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Pasquale Casale - One of the best experts on this subject based on the ideXlab platform.

  • Robotic Surgery in Pediatric Urology
    Current Urology Reports, 2014
    Co-Authors: Jason P. Batavia, Pasquale Casale
    Abstract:

    Minimally invasive laparoscopic procedures for urological diseases in children have proven to be safe and effective, with outcomes comparable to open procedures. Technical advances, including improved instruments and high-definition cameras, have contributed to the expanded role of minimal invasive surgery (MIS) in children. The major drawback to laparoscopy has been the relatively steep learning curve due to the technical difficulties of suturing and the limitations of instrument dexterity and range of motion. Recently, robotic-assisted laparoscopic surgery (RAS) has gained popularity in both adult and Pediatric Urology. RAS has several advantages over conventional laparoscopic surgery, particularly in the improved exposure via magnified 3-dimensional view and simplification of suturing with the increased degree of freedom and movement of the robotic arm. This review discusses the role of RAS in Pediatric Urology and provides technical aspects of RAS in specific urologic procedures as well.

  • learning curve of robotic assisted pyeloplasty for Pediatric Urology fellows
    The Journal of Urology, 2013
    Co-Authors: Gregory E Tasian, Douglas J. Wiebe, Pasquale Casale
    Abstract:

    Purpose: Little is known about the learning curve of robotic surgery for surgeons in training. We hypothesized that Pediatric Urology fellows could attain proficiency in robotic pyeloplasty, defined as operative time equivalent to that of an experienced robotic surgeon, within the 2-year time frame of fellowship.Materials and Methods: From 2006 to 2010 we performed a prospective cohort study of Pediatric robotic pyeloplasty done by 4 Pediatric Urology fellows and 1 Pediatric Urology attending surgeon. We recorded operative times and surgical outcomes of the total of 20 consecutive robotic pyeloplasties performed by the 4 Pediatric Urology fellows (80 cases) and a random sample of 20 performed by the attending surgeon. Multivariate linear regression was used to determine the change in operative time for each case done by fellows and estimate the number of cases needed for fellows to achieve the median operative time of the attending Pediatric urologist.Results: Fellow operative time decreased at a constant...

  • robotic assisted laparoscopic surgery in Pediatric Urology an update
    Scandinavian Journal of Surgery, 2009
    Co-Authors: Pasquale Casale, Y Kojima
    Abstract:

    Laparoscopic procedures for urological diseases in children, such as nephrectomy, pyeloplasty and orchiopexy, have proven to be safe and effective with outcome comparable to the open procedure. However, main drawback has been the relatively steep learning curve for this procedure because of technical difficulties of suturing and anastomosis. More recently, robotic-assisted laparoscopic surgery (RAS) has gained enormous popularity in adult Urology and is increasingly being adopted around the world; however, few Pediatric Urology series have been reported. RAS has several advantages over conventional laparoscopic surgery, with the main advantage being simplification and precision of exposure and suturing because of allowing movements of the robotic arm in real time with increased degree of freedom and magnified 3-dimentional view. These features render RAS ideal for complex reconstructive surgery in a Pediatric urological population. This review discusses the role of RAS in Pediatric Urology, and provides some technical aspects of RAS and a critical summary of current knowledge on its indications and outcome. Almost all operations that are classically performed as open or conventional laparoscopic reconstructive surgery for children with urological anomalies could be replaced by RAS, which may be established as an alternative minimally invasive surgery in the future.

  • robotic Pediatric Urology
    Current Urology Reports, 2009
    Co-Authors: Pasquale Casale
    Abstract:

    Robotic-assisted minimally invasive surgery is penetrating Pediatric Urology. The freedom afforded by the “surgical actuators” has led to the expanding adoption of robotics, and it is unlikely that much of laparoscopy will not trend toward some iteration of robotic influence. The da Vinci surgical system (Intuitive Surgical, Sunnyvale, CA) provides delicate telemanipulation, coalesced with three-dimensional visualization and superior magnification. It has bridged the gap between laparoscopy and open surgery. Nonetheless, a confident understanding of pure laparoscopy is paramount in the event that mechanical malfunction is experienced. Robotic Pediatric urologic procedures such as pyeloplasty, ureteral reimplantation, abdominal testis surgery, and partial or total nephrectomy with or without ureteral stump removal are routinely performed at select centers offering robotic expertise. Complex reconstructive surgeries such as appendicovesicostomy, antegrade continent enema creation, and augmentation cystoplasty can be performed but are still in their infancy.

  • robotic Pediatric Urology
    Expert Review of Medical Devices, 2008
    Co-Authors: Pasquale Casale
    Abstract:

    The number of current advances in robotic surgery for the Pediatric population is growing every day: the different procedures range from extirpative to reconstructive, including pyeloplasty, reimplantation, catheterizable channels and augmentation. Despite its early success, robotic surgery still poses many challenges in Pediatric patients. Robotics also allows the seasoned laparoscopist to become more proficient and refined, providing a greater armamentarium to expand minimally invasive surgery to more complex reconstructive procedures. The procedure most performed with the da Vinci Surgical System in Pediatric Urology is pyeloplasty for ureteropelvic junction obstruction. There are many other procedures that can be performed with the robot, such as ureteral reimplantation, and nephrectomy, both total and partial. The reconstructive aspect has been taken to the next level where more difficult procedures, such as appendicovesicostomy and bladder augmentation, can be performed in children.

Paul H Noh - One of the best experts on this subject based on the ideXlab platform.

Duncan T Wilcox - One of the best experts on this subject based on the ideXlab platform.

Craig A. Peters - One of the best experts on this subject based on the ideXlab platform.

  • Robotic Assisted Surgery in Pediatric Urology: Current Status and Future Directions
    'Frontiers Media SA', 2019
    Co-Authors: Catherine J. Chen, Craig A. Peters
    Abstract:

    The evolution of robotic surgical technology and its application in Pediatric Urology have been rapid and essentially successful. Further development remains limited in three key areas: procedural inefficiencies, cost and integration of surgical and clinical information. By addressing these challenges through technology and novel surgical paradigms, the real potential of surgical robotics in Pediatric, as well as adult applications, may ultimately be realized. With this evolution, a continued focus on patient-centered outcomes will be essential to provide optimal guidance to technical innovations

  • robotically assisted surgery in Pediatric Urology
    Urologic Clinics of North America, 2004
    Co-Authors: Craig A. Peters
    Abstract:

    Robotic assistance may permit more generalized development of laparoscopic reconstruction in Pediatric urological procedures such as pyeloplasty and anti-reflux surgery. The relatively slow adaptation of laparoscopic techniques in reconstructive Pediatric Urology appears to be due to the challenges of efficient and accurate laparoscopic suturing. This review summarizes the current robotic options available for Pediatric urological applications, the means of utilization, and early experience. The most commonly available robotic system is the daVinci® (Intuitive Surgical, Mountain View, California) with its EndoWrist technology that permits highly accurate and precise manipulation for laparoscopic dissection, tissue handling,and suturing. The system is large and costly in its current version, but has demonstrated its efficiency and potential in a wide variety of adult applications and now with Pediatric uses. Most procedures performed have been transperitoneal, due to the large size of the instruments (12-m...

  • robotically assisted surgery in Pediatric Urology
    Urologic Clinics of North America, 2004
    Co-Authors: Craig A. Peters
    Abstract:

    Robotically assisted laparoscopic surgery likely will be a part of Pediatric urologic surgery. It will look different than it does now because of technologic and procedural innovations. The inherent value of precise visualization, tissue handling, and reconstruction, coupled with the reduced morbidity of laparoscopic surgery, suggests the potential value of these technologies and methods. Although there is much development to be done, the early results are encouraging. Pediatric urologists specifically, and Pediatric surgical practitioners in general, must be involved in the evolution of these techniques and devices, to prevent having to adapt adult surgery-oriented systems to Pediatric patients. Pediatric urologists need to be involved in this development actively to guide its course.

  • Laparoscopy in Pediatric Urology
    Current Opinion in Urology, 2004
    Co-Authors: Craig A. Peters
    Abstract:

    Laparoscopy has been used in Pediatric Urology for the diagnosis of nonpalpable testes for more than fifteen years. Expansion of Pediatric urologic applications of laparoscopic surgical techniques is inevitable with the recent explosion of urologic laparoscopy. While the needs are distinct and at times divergent from those in the adult population, many benefits may be realized with this developing technology in children. Refinement of diagnostic capabilities as well as interventional procedures for the undescended testis are being developed. Increased use for varicocele treatment and intersex evaluation can be expected. Potential applications of laparoscopic techniques for the Pediatric urologist include nephrectomy for various benign diseases, ureteral surgery for reflux, bladder autoaugmentation, and hernia repair. Laparoscopic possibilities are limited only by imagination and technology. A skeptical approach is justified and judicious application of these technologies in children is essential. Just as the child is not a small adult, Pediatric laparoscopy is not just the use of smaller instruments. © 1993.

Radmayr Christian - One of the best experts on this subject based on the ideXlab platform.

  • Clinical and surgical consequences of the COVID-19 pandemic for patients with Pediatric urological problems Statement of the EAU guidelines panel for paediatric Urology, March 30 2020
    'Elsevier BV', 2020
    Co-Authors: Quaedackers, Josine Slt, Stein Raimund, Rien Jm Nijman, Tekgul Serdar, Radmayr Christian, Bhatt Nikita, Dogan, Hasan Serkan, Hoen Lisette, Silay, Mesrur Selcuk, Bogaert Guy
    Abstract:

    The COVID-19-pandemic forces hospitals to reorganize into a dual patient flow system. Healthcare professionals are forced to make decisions in patient prioritization throughout specialties. Most Pediatric Urology pathologies do not require immediate or urgent care, however, delay may compromise future renal function or fertility. Contact with patients and parents, either physical in safe conditions or by (video)telephone must continue. The Paediatric-Urology-Guidelines-panel of the EAU proposes recommendations on prioritization of care. Pediatric-Urology program directors must ensure education, safety and attention for mental health of staff. Upon resumption of care, adequate prioritization must ensure minimal impact on outcome.status: publishe

  • Are EAU/ESPU Pediatric Urology guideline recommendations on neurogenic bladder well received by the patients? Results of a survey on awareness in spina bifida patients and caregivers
    'Wiley', 2019
    Co-Authors: Dogan, Hasan S, Stein Raimund, Hoen, Lisette A 't, Bogaert Guy, Rien Jm Nijman, Tekgul Serdar, Quaedackers Josine, Silay, Mesrur S, Radmayr Christian
    Abstract:

    AIMS: The Paediatric Urology Guidelines Panel reports initial experience with patient involvement in spina bifida patient groups to gather information on their awareness of the guidelines and reflection of guideline recommendations. METHODS: The survey was delivered to spina bifida patients/parents via the national society groups in Turkey, Germany, and The Netherlands. Questions included demographic features, medical status, awareness, and agreement on the recommendations given in the guidelines and future expectations. RESULTS: A total of 291 patients from 3 countries responded to the survey. Mean age was 13.9 ± 12.2 years, male/female ratio 138/151, 75% of all surveys were completed by the caregivers. The medication was taken by 78% of patients (64% anticholinergics). Complete dryness rates for urine and stool were 24% and 47%, respectively. The agreement rates on the recommendations regarding urodynamics, intermittent catheterization, anticholinergics drug use, bowel management, and life-long follow-up were 97%, 82%, 91%, 77%, and 98%, respectively. Only 8% of responders were aware of the European Association of Urology/European Society for Pediatric Urology guidelines. The priorities of patients for future expectations were as the following: quality of life (QoL), surgical techniques, development of new medications and sexuality/fertility issues. Male spina bifida patients preferred new medications and sex/fertility issues more, whereas females favored QoL issues improvement more. CONCLUSIONS: Although the native language of the involved patients was different from English, awareness of guidelines was 8%. The general approval of the recommendations given in the guidelines is quite high. The national society groups showed a great interest to get involved in the creation of the guidelines to improve health care for spina bifida patients.status: publishe

  • Are EAU/ESPU Pediatric Urology guideline recommendations on neurogenic bladder well received by the patients? Results of a survey on awareness in spina bifida patients and caregivers
    'Wiley', 2019
    Co-Authors: Dogan, Hasan S, Stein Raimund, Hoen, Lisette A 't, Bogaert Guy, Tekgul Serdar, Quaedackers Josine, Silay, Mesrur S, Nijman, Rien J. M., Radmayr Christian
    Abstract:

    Aims The Paediatric Urology Guidelines Panel reports initial experience with patient involvement in spina bifida patient groups to gather information on their awareness of the guidelines and reflection of guideline recommendations. Methods The survey was delivered to spina bifida patients/parents via the national society groups in Turkey, Germany, and The Netherlands. Questions included demographic features, medical status, awareness, and agreement on the recommendations given in the guidelines and future expectations. Results A total of 291 patients from 3 countries responded to the survey. Mean age was 13.9 +/- 12.2 years, male/female ratio 138/151, 75% of all surveys were completed by the caregivers. The medication was taken by 78% of patients (64% anticholinergics). Complete dryness rates for urine and stool were 24% and 47%, respectively. The agreement rates on the recommendations regarding urodynamics, intermittent catheterization, anticholinergics drug use, bowel management, and life-long follow-up were 97%, 82%, 91%, 77%, and 98%, respectively. Only 8% of responders were aware of the European Association of Urology/European Society for Pediatric Urology guidelines. The priorities of patients for future expectations were as the following: quality of life (QoL), surgical techniques, development of new medications and sexuality/fertility issues. Male spina bifida patients preferred new medications and sex/fertility issues more, whereas females favored QoL issues improvement more. Conclusions Although the native language of the involved patients was different from English, awareness of guidelines was 8%. The general approval of the recommendations given in the guidelines is quite high. The national society groups showed a great interest to get involved in the creation of the guidelines to improve health care for spina bifida patients