Retroperitoneoscopic nephrectomy in benign pathology

INTRODUCTION: We report our experience with 43 retroperitoneal laparoscopic nephrectomy for benign kidney disease. MATERIALS AND METHODS: All patients had a poor function from obstructive uropathology and renal atrophy. None of these patients had a previous lumbotomy. Retroperitoneoscopy was performed with 4 trocar port technique in a lateral position. The retroperitoneal space is created by using a Gaur's balloon made of sterile glove. The approach to vascular pedicle was done posteriorly and vessels were clipped by metal and Hem-o-lock (Weck Closure Systems, North Carolina, USA) clips. The sample was intact extracted in an Endo-Bag prolonging one trocar incision. RESULTS: Median operative time was 160 minutes and median blood loss was 200 mL. Four cases (9%) were converted to open surgery: one case due to bleeding and 3 cases due to technical difficulties regarding perirenal adherences. Most patients (39) checked out from the Hospital in day two. Four of them were left over 3 days due to wound complications. CONCLUSIONS: Retroperitoneoscopy offers a safe, effective and reproductive access to nephrectomy for benign pathologies

Retroperitoneoscopy for treatment of renal and ureteral stones

OBJECTIVE: To assess the efficacy of retroperitoneoscopy for treating stones in the renal pelvis and proximal ureter. MATERIALS AND METHODS: In the period from August 2003 to August 2004, 35 retroperitoneoscopies for treatment of urinary stones were performed on 34 patients. Fifteen patients (42%) had stones in the renal pelvis, and in 2 cases, there were associated stones in the upper caliceal group. Twenty patients (58%) had ureteral stones, all of them located above the iliac vessel. Twenty-five patients (71%) had previously undergone at least one session of extracorporeal lithotripsy and 8 patients (26%) also underwent ureteroscopy to attempt to remove the stone. Eight patients underwent retroperitoneoscopy as a primary procedure. Stone size ranged from 0.5 to 6 cm with a mean of 2.1 cm. RESULTS: Retroperitoneoscopy was performed by lumbar approach with initial access conducted by open technique and creation of space by digital dissection. We used a 10-mm Hasson trocar for the optics, and 2 or 3 additional working ports placed under visualization. Following identification, the urinary tract was opened with a laparoscopic scalpel and the stone was removed intact. The urinary tract was closed with absorbable 4-0 suture and a Penrose drain was left in the retroperitoneum. In 17 patients (49%), a double-J stent was maintained postoperatively. Surgical time ranged from 60 to 260 minutes with a mean of 140 minutes. The mean hospital stay was 3 days (1-10 days). The mean length of retroperitoneal urinary drainage was 3 days (1-10 days). There were minor complications in 6 (17.6%) patients and 1 case of conversion due to technical difficulty. Thirty-three patients (94%) became stone free. CONCLUSION: Retroperitoneoscopy is an effective, low-morbidity alternative for treatment of urinary stones

Laparoscopic ureteral reimplant for ureteral stricture

PURPOSE: Evaluate the initial experience of laparoscopic ureteral reimplant for ureteral stenosis. MATERIALS AND METHODS: From January 2004 to June 2008, 10 patients underwent 11 laparoscopic reconstruction surgeries for ureteral stenosis. Seven cases of stenosis of the distal ureter, two at the level of iliac vessels, a case of bilateral distal stenosis and one in the medium third. Eight ureteroneocystotomies were performed by extravesical technique with anti-reflux mechanism, two cases of vesical reimplant with Boari technique and one case using the psoas hitch technique. RESULTS: The average surgical time was 166 minutes (115-245 min), mean blood loss was 162 mL (100-210 mL) and the average hospital stay was 2.9 days (2-4 days). There were two complications: a lesion of the sigmoid colon identified peroperatively and treated with laparoscopic sutures with good evolution, and a case of ureteral stone obstruction at the 30th day postoperative, treated by laser ureterolitotripsy. All patients had resolution of the stenosis at an average follow-up period of 18 months (3-54 months). CONCLUSIONS: Laparoscopic surgery represents a feasible, safe and low morbidity technique for ureteral reimplant in ureteral stenosis

Study of Photon Strength Function of Actinides : the Case of U-235, Np-238 and Pu-241

The decay from excited levels in medium and heavy nuclei can be described in a statistical approach by means of Photon Strength Functions and Level Density distributions. The study of electromagnetic cascades following neutron capture based on the use of high efficiency detectors has been shown to be well suited for probing the properties of the Photon Strength Function of heavy (high level density) and/or radioactive (high background) nuclei. In this work we have investigated for the first time the validity of the recommended PSF of actinides, in particular U-235, Np-238 and Pu-241. Our study includes the search for resonance structures in the PSF below S-n and draws conclusions regarding their existence and their characteristics in terms of energy, width and electromagnetic nature.Peer reviewe

Neutron Capture Measurements on Minor Actinides at the n_TOF Facility at CERN : Past, Present and Future

The successful development of advanced nuclear systems for sustainable energy production and nuclear waste management depends on high quality nuclear data libraries. Recent sensitivity studies and reports [1-3] have identified the need for substantially improving the accuracy of neutron cross-section data for minor actinides. The n_TOF collaboration has initiated an ambitious experimental program for the measurement of neutron capture cross sections of minor actinides. Two experimental setups have been constructed for this purpose: a Total Absorption Calorimeter (TAC) [4] for measuring neutron capture cross-sections of low-mass and/or radioactive samples and a set of two low neutron sensitivity C(6)D(6) detectors for the less radioactive materials.Peer reviewe