BACKGROUND Ureteral reconstruction is a highly technical type of laparoscopic or open surgery.The incidence of ureteral injury is low;however,ureteral injuries tend to be overtreated.Robotic surgery for urinary recons...BACKGROUND Ureteral reconstruction is a highly technical type of laparoscopic or open surgery.The incidence of ureteral injury is low;however,ureteral injuries tend to be overtreated.Robotic surgery for urinary reconstructive surgery is growing in popularity,which has made procedures such as pyeloplasty,ureteroureterostomy,and ureteroneocystostomy possible,with minimal damage to the patient.To the best of our knowledge,this is the first report of robot-assisted laparoscopic pyeloureterostomy in Korea,in a 17-year-old female patient with a ureteral injury.CASE SUMMARY The patient,a 17-year-old girl without previous medical history,was presented at the emergency room and complained of abdominal and back pain.Tenderness in the right upper quadrant was observed on physical examination.Hemorrhage in the right perirenal space was observed without abdominal organ injuries on the initial enhanced abdomen computed tomography(CT)scan.Ureteral injury was not suspected at this time.The patient was stabilized via conservative treatment,but complained of right flank pain 3 wk later and revisited the emergency room.An enhanced abdominal CT scan revealed a huge urinoma in the right perirenal space with hydronephrosis of the right kidney.Retrograde and antegrade pyelography were performed.Extravasation and discontinuity of the ureter were found.A rupture of the ureteropelvic junction was diagnosed and reconstructive surgery was performed.After 3 mo,the patient did not complain of any symptoms without any abnormal radiologic findings.CONCLUSION This case report discusses the safety and effectiveness of this minimal invasive procedure as an alternative to conventional open or laparoscopic surgery.展开更多
BACKGROUND Testicular torsion is an emergent disease in urology,and there has been discussion of the treatment of testicular torsion.Testicular decompression has been established as a critical treatment for testicular...BACKGROUND Testicular torsion is an emergent disease in urology,and there has been discussion of the treatment of testicular torsion.Testicular decompression has been established as a critical treatment for testicular compartment syndrome(TCS),which occurs after detorsion in a patient who is diagnosed with testis torsion.Until now,testicular fasciotomy and incision of tunica albuginea with tunica vaginalis flap(TVF)graft have been suggested for decompression,and some studies about the efficacy of TVF were reported.However,this method is time consuming and needs meticulous technique,so other methods such as orchio-septopexy are suggested.The objective of this clinical case report was to propose new surgical method using collagen fleece(Tachosil®)instead of tunica vagina flap.CASE SUMMARY A 5-year-old boy with scrotal pain visited our hospital 24 h after symptom onset.After history taking,physical examination,and scrotum ultrasonography,he was diagnosed with testis torsion.Emergency surgery was performed after diagnosis.Following the incision of scrotum and fasciotomy,we covered his tunica albuginea with collagen fleece called Tachosil®instead of covering with TVF.CONCLUSION Short-term follow-up showed normal blood flow in testis without a TCS.This is the first case report of using Tachosil®in testicular torsion surgery,and its advantages were already reported in other surgeries like Peyronie’s disease.Our case suggests this new technique is an appropriate method because of its advantages including its cost-effective and time-saving characteristics.The main limitation is the short follow-up,so more studies are needed to provide a high level of evidence about its efficacy and safety.展开更多
基金Supported by Soonchunhyang University Research Fund,No.20200024.
文摘BACKGROUND Ureteral reconstruction is a highly technical type of laparoscopic or open surgery.The incidence of ureteral injury is low;however,ureteral injuries tend to be overtreated.Robotic surgery for urinary reconstructive surgery is growing in popularity,which has made procedures such as pyeloplasty,ureteroureterostomy,and ureteroneocystostomy possible,with minimal damage to the patient.To the best of our knowledge,this is the first report of robot-assisted laparoscopic pyeloureterostomy in Korea,in a 17-year-old female patient with a ureteral injury.CASE SUMMARY The patient,a 17-year-old girl without previous medical history,was presented at the emergency room and complained of abdominal and back pain.Tenderness in the right upper quadrant was observed on physical examination.Hemorrhage in the right perirenal space was observed without abdominal organ injuries on the initial enhanced abdomen computed tomography(CT)scan.Ureteral injury was not suspected at this time.The patient was stabilized via conservative treatment,but complained of right flank pain 3 wk later and revisited the emergency room.An enhanced abdominal CT scan revealed a huge urinoma in the right perirenal space with hydronephrosis of the right kidney.Retrograde and antegrade pyelography were performed.Extravasation and discontinuity of the ureter were found.A rupture of the ureteropelvic junction was diagnosed and reconstructive surgery was performed.After 3 mo,the patient did not complain of any symptoms without any abnormal radiologic findings.CONCLUSION This case report discusses the safety and effectiveness of this minimal invasive procedure as an alternative to conventional open or laparoscopic surgery.
基金Supported by The Soonchunhyang University Research Fund,No.20230029.
文摘BACKGROUND Testicular torsion is an emergent disease in urology,and there has been discussion of the treatment of testicular torsion.Testicular decompression has been established as a critical treatment for testicular compartment syndrome(TCS),which occurs after detorsion in a patient who is diagnosed with testis torsion.Until now,testicular fasciotomy and incision of tunica albuginea with tunica vaginalis flap(TVF)graft have been suggested for decompression,and some studies about the efficacy of TVF were reported.However,this method is time consuming and needs meticulous technique,so other methods such as orchio-septopexy are suggested.The objective of this clinical case report was to propose new surgical method using collagen fleece(Tachosil®)instead of tunica vagina flap.CASE SUMMARY A 5-year-old boy with scrotal pain visited our hospital 24 h after symptom onset.After history taking,physical examination,and scrotum ultrasonography,he was diagnosed with testis torsion.Emergency surgery was performed after diagnosis.Following the incision of scrotum and fasciotomy,we covered his tunica albuginea with collagen fleece called Tachosil®instead of covering with TVF.CONCLUSION Short-term follow-up showed normal blood flow in testis without a TCS.This is the first case report of using Tachosil®in testicular torsion surgery,and its advantages were already reported in other surgeries like Peyronie’s disease.Our case suggests this new technique is an appropriate method because of its advantages including its cost-effective and time-saving characteristics.The main limitation is the short follow-up,so more studies are needed to provide a high level of evidence about its efficacy and safety.
