3.Robotic urologic surgery using the KangDuo-Surgical Robot-01 system: A single-center prospective analysis.
Shengwei XIONG ; Shubo FAN ; Silu CHEN ; Xiang WANG ; Guanpeng HAN ; Zhihua LI ; Wei ZUO ; Zhenyu LI ; Kunlin YANG ; Zhongyuan ZHANG ; Cheng SHEN ; Liqun ZHOU ; Xuesong LI
Chinese Medical Journal 2023;136(24):2960-2966
BACKGROUND:
The KangDuo-Surgical Robot-01 (KD-SR-01) system is a new surgical robot recently developed in China. The aim of this study was to present our single-center experience and mid-term outcomes of urological procedures using the KD-SR-01 system.
METHODS:
From August 2020 to April 2023, consecutive urologic procedures were performed at Peking University First Hospital using the KD-SR-01 system. The clinical features, perioperative data, and follow-up outcomes were prospectively collected and analyzed.
RESULTS:
A total of 110 consecutive patients were recruited. Among these patients, 28 underwent partial nephrectomy (PN), 41 underwent urinary tract reconstruction (26 underwent pyeloplasty, 3 underwent ureteral reconstruction and 12 underwent ureterovesical reimplantation [UR]), and 41 underwent radical prostatectomy (RP). The median operative time for PN was 112.5 min, 157.0 min for pyeloplasty, 151.0 min for ureteral reconstruction, 142.5 min for UR, and 138.0 min for RP. The median intraoperative blood loss was 10 mL for PN, 10 mL for pyeloplasty, 30 mL for ureteral reconstruction, 20 mL for UR, and 50 mL for RP. All procedures were successfully completed without conversion, and there were no major complications in any patient. The median warm ischemia time of PN was 17.3 min, and positive surgical margin was not noted in any patient. The overall positive surgical margin rate of RP was 39% (16/41), and no biochemical recurrence was observed in any RP patient during the median follow-up of 11.0 months. The surgical success rates of pyeloplasty and UR were 96% (25/26) and 92% (11/12) during the median follow-up of 29.5 months and 11.5 months, respectively.
CONCLUSION
The KD-SR-01 system appears feasible, safe, and effective for most urological procedures, based on our single-center experience.
Male
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Humans
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Robotic Surgical Procedures/methods*
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Robotics
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Treatment Outcome
;
Retrospective Studies
;
Ureter/surgery*
;
Urologic Surgical Procedures/methods*
;
Laparoscopy/methods*
4.Effect of Varicocelectomy on Male Infertility.
Korean Journal of Urology 2014;55(11):703-709
Varicocele is the most common cause of male infertility and is generally correctable or at least improvable by various surgical and radiologic techniques. Therefore, it seems simple and reasonable that varicocele should be treated in infertile men with varicocele. However, the role of varicocele repair for the treatment of subfertile men has been questioned during the past decades. Although varicocele repair can induce improvement of semen quality, the obvious benefit of spontaneous pregnancy has not been shown through several meta-analyses. Recently, a well-designed randomized clinical trial was introduced, and, subsequently, a novel meta-analysis was published. The results of these studies advocate that varicocele repair be regarded as a standard treatment modality in infertile men with clinical varicocele and abnormal semen parameters, which is also supported by current clinical guidelines. Microsurgical varicocelectomy has been regarded as the gold standard compared to other surgical techniques and radiological management in terms of the recurrence rate and the pregnancy rate. However, none of the methods has been proven through well-designed clinical trials to be superior to the others in the ability to improve fertility. Accordingly, high-quality data from well-designed studies are needed to resolve unanswered questions and update current knowledge. Upcoming trials should be designed to define the best technique and also to define how to select the best candidates who will benefit from varicocele repair.
*Fertility
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Humans
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Infertility, Male/*etiology/surgery
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Male
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Urologic Surgical Procedures, Male/*methods
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Varicocele/complications/*surgery
5.Management of moderate to severe pediatric concealed penis in children by Devine's technique via incision between the penis and scrotum.
Xin-Sheng ZHANG ; Shi-Xiong LIU ; Xue-Yan XIANG ; Wen-Gang ZHANG ; Da-Xing TANG
National Journal of Andrology 2014;20(4):338-341
OBJECTIVETo search for a simple and effective surgical approach to the management of moderate to severe pediatric concealed penis in children.
METHODSWe used Devine's technique via incision between the penis and scrotum in the treatment of 68 cases of moderate to severe pediatric concealed penis. The patients were aged 3 -13 (mean 6.5) years, 30 with moderate and 38 with severe pediatric concealed penis.
RESULTSThis strategy achieved good near- and long-term effects and satisfactory appearance of the penis, which was similar to that of circumcision. At 3 months after surgery, the penile length was 3 - 5.2 cm, averaging (2.35 +/- 0.35) cm.
CONCLUSIONDevine's technique via incision between the penis and scrotum is a simple and effective surgical option for moderate to severe pediatric concealed penis in children.
Adolescent ; Child ; Child, Preschool ; Humans ; Male ; Penis ; abnormalities ; surgery ; Scrotum ; surgery ; Urologic Surgical Procedures, Male ; methods
6.Treatment of long-segment urethral stricture by free internal prepuce lamina patch urethroplasty.
Hong-Fei WU ; Li-Xin QIAN ; Min GU ; Guo-Wei XIA ; Li-Xin HUA ; Ning-Hong SONG ; Jie LI ; Xiao-Bing JU
National Journal of Andrology 2003;9(9):661-662
OBJECTIVETo investigate the effect of free internal prepuce lamina patch urethroplasty on long-segment urethral stricture.
METHODSEight patients of long-segment urethral stricture underwent resection of atresia posterior urethra and/or incision of stricture anterior urethra, free internal prepuce lamina patch as of corresponding length and width were taken for the reconstruction of the urethra, and mean while multi-hole silica ge tract was placed in the urethra.
RESULTSMiction was easy and fluent in 7 cases, and unobstructed in 1 case after two urethral soundings.
CONCLUSIONFree internal prepuce lamina patch urethroplasty was a good method for treating long-segment urethral stricture.
Adult ; Humans ; Male ; Middle Aged ; Urethra ; surgery ; Urethral Stricture ; surgery ; Urologic Surgical Procedures, Male ; methods
7.An arc incision surgical approach in congenital megaprepuce.
Hou-Wei LIN ; Ling ZHANG ; Hong-Quan GENG ; Xiao-Liang FANG ; Guo-Feng XU ; Mao-Sheng XU ; Wei CAI
Chinese Medical Journal 2015;128(4):555-557
8.Treatment of buried penis in children with fixation at the dartos coat of penis through prepubic route.
Ci ZHANG ; Hui-Jun QIAN ; Ling-Long WANG
National Journal of Andrology 2006;12(5):441-442
OBJECTIVETo observe the long-time results of the treatment of buried penis with fixation at the base of penis through pre-pubic route.
METHODSFrom Aug 2002 to Dec 2003, the procedure was performed in 34 children without penile skin insufficiency. The major technique involved the release of hided penis shaft by partly shearing suspensory ligament, fixating the bucks fascia and tunica albuginea at 3 and 9 o'clock positions with the subcutaneous penile skin at the base of penis just under the pubic symphysis.
RESULTSTwenty-one patients have been reviewed over one year with satisfactory appearance. Thirteen patients were lost to follow-up. No recurrence happened in our group.
CONCLUSIONWe compare this technique with major treatment methods for buried penis in children at present, and we conclude this technique is a reasonable, simplified and aesthetical method for the treatment of buried penis in children.
Child ; Child, Preschool ; Follow-Up Studies ; Humans ; Male ; Penis ; abnormalities ; surgery ; Urologic Surgical Procedures, Male ; methods
9.A modified fixation technique for the treatment of buried penis in children.
Xu CUI ; Bing-Jing GAO ; Liu CHEN ; Wen-Hua HUANG ; Chao-Ming ZHOU
Asian Journal of Andrology 2023;25(1):78-81
For many years, surgical treatment of buried penis in children has been researched by several scholars, and numerous methods exist. This study aimed to explore the clinical effect of a modified fixation technique in treating buried penis in children. Clinical data of 94 patients with buried penis who were treated using the modified penile fixation technique from March 2017 to February 2019 in Fujian Maternity and Child Health Hospital (Fuzhou, China) were retrospectively collected, compared, and analyzed. Clinical data of 107 patients with buried penis who were treated using traditional penile fixation technique from February 2014 to February 2017 were chosen for comparison. The results showed that at 6 months and 12 months after surgery, the penile lengths in the modified penile fixation group were longer than those in the traditional penile fixation group (both P < 0.05). The incidence of postoperative skin contracture and penile retraction in the modified penile fixation group was less than that in the traditional penile fixation group (P = 0.034 and P = 0.012, respectively). When the two groups were compared in terms of parents' satisfaction scores, the scores for penile size, penile morphology, and voiding status in the modified penile fixation group were higher than those in the traditional penile fixation group at 2-week, 6-month, and 12-month follow-ups after surgery (all P < 0.05). We concluded that the modified penile fixation technique could effectively reduce the incidence of skin contracture and penile retraction and improve the penile length and satisfaction of patients' parents.
Female
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Pregnancy
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Male
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Humans
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Child
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Retrospective Studies
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Urologic Surgical Procedures, Male/methods*
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Penis/surgery*
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China
;
Contracture
10.Modified tubularized incised plate technique for hypospadias: a report of 169 cases.
Jun HE ; Wei ZHENG ; Yao-Wang ZHAO ; Jian-Cheng ZU ; Xiao-Kun ZHAO
National Journal of Andrology 2010;16(12):1076-1078
OBJECTIVETo explore the clinical application of the tubularized incised plate (TIP) in the surgical treatment of hypospadias.
METHODSThis study included 169 cases of hypospadias treated by TIP surgery from January 2007 to April 2009. The patients ranged in age from 1.5 to 12 years (mean 3.68 yr). The TIP technique was modified based on that described by Snodgrass, with the urethral plate longitudinally incised and a urethral stent kept in place. The patients were hospitalized for 10 days postoperatively, and followed up for an average of 2 years, ranging from 6 months to 3 years.
RESULTSComplications developed in 18 (10.6%) of the patients, most frequently meatal stenosis (9 cases, 5.3%) and urethrocutaneous fistula (8 cases, 4.7%).
CONCLUSIONThe TIP technique, as a surgical method, can be applied to most hypospadias cases. The accumulation of clinical experience and skills may help raise the success rate and reduce the complications of TIP surgery.
Child ; Child, Preschool ; Humans ; Hypospadias ; surgery ; Infant ; Male ; Treatment Outcome ; Urethra ; surgery ; Urologic Surgical Procedures ; methods