injected down the nephrostomy tract. An indwelling stent and bladder Catheter were placed following which all guidewires were removed and skin sutures were placed.Results: The operative times were 75 and 180 minutes, respectively. Both patients had stable postop...
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laparoscopic pyeloplasty for secondary ureteropelvic junction obstruction preliminary experience
Urology, 1995Co-Authors: Elspeth M Mcdougall, Ralph V Clayman, Stephen Y NakadaAbstract:Abstract Objectives To identify whether laparoscopic pyeloplasty is a reasonable treatment option for secondary ureteropelvic junction (UPJ) obstruction. Methods Since March 1994, we have performed laparoscopic pyeloplasties for secondary UPJ obstruction on 4 symptomatic patients ranging in age from 26 to 39 years. Prior failed procedures included antegrade endopyelotomies (3) and Acucise endopyelotomies (3). Two patients underwent two prior endopyelotomies. Techniques of laparoscopic reconstruction included Anderson-Hines dismembered (3) and Culp-DeWeerd flap (1) procedures. Repairs were performed with interrupted and running 3.0 and 4.0 Vicryl sutures using intracorporeal knots and Lapra-Ty absorbable suture clips. Results Average operating time was 530 minutes (range, 465 to 645), which included preoperative cystoscopic placement of an external 7 F Occlusion Balloon Catheter into the renal pelvis and placement of an internal double pigtail ureteral stent at the conclusion of the procedure. Average blood loss was 111 cc (range, 75 to 150). All 4 patients were found to have anterior crossing vessels intraoperatively. Average postoperative hospital stay was 4 days (range, 3 to 7). All 4 patients have a patent, nonobstructed UPJ by either Whitaker test or diuretic renography at an average of 3.3 months postoperatively (range, 1 to 5). Average return to normal activity was 4.5 weeks (range, 3 to 8). Utilizing an analogue pain scale, 2 of the patients are pain-free, and the other 2 are improved (45% and 85%) at an average of 8 months (range, 2 to 12) postoperatively. One patient developed stones in the renal pelvis and required percutaneous nephrolithotomy 10 weeks postoperatively. Conclusions Laparoscopic pyeloplasty appears to be feasible and effective, although a technically challenging operative procedure for treating secondary (postendopyelotomy) UPJ obstruction. Further clinical experience and long-term follow-up are needed.
Elspeth M Mcdougall - One of the best experts on this subject based on the ideXlab platform.
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intraoperative Catheter management during laparoscopic excision of a giant bladder diverticulum
Journal of Laparoendoscopic & Advanced Surgical Techniques, 2004Co-Authors: Sepehr Khonsari, David I Lee, Jay Basillote, Elspeth M Mcdougall, Ralph V ClaymanAbstract:Background: Massive bladder diverticula present a technical challenge to the laparoscopic surgeon. We describe a laparoscopic approach to transperitoneal diverticulectomy, using a specific Catheter arrangement to allow excellent control of the various portions of the procedure. Methods: A 49-year-old male with longstanding frequency was diagnosed with a 1000 cc bladder diverticulum and bladder neck outlet obstruction. Laparoscopic transperitoneal diverticulectomy was performed using a triple Catheter arrangement: endoscopic placement of a Councill Catheter in the diverticulum, fluoroscopic positioning of an Occlusion Balloon Catheter in the renal pelvis, and placement of a Cope loop suprapubic tube. Additionally, a transurethral incision of the prostate was performed. Results: The procedure was completed laparoscopically using a four port transperitoneal approach. During the procedure, the diverticulum could be filled and emptied as needed; the Catheter across the diverticular neck facilitated subsequent ...
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sealing percutaneous nephrolithotomy tracts with gelatin matrix hemostatic sealant initial clinical use
The Journal of Urology, 2004Co-Authors: David I Lee, Carlos Uribe, Louis Eichel, Sepehr Khonsari, Jay Basillote, Hyung Keun Park, Elspeth M Mcdougall, Ralph V ClaymanAbstract:ABSTRACTPurpose: Tubeless percutaneous nephrolithotomy (PCNL) has been performed at several centers with good success. However, these cases have been carefully selected with regard to short duration and smaller stone burden to prevent complications associated with the loss of access to the collecting system. We describe the use of gelatin matrix hemostatic sealant (FloSeal Baxter Medical, Fremont, California) as an adjunct to tubeless percutaneous nephrolithotomy to help preclude bleeding complications.Materials and Methods: Two patients were treated with PCNL through a single nephrostomy tract. At the satisfactory conclusion of the cases the tract was occluded retrograde with an Occlusion Balloon Catheter and gelatin matrix hemostatic sealant was injected down the nephrostomy tract. An indwelling stent and bladder Catheter were placed following which all guidewires were removed and skin sutures were placed.Results: The operative times were 75 and 180 minutes, respectively. Both patients had stable postop...
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laparoscopic pyeloplasty for secondary ureteropelvic junction obstruction preliminary experience
Urology, 1995Co-Authors: Elspeth M Mcdougall, Ralph V Clayman, Stephen Y NakadaAbstract:Abstract Objectives To identify whether laparoscopic pyeloplasty is a reasonable treatment option for secondary ureteropelvic junction (UPJ) obstruction. Methods Since March 1994, we have performed laparoscopic pyeloplasties for secondary UPJ obstruction on 4 symptomatic patients ranging in age from 26 to 39 years. Prior failed procedures included antegrade endopyelotomies (3) and Acucise endopyelotomies (3). Two patients underwent two prior endopyelotomies. Techniques of laparoscopic reconstruction included Anderson-Hines dismembered (3) and Culp-DeWeerd flap (1) procedures. Repairs were performed with interrupted and running 3.0 and 4.0 Vicryl sutures using intracorporeal knots and Lapra-Ty absorbable suture clips. Results Average operating time was 530 minutes (range, 465 to 645), which included preoperative cystoscopic placement of an external 7 F Occlusion Balloon Catheter into the renal pelvis and placement of an internal double pigtail ureteral stent at the conclusion of the procedure. Average blood loss was 111 cc (range, 75 to 150). All 4 patients were found to have anterior crossing vessels intraoperatively. Average postoperative hospital stay was 4 days (range, 3 to 7). All 4 patients have a patent, nonobstructed UPJ by either Whitaker test or diuretic renography at an average of 3.3 months postoperatively (range, 1 to 5). Average return to normal activity was 4.5 weeks (range, 3 to 8). Utilizing an analogue pain scale, 2 of the patients are pain-free, and the other 2 are improved (45% and 85%) at an average of 8 months (range, 2 to 12) postoperatively. One patient developed stones in the renal pelvis and required percutaneous nephrolithotomy 10 weeks postoperatively. Conclusions Laparoscopic pyeloplasty appears to be feasible and effective, although a technically challenging operative procedure for treating secondary (postendopyelotomy) UPJ obstruction. Further clinical experience and long-term follow-up are needed.
Stephen Y Nakada - One of the best experts on this subject based on the ideXlab platform.
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laparoscopic pyeloplasty for secondary ureteropelvic junction obstruction preliminary experience
Urology, 1995Co-Authors: Elspeth M Mcdougall, Ralph V Clayman, Stephen Y NakadaAbstract:Abstract Objectives To identify whether laparoscopic pyeloplasty is a reasonable treatment option for secondary ureteropelvic junction (UPJ) obstruction. Methods Since March 1994, we have performed laparoscopic pyeloplasties for secondary UPJ obstruction on 4 symptomatic patients ranging in age from 26 to 39 years. Prior failed procedures included antegrade endopyelotomies (3) and Acucise endopyelotomies (3). Two patients underwent two prior endopyelotomies. Techniques of laparoscopic reconstruction included Anderson-Hines dismembered (3) and Culp-DeWeerd flap (1) procedures. Repairs were performed with interrupted and running 3.0 and 4.0 Vicryl sutures using intracorporeal knots and Lapra-Ty absorbable suture clips. Results Average operating time was 530 minutes (range, 465 to 645), which included preoperative cystoscopic placement of an external 7 F Occlusion Balloon Catheter into the renal pelvis and placement of an internal double pigtail ureteral stent at the conclusion of the procedure. Average blood loss was 111 cc (range, 75 to 150). All 4 patients were found to have anterior crossing vessels intraoperatively. Average postoperative hospital stay was 4 days (range, 3 to 7). All 4 patients have a patent, nonobstructed UPJ by either Whitaker test or diuretic renography at an average of 3.3 months postoperatively (range, 1 to 5). Average return to normal activity was 4.5 weeks (range, 3 to 8). Utilizing an analogue pain scale, 2 of the patients are pain-free, and the other 2 are improved (45% and 85%) at an average of 8 months (range, 2 to 12) postoperatively. One patient developed stones in the renal pelvis and required percutaneous nephrolithotomy 10 weeks postoperatively. Conclusions Laparoscopic pyeloplasty appears to be feasible and effective, although a technically challenging operative procedure for treating secondary (postendopyelotomy) UPJ obstruction. Further clinical experience and long-term follow-up are needed.
Edward T Riley - One of the best experts on this subject based on the ideXlab platform.
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epidural anesthesia for elective cesarean delivery with intraoperative arterial Occlusion Balloon Catheter placement
Anesthesia & Analgesia, 2006Co-Authors: Andrea Fuller, Brendan Carvalho, Catherine Brummel, Edward T RileyAbstract:Obstetric hemorrhage is a leading cause of maternal mortality. We describe the anesthetic management of elective cesarean delivery in patients at high risk for hemorrhage. The utility and limitations of intraarterial Balloon Catheter placement and epidural anesthesia are described.
Yasumi Uchida - One of the best experts on this subject based on the ideXlab platform.
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Induction of thrombolysis and prevention of thrombus formation by local drug delivery with a double-Occlusion Balloon Catheter
Heart and Vessels, 1996Co-Authors: Takanobu Tomaru, Yoshiharu Fujimori, Fumitaka Nakamura, Naoto Aoki, Yoshimitsu Sakamoto, Kohichi Kawai, Masao Omata, Yasumi UchidaAbstract:The efficacy of the local delivery of an antithrombotic drug in preventing thrombosis and enabling thrombolysis was investigated in 29 dogs. An antithrombotic drug (heparin, 25U/kg), or an antithrombin (argatroban, 0.05 mg/kg) was infused into injured canine iliac arteries, using a double-Occlusion Balloon Catheter, and the preventive effect of the drug was evaluated. Local delivery of low-dose tissuetype plasminogen activator (t-PA; Tisokinase, 50 000 U; Kowa, Nagoya and Asahi Chemical Industries, Fuji, Japan) into thrombosed canine iliac arteries, using the same Catheter, or intravenous infusion of low-dose or high-dose t-PA (30 000U/kg), was also performed. Angiographically, stenotic thrombosis was 2% by local delivery of argatroban and 7% by local delivery of heparin ( P < 0.01 vs each control; 47% and 51% respectively). Thrombotic stenosis, as observed by angiography, decreased from 91% to 9% after local delivery of t-PA, and from 94% to 52% in controls. Local delivery of t-PA effectively reduced the thrombus size ( P < 0.01 vs control). After systemic intravenous delivery of low-dose t-PA, no reduction of residual thrombotic stenosis, was observed. Reduction of residual thrombotic stenosis after intravenous delivery of high-dose t-PA, was similar to that achieved by local delivery of the drug. Angioscopy demonstrated a similar trend. High-dose drug delivery reduced systemic coagulability. Local delivery of an antithrombotic drug, using a double-Occlusion Balloon Catheter, effectively prevented thrombus formation, and local delivery of t-PA induced thrombolysis without exerting a significant influence on coagulability.
