The pubovesical complex-sparing technique on laparoscopic radical prostatectomy

ABSTRACT Introduction: Preservation of urinary continence is a great challenge in Radical Prostatectomy. In order to improve functional results, Asimakopoulos et al. (2010) described a robot-assisted surgical technique with preservation of the pubovesical complex (PVC). We present a pure laparoscopic execution. Presentation: A 61-year-old male patient with a diagnosis of prostate cancer, with PSA 6.54ng/ml, DRE: T1C and Gleason 6 (3+3) 1/12 fragments. All therapeutic possibilities were discussed, including active surveillance. The patient opted for surgical treatment. A transperitoneal technique was used. We started the dissection on the left side, in the limit between the detrusor and the base of the prostate. The left seminal vesicle was dissected and left neurovascular bundle released by a high anterior dissection. We repeated the same procedure on the right side. The urethra was then divided, prostatic apex was laterally drawn and PVC was released. The bladder neck was divided and an urethrovesical anastomosis was achieved. A pelvic drain was placed. Results: The total operative time was 150 minutes. The estimated blood loss was 300mL. The drain was removed on the 1st postoperative day and the patient was discharged. The Foley catheter was removed after 7 days and the patient remained completely dry. Hystopathology revealed adenocarcinoma Gleason 6, negative margins. PSA after 30 days was <0.04ng/mL, and the patient reported partial penile erection. Conclusion: The Pubovesical Complex-Sparing Technique on Laparoscopic Radical Prostatectomy was feasible and safe. Further adequately designed studies are needed to confirm whether this technique enhances early functional outcomes

Cation Alkyl Side Chain Length and Symmetry Effects on the Surface Tension of Ionic Liquids

Aiming at providing a comprehensive study of the influence of the cation symmetry and alkyl side chain length on the surface tension and surface organization of ionic liquids (ILs), this work addresses the experimental measurements of the surface tension of two extended series of ILs, namely R,R'-dialkylimidazolium bis-Rtrifluoromethyl)sulfonyllimide ([C(n)C(n)im][NTf2]) and R-alkyl-3-methylimidazolium bis[ (trifluoromethyl)sulfonyl] imide ([C-n C(1)im]-[NTf2D, and their dependence with temperature (from 298 to 343 K). For both series of ILs the surface tension decreases with an increase in the cation side alkyl chain length up to aliphatic chains no longer than hexyl, here labeled as critical alkyl chain length (CACL). For ILs with aliphatic moieties longer than CACL the surface tension displays an almost constant value up to [C(12)C(1)im][NTf2] or [C(16)C(1)im][NTf2]. These constant values further converge to the surface tension of long chain n-alkanes, indicating that, for sufficiently long alkyl side chains, the surface ordering is strongly dominated by the aliphatic tails present in the IL. The enthalpies and entropies of surface were also derived and the critical temperatures were estimated from the experimental data. The trend of the derived thermodynamic Properties highlights the effect of the structural organization of the IL at the surface with visible trend shifts occurring at a well-defined CACL in both symmetric and asymmetric series of ILs. Finally, the structure of a long-alkyl side chain IL at the vacuum-liquid interface was also explored using Molecular Dynamics simulations. In general, it was found that for the symmetric series of ILs, at the outermost polar layers, more cations point one of their aliphatic tails outward and the other inward, relative to the surface, than cations pointing both tails outward. The number of the former, while being the preferred conformation, exceeds the latter by around 75%