Atlas of Robotic Urologic Surgery.

Intro -- Dedication -- Preface -- Contents -- Contributors -- Part I: Getting Started in Robotic Surgery -- 1: Establishing a Robotics Team and Practice -- Market Analysis -- The Surgeon(s) -- Robot Coordinator -- Staffing -- Anesthesia -- Performance Improvement -- Stationary vs. Mobile Setup -- Storage Management -- OR Room Setup -- Hospital Support: Troubleshooting -- Establishing a Robotic Practice: Important Considerations -- References -- 2: Robotics Training and Simulation -- Introduction -- Rise of Robotic Surgery -- Surgical Training and Credentialing -- Learning Curve -- Surgical Simulation -- Robotic Simulators -- Surgical Skills Training -- Novel Avenues of Surgical Grading -- Conclusion -- References -- 3: Robotic Instrumentation, Personnel, and Operating Room Setup -- Introduction -- Surgical Team -- Operating Room Setup -- Patient Positioning -- Abdominal Access -- The da Vinci® Surgical System -- Surgeon Console -- Patient Cart -- Vision Cart -- EndoWrist® Instruments -- Preparing the da Vinci® for Surgery -- Patient Cart Docking -- System Shutdown -- Conclusions -- References -- 4: Anesthetic Considerations with Robotic Surgery -- Introduction -- Pneumoperitoneum -- Insufflation Techniques -- Insufflation Pressures -- Complications of the Pneumoperitoneum -- Subcutaneous Emphysema -- Capnothorax, Capnomediastinum, and Capnopericardium -- Postoperative Pneumoperitoneum -- Choice of Anesthesia -- General Anesthesia -- Regional Anesthesia -- IV Fluid Management -- Monitoring -- CO2/EtCO2 -- Temperature -- Invasive Monitoring -- Positioning -- Practical Concerns Regarding Positioning -- Specific Positioning Concerns -- Lithotomy -- Steep Trendelenburg -- Lateral Decubitus -- Specific Position-Related Injuries -- Ocular Injury -- Laryngeal Edema -- Position Effects on Physiology -- Cardiac -- Pulmonary -- Neurologic -- Pain Management.

Opioid Analgesics -- Nonopioid Analgesics -- Postoperative Nauseas and Vomiting -- Metoclopramide -- Dexamethasone -- Transdermal Scopolamine -- Ondansetron -- Acupressure -- References -- Part II: Robotic Surgery of the Upper Urinary Tract -- 5: Robot-Assisted Total and Partial Adrenalectomy -- Robot-Assisted Total Adrenalectomy -- Patient Selection -- Preoperative Evaluation and Preparation -- Operative Setup -- Patient Positioning -- Trocar Configuration -- Surgical Anatomy -- Step-by-Step Technique (Video 5.1) -- Transperitoneal Left Robot-Assisted Adrenalectomy -- Step 1: Trocar Placement -- Step 2: Mobilization of Colon and Spleen -- Step 3: Exposure and Ligation of Left Adrenal Vein -- Step 4: Dissection of Pancreas Away from Gerota's Fascia -- Step 5: Dissection of Upper Pole Renal Attachments -- Step 6: Dissection of Medial, Lateral, and Superior Attachments -- Step 7: Entrapment and Extraction of Specimen -- Transperitoneal Right Robot-Assisted Adrenalectomy -- Step 1: Trocar Placement -- Step 2: Mobilization of Liver, Colon, and Duodenum -- Step 3: Exposure and Ligation of Right Adrenal Vein -- Step 4: Dissection of Inferior, Posterior, and Superior Attachments -- Robot-Assisted Partial Adrenalectomy -- Patient Selection -- Use of Intraoperative Imaging -- Patient Positioning and Operative Setup -- Surgical Technique -- Postoperative Care -- Steps to Avoid Complications -- Conclusion -- References -- 6: Robotic Partial Nephrectomy: Transperitoneal Technique -- Patient Selection -- Preoperative Preparation -- Operating Room Setup -- Patient Preparation and Positioning -- Step-by-Step Technique -- Step 1: Insufflation -- Step 2: Trocar Placement -- Step 3: Mobilization of Ipsilateral Colon (Table 6.1) -- Left-Sided Dissection -- Right-Sided Dissection -- Step 4: Renal Hilar Dissection (Table 6.2).

Step 5: Dissection and Exposure of the Renal Tumor (Table 6.3) -- Step 6: Ultrasonic Demarcation of Renal Tumor Margins (Table 6.4) -- Step 7: Pre-clamp Checklist and Suture Preparation -- Step 8: Clamping of Renal Vessels, Tumor Excision, and Renorraphy (Table 6.5) -- Step 9: Renorrhaphy (Table 6.6) -- Step 10: Extraction and Closure (Table 6.7) -- Postoperative Management -- Complications -- Conclusion -- References -- 7: Robotic Partial Nephrectomy: Advanced Techniques and Use of Intraoperative Imaging -- Introduction -- Pre-operative Preparation -- Pre-operative Evaluation -- Operative Room Set-up -- Patient Positioning -- Instrumentation and Equipment List -- Equipment -- Trocars -- Assistant Instruments -- Recommended Sutures -- Step-by-Step Technique (Videos 7.1, 7.2 and 7.3) -- Step 1: Pneumoperitoneum and Trocar Placement (Fig. 7.3) -- Steps 2-3: Bowel Mobilization and Hilum Dissection -- Steps 4-5: Hilar Micro-dissection and Super-Selective Arterial Clamping -- Medially Located Tumors and Visible Confirmation of Interrupted Perfusion -- Laterally Located and Intra-renal Tumors and Doppler Use -- Steps 6-8: Tumor Scoring, Excision, and Renorrhaphy -- Step 9: Completely-Unclamped ("Zero-Ischemia"), Minimal-Margin Partial Nephrectomy -- Step 10: Intraoperative Near Infrared Fluorescence Using Indo-cyanine Green -- Post-operative Management -- Special Considerations -- References -- 8: Retroperitoneal Robotic Partial Nephrectomy -- Patient Selection -- Preoperative Preparation -- Operative Setup -- Patient Positioning and Preparation -- Trocar Configuration -- Instrument and Equipment List -- Equipment -- Trocars -- Recommended Sutures (Fig. 8.4) -- Instruments Used by the Surgical Assistant -- Step-by-Step Technique (Videos 8.1, 8.2, 8.3, 8.4, and 8.5) -- Step 1: Retroperitoneal Access and Trocar Placement.

Step 2: Management of Paranephric and Perinephric Fat (Table 8.1) -- Step 3: Hilar Dissection (Table 8.2) -- Step 4: Tumor Exposure: Defatting the Kidney and Identifying the Renal Mass (Table 8.3) -- Step 5: Tumor Excision and Renorrhaphy (Table 8.4) -- Step 6: Extraction and Closure -- Postoperative Management -- Special Considerations -- Steps to Avoid Complications -- References -- 9: Robotic Radical Nephrectomy and Nephrectomy with Caval Tumor Thrombus -- Patient Selection -- Preoperative Preparation -- Operative Setup -- Patient Positioning and Preparation -- Trocar Configuration -- Instrument and Equipment List -- Equipment -- Trocars -- Recommended Sutures -- Instruments Used by the Surgical Assistant -- Step-by-Step Technique -- Right Nephrectomy -- Step 1: Colon Reflection -- Step 2: Duodenum and Cava -- Step 3: Psoas Muscle -- Step 4: Vessel Ligation -- Step 5: Adrenal Plane -- Step 6: Ureter -- Step 7: Completion -- Left Nephrectomy -- Step 1: Wide Access to the Retroperitoneum -- Step 2: Psoas Plane -- Step 3: Vascular Dissection -- Step 4: Adrenal and Upper Pole -- IVC Tumor Thrombus -- Postoperative Management -- Complications -- References -- 10: Robot-Assisted Radical Nephroureterectomy -- Patient Selection -- Preoperative Preparation -- Operative Setup -- Patient Positioning -- Trocar Configuration -- Instrumentation and Equipment List -- Equipment -- Trocars -- Recommended Sutures -- Instruments Used by the Surgical Assistant -- Step-by-Step Technique (See Video 10.1) -- Step 1: Abdominal Access and Trocar Placement -- Step 2: Mobilization of Colon (Table 10.1) -- Step 3: Dissection and Early Ligation of Ureter -- Step 4: Dissection of Renal Hilum (Table 10.2) -- Step 5: Dissection of Adrenal Gland and Posterolateral Renal Attachments -- Step 6: Regional Perihilar Lymphadenectomy.

Step 7: Dissection of Distal Ureter and Bladder Cuff (Table 10.3) -- Step 8: Excision of Bladder Cuff -- Step 9: Closure of Cystotomy (Table 10.4) -- Step 10: Regional Pelvic Lymphadenectomy (Table 10.5) -- Step 11: Entrapment and Delivery of Specimens and Exiting the Abdomen -- Postoperative Management -- Special Considerations -- Steps to Avoid Complications -- References -- 11: Robot-Assisted Pyeloplasty -- Introduction -- Patient Selection -- Preoperative Preparation -- Operative Setup -- Patient Positioning and Preparation -- Trocar Configuration for Da Vinci S and Si Systems -- Trocar Configuration for Da Vinci Xi System -- Instrumentation and Equipment List -- Equipment -- Trocars for S:Si -- Trocars for Xi -- Recommended Sutures -- Instruments Used by the Surgical Assistant -- Robotic Pyeloplasty: Step-by-Step Technique (see Video 11.1) -- Basic Principles -- Step 1: Cystoscopy, Retrograde Pyelogram and Ureteral Stent Placement -- Step 2: Repositioning and Abdominal Access -- Step 3: Docking the Patient-Side Robotic Cart -- Step 4: Mobilization of the Ipsilateral Colon and Small Intestines (Table 11.2) -- Step 5: Renal Hilar Dissection -- Step 6: Identification and Dissection of the Ureteropelvic Junction -- Step 7: Transecting the Ureteropelvic Junction -- Step 8: Reduction of a Redundant Renal Pelvis and Spatulation of the Ureter (Table 11.3) -- Step 9: Anastomosis of the Ureter and Renal Pelvis (Table 11.4) -- Step 10: Exiting the Abdomen -- Postoperative Management -- Special Considerations -- Special Considerations Regarding Da Vinci Xi System -- Steps to Avoid Complications -- References -- 12: Robot-Assisted Laparoscopic Extended Pyelolithotomy and Ureterolithotomy -- Robotic Pyelolithotomy -- Patient Selection -- Preoperative Preparation -- Urine Culture and Bowel Preparation -- Informed Consent -- Operative Setup.

Patient Positioning and Preparation.

Description based on publisher supplied metadata and other sources.

Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, 2024. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries.