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Rebuffo S, Ticonosco M, Ruvolo CC, Pissavini A, Balestrazzi E, Paciotti M, Frego N, Sorce G, Belmonte M, Lores MP, Piro A, Piramide F, Bravi CA, De Groote R, Mottrie A, De Naeyer G. Robot-Assisted Pyeloplasty with HUGO™ Robotic System: Initial Experience and Optimal Surgical Set-Up at a Tertiary Referral Robotic Center. J Endourol 2024; 38:323-330. [PMID: 38269425 DOI: 10.1089/end.2023.0598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024] Open
Abstract
Background: In February 2021 Medtronic® (Minneapolis, MN) launched the HUGO™ Robot-Assisted Surgery (RAS) System in the global market. The aim of the current study is to describe the first case series and the optimal setup of robot-assisted pyeloplasty procedure, performed with HUGO RAS system in a tertiary referral robotic center. Methods: Data from consecutive patients who underwent robot-assisted pyeloplasty at Onze-Lieve-Vrouwziekenhuis Hospital (Aalst, Belgium) were recorded. Baseline characteristics, and perioperative and surgical outcomes were collected. Results: Overall, 10 robot-assisted pyeloplasties were performed (October 2022-September 2023). Based on our expertise, the following minor setting changes have been made, relative to the official setup guide: the endoscope port and, subsequently, the left and right-hand ports were positioned more laterally. Additionally, the reserve/4th port was placed more laterally and cranially, and adjusted the arm cart's tilt angle, reducing it from -30° to -15°. The median docking time was 8 (interquartile range [IQR]: 7.2-9.8) minutes, and the median active console time was 89.5 (80.0-95.8) minutes. No conversion to open/laparoscopic surgery or perioperative complications was encountered. A single technical problem was recorded in 1 (10%) procedure. Specifically, one arm was blocked, and the procedure was accomplished with three arms without compromising the procedure success. Conclusions: This study represents the first worldwide series of robot-assisted pyeloplasty performed with the HUGO RAS system and shows promising results. The procedure might be safely performed with this robotic platform achieving optimal perioperative outcomes.
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Affiliation(s)
- Silvia Rebuffo
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Ghent, Belgium
- Department of Urology, Policlinico San Martino Hospital, University of Genova, Genova, Italy
| | - Marco Ticonosco
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Ghent, Belgium
- Department of Urology, Ospedale Policlinico e Nuovo Ospedale Civile S.Agostino Estense Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Claudia Collà Ruvolo
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Ghent, Belgium
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, School of Medicine, University of Naples "Federico II", Naples, Italy
| | - Alessandro Pissavini
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Ghent, Belgium
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Eleonora Balestrazzi
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Ghent, Belgium
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Marco Paciotti
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Ghent, Belgium
- Department of Urology, Humanitas Research Hospital- IRCCS, Rozzano, Italy
| | - Nicola Frego
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Ghent, Belgium
- Department of Urology, Humanitas Research Hospital- IRCCS, Rozzano, Italy
| | - Gabriele Sorce
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Ghent, Belgium
- Unit of Urology, Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Mario Belmonte
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Ghent, Belgium
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Maria Peraire Lores
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Ghent, Belgium
| | - Adele Piro
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Ghent, Belgium
- Department of Urology, Ospedale Policlinico e Nuovo Ospedale Civile S.Agostino Estense Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Federico Piramide
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Ghent, Belgium
- Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, Turin, Italy
| | - Carlo Andrea Bravi
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Ghent, Belgium
- Department of Urology, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Ruben De Groote
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
| | - Alexandre Mottrie
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Ghent, Belgium
| | - Geert De Naeyer
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
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Fayziev O Y, Satvaldieva E A, Yusupov A S, Agzamova S A, Abzalova M Y. [Evaluation of the efficiency and safety of pain relief in the postoperative period in children after urological interventions]. Urologiia 2023:108-112. [PMID: 38156692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Urinary tract disorders are one of the most common pathologies in children, regardless of age, and every year their prevalence is growing. Our study is dedicated to improvement of postoperative pain management after pediatric urologic procedures and to implementation of modern approaches for enhanced recovery. AIM To develop optimal methods of postoperative pain relief for moderate and severe intensity of pain syndrome in children undergoing urological procedures. MATERIALS AND METHODS The study involved 34 patients who were undergone to urological procedures. For an objective assessment of the quality of anesthesia, the following research methods were used: clinical study with the determination of the pain intensity on a visual analogue scale (VAS) and the determination of systolic and diastolic blood pressure, pulse oximetry and echocardiographic study. RESULTS The analysis of the postoperative period with monitoring of blood pressure, oxygen saturation, pulse oximetry, subjective assessment of the pain intensity on the VAS and the echocardiographic study showed that the relative stability of the condition was associated with an adequate pain relief. The use of a combination of infulgan, which caused an early analgesic effect, with tramadol realizing its action later, provides a prolongation of analgesia. A combination of tramadol with infulgan was several times more efficient than ketorolac. CONCLUSIONS The use of a combined analgesia after urological procedures, including ketorolac, provides a hemodynamically stability in the entire postoperative period.
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Affiliation(s)
- Ya Fayziev O
- Department of Anesthesiology and Intensive Care, Pediatric Anesthesiology and Intensive Care, Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
- Department of Family Medicine No. 1, Physical Education, Civil Defense of the Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
- Department of Medical Radiology, Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
| | - A Satvaldieva E
- Department of Anesthesiology and Intensive Care, Pediatric Anesthesiology and Intensive Care, Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
- Department of Family Medicine No. 1, Physical Education, Civil Defense of the Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
- Department of Medical Radiology, Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
| | - S Yusupov A
- Department of Anesthesiology and Intensive Care, Pediatric Anesthesiology and Intensive Care, Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
- Department of Family Medicine No. 1, Physical Education, Civil Defense of the Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
- Department of Medical Radiology, Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
| | - A Agzamova S
- Department of Anesthesiology and Intensive Care, Pediatric Anesthesiology and Intensive Care, Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
- Department of Family Medicine No. 1, Physical Education, Civil Defense of the Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
- Department of Medical Radiology, Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
| | - Ya Abzalova M
- Department of Anesthesiology and Intensive Care, Pediatric Anesthesiology and Intensive Care, Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
- Department of Family Medicine No. 1, Physical Education, Civil Defense of the Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
- Department of Medical Radiology, Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
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Aloweidi AS, Abu-Halaweh SA, Al-Edwan GM, AL Demour SH, Abu Mahfuz LT, Noubani ON, Al Rwaidi MM, Bsisu IK, Abufaraj MM. The combinatorial use of propofol-fentanyl-ketamine for sedoanalgesia in patients undergoing urological procedures. Saudi Med J 2021; 42:629-635. [PMID: 34078724 PMCID: PMC9149711 DOI: 10.15537/smj.2021.42.6.20210071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 04/18/2021] [Indexed: 11/25/2022] Open
Abstract
Objectives: To compare sedoanalgesia achieved using propofol-fentanyl-ketamine (PFK) combination with general anesthesia (GA) in terms of safety, hemodynamic stability, and perioperative complications. Methods: Patients in the GA group were anesthetized using fentanyl (2 μg kg-1) and propofol (2 mg kg-1). The PFK group was anesthetized using a mixture of which each one ml contains 0.005 mg of fentanyl, 5 mg of propofol, 5 mg of ketamine, and 2 mg of lidocaine. Patients received an initial dose of 0.05 ml kg-1, followed by 0.05 mg kg-1 60 seconds later. Maintenance boluses of 0.025 ml kg-1 were administered every 3-5 minutes. Respiration occurred spontaneously through a simple face mask with 3 L min-1 O2. Results: The GA group had 37 (37%) patients develop hypotensive episodes, compared to one (1%) episode in the PFK group (p<0.001). Five (5%) patients in the PFK group had an episode of transient O2 desaturation, compared to one (1%) patient in the GA group (p=0.212). The duration of induction and termination of anesthesia were significantly shorter in the PFK group (p<0.001). Conclusion: The PFK combination herein described is safe, effective, and provides intraoperative hemodynamic stability in patients with multiple comorbidities undergoing urological procedures.
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Affiliation(s)
- Abdelkarim S. Aloweidi
- From the Department of Anesthesia and Intensive Care (Aloweidi, Abu-Halaweh, Abu Mahfuz, Noubani, Al Rwaidi, Bsisu); from the Division of Urology, Department of Special Surgery (Al-Edwan, AL Demour, Abufaraj), School of Medicine, The University of Jordan, Amman, Jordan; and from the Department of Urology (Abufaraj), Medical University of Vienna, Vienna, Austria.
| | - Sami A. Abu-Halaweh
- From the Department of Anesthesia and Intensive Care (Aloweidi, Abu-Halaweh, Abu Mahfuz, Noubani, Al Rwaidi, Bsisu); from the Division of Urology, Department of Special Surgery (Al-Edwan, AL Demour, Abufaraj), School of Medicine, The University of Jordan, Amman, Jordan; and from the Department of Urology (Abufaraj), Medical University of Vienna, Vienna, Austria.
| | - Ghazi M. Al-Edwan
- From the Department of Anesthesia and Intensive Care (Aloweidi, Abu-Halaweh, Abu Mahfuz, Noubani, Al Rwaidi, Bsisu); from the Division of Urology, Department of Special Surgery (Al-Edwan, AL Demour, Abufaraj), School of Medicine, The University of Jordan, Amman, Jordan; and from the Department of Urology (Abufaraj), Medical University of Vienna, Vienna, Austria.
| | - Saddam H. AL Demour
- From the Department of Anesthesia and Intensive Care (Aloweidi, Abu-Halaweh, Abu Mahfuz, Noubani, Al Rwaidi, Bsisu); from the Division of Urology, Department of Special Surgery (Al-Edwan, AL Demour, Abufaraj), School of Medicine, The University of Jordan, Amman, Jordan; and from the Department of Urology (Abufaraj), Medical University of Vienna, Vienna, Austria.
| | - Laith T. Abu Mahfuz
- From the Department of Anesthesia and Intensive Care (Aloweidi, Abu-Halaweh, Abu Mahfuz, Noubani, Al Rwaidi, Bsisu); from the Division of Urology, Department of Special Surgery (Al-Edwan, AL Demour, Abufaraj), School of Medicine, The University of Jordan, Amman, Jordan; and from the Department of Urology (Abufaraj), Medical University of Vienna, Vienna, Austria.
| | - Osama N. Noubani
- From the Department of Anesthesia and Intensive Care (Aloweidi, Abu-Halaweh, Abu Mahfuz, Noubani, Al Rwaidi, Bsisu); from the Division of Urology, Department of Special Surgery (Al-Edwan, AL Demour, Abufaraj), School of Medicine, The University of Jordan, Amman, Jordan; and from the Department of Urology (Abufaraj), Medical University of Vienna, Vienna, Austria.
| | - Mohammad M. Al Rwaidi
- From the Department of Anesthesia and Intensive Care (Aloweidi, Abu-Halaweh, Abu Mahfuz, Noubani, Al Rwaidi, Bsisu); from the Division of Urology, Department of Special Surgery (Al-Edwan, AL Demour, Abufaraj), School of Medicine, The University of Jordan, Amman, Jordan; and from the Department of Urology (Abufaraj), Medical University of Vienna, Vienna, Austria.
| | - Isam K. Bsisu
- From the Department of Anesthesia and Intensive Care (Aloweidi, Abu-Halaweh, Abu Mahfuz, Noubani, Al Rwaidi, Bsisu); from the Division of Urology, Department of Special Surgery (Al-Edwan, AL Demour, Abufaraj), School of Medicine, The University of Jordan, Amman, Jordan; and from the Department of Urology (Abufaraj), Medical University of Vienna, Vienna, Austria.
- Address correspondence and reprint request to: Dr. Isam K. Bsisu, Department of Anesthesia and Intensive Care, School of Medicine, The University of Jordan, Amman, Jordan. E-mail: ORCID ID: https://orcid.org/0000-0002-8999-8334
| | - Mohammad M. Abufaraj
- From the Department of Anesthesia and Intensive Care (Aloweidi, Abu-Halaweh, Abu Mahfuz, Noubani, Al Rwaidi, Bsisu); from the Division of Urology, Department of Special Surgery (Al-Edwan, AL Demour, Abufaraj), School of Medicine, The University of Jordan, Amman, Jordan; and from the Department of Urology (Abufaraj), Medical University of Vienna, Vienna, Austria.
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Kutlu M, Arslan M, Ozlulerden Y, Ozdemir K, Sayin-Kutlu S, Aybek Z. A short course of antimicrobial therapy for asymptomatic bacteriuria is safe and effective before urologic procedures. J Infect Dev Ctries 2021; 15:742-746. [PMID: 34106900 DOI: 10.3855/jidc.14377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 12/29/2020] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION In the presence of asymptomatic bacteriuria (ASB) before the urological procedure, the duration of antimicrobial treatment is controversial. This study aims to evaluate whether a short course of antimicrobial therapy is safe and effective in cases with ASB before urological procedures. METHODOLOGY We retrospectively reviewed adult patients who had ASB before undergoing several urological procedures between 2011 and 2019. The patients received a single dose of an appropriate parenteral antibiotic, determined by antimicrobial sensitivity testing, 30 to 60 minutes before the urological procedure. If a urinary catheter was placed post-procedure, a second dose was given. RESULTS A total of 293 patients who had ASB before undergoing several urological procedures were included in the study. The total number of procedures was 328. Female/male ratio was 92 (31.4%)/201 (68.6%). The mean age was 63.7 ± 14.9 years. The most common isolated microorganisms were Escherichia coli (155 [47%]), Klebsiella pneumoniae (38 [11.6%]), and Pseudomonas aeruginosa (28 [8.5%]). The most common antimicrobial used was ertapenem. A second dose antimicrobial was given for 290 procedures due to a urinary catheter after a urological procedure. The mean hospitalization time was 3.97 ± 3.42 days. None of the patients developed infectious complications. CONCLUSIONS This study has demonstrated that a single dose of parenteral antimicrobial drug administered 30-60 minutes before the urologic procedures and a second dose in the presence of a post-procedure catheter, was adequate to prevent post-procedure septicemia and urinary tract infection.
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Affiliation(s)
- Murat Kutlu
- Department of Infectious Diseases and Clinical Microbiology, Pamukkale University School of Medicine, Denizli, Turkey.
| | - Merve Arslan
- Department of Infectious Diseases and Clinical Microbiology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Yusuf Ozlulerden
- Department of Urology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Kevser Ozdemir
- Department of Infectious Diseases and Clinical Microbiology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Selda Sayin-Kutlu
- Department of Infectious Diseases and Clinical Microbiology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Zafer Aybek
- Department of Urology, Pamukkale University School of Medicine, Denizli, Turkey
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Mohee AR, West R, Baig W, Eardley I, Sandoe JAT. A case-control study: are urological procedures risk factors for the development of infective endocarditis? BJU Int 2014; 114:118-24. [PMID: 24180426 DOI: 10.1111/bju.12550] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To evaluate the association between urological procedures and the development of infective endocarditis (IE), as there are case-reports linking urological procedures to IE but evidence of a causal relationship is lacking and no major guidelines advise prophylaxis to prevent development of IE during transurethral urological procedures. No case-control study has been undertaken to examine the relationship between urological procedures and the development of IE. PATIENTS AND METHODS Retrospective evaluation of the IE database at our institution. The population consisted of patients diagnosed with enterococcal, staphylococcal, Streptococcus bovis-group and oral streptococcal IE over a 10-year period. Possible risk factors for the development of IE, including urological procedures were collected. A case-control design was used and univariable and multivariable analyses were carried out. Missing data was accounted for using the multiple imputations method. RESULTS We included 384 patients with IE. There was a statistical association between the development of enterococcal IE and preceding urological procedures (odds ratio 8.21, 95% confidence interval 3.54-19.05, P < 0.05). Increasing age and being an intravenous drug user were also associated with enterococcal IE. Haemodialysis and the presence of an intracardiac device were associated with the development of coagulase-negative staphyloccal IE. CONCLUSION This is the first study to show a statistical association between urological procedures and the development of IE. The bacteraemia leading to IE may be a result of the urological procedures or a consequence of the underlying urological pathology causing recurrent subclinical bacteraemias.
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Affiliation(s)
- Amar R Mohee
- Department of Urology, The Salford Royal NHS Trust, Salford, UK
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