Current status of robot-assisted surgery

The introduction of robot-assisted surgery, and specifically the da Vinci Surgical System, is one of the biggest breakthroughs in surgery since the introduction of anaesthesia, and represents the most significant advancement in minimally invasive surgery of this decade. One of the first surgical uses of the robot was in orthopaedics, neurosurgery, and cardiac surgery. However, it was the use in urology, and particularly in prostate surgery, that led to its widespread popularity. Robotic surgery, is also widely used in other surgical specialties including general surgery, gynaecology, and head and neck surgery. In this article, we reviewed the current applications of robot-assisted surgery in different surgical specialties with an emphasis on urology. Clinical results as compared with traditional open and/or laparoscopic surgery and a glimpse into the future development of robotics were also discussed. A short introduction of the emerging areas of robotic surgery were also briefly reviewed. Despite the increasing popularity of robotic surgery, except in robot-assisted radical prostatectomy, there is no unequivocal evidence to show its superiority over traditional laparoscopic surgery in other surgical procedures. Further trials are eagerly awaited to ascertain the long-term results and potential benefits of robotic surgery.published_or_final_versio

PCNL trajectory: a novel concept to predict success in supine PCNL

香港泌尿外科學會Oral (Free Paper) Session IV - Andrology, Men’s Health and Stone Disease: OP.4-5OBJECTIVE: Supine PCNL confers certain advantages over its prone counterpart but access parameters change with supine positioning. Supine position limits maneuverability of instruments, limiting access to upper and mid-pole stones. We aim to determine predictive factors for success of supine PCNL through road-mapping of ...published_or_final_versionThe 17th Annual Scientific Meeting of the Hong Kong Urological Association, Hong Kong, 6 November 2011. In Program Book, 2011, p. 5

PCNL trajectory to predict success in supine PCNL: a novel concept

This journal suppl. contatin program & abstracts of the 29th World Congress of Endourology & SWL WCE, 2011Session - MP23: PNL 2: abstract no. MP23-13INTRODUCTION: Supine PCNL confers certain advantages over prone. Access parameters change with positioning. Supine position limits maneuverability of instruments, limiting access to upper & mid-pole stones. We aim to determine predictive factors for success of supine PCNL through road-mapping of PCNL trajectory. MATERIAL & METHOD: Consecutive patients undergoing PCNL from July-Dec2010 were recruited. Choice of position was made by surgeon. Tracts were performed under USG & fluoroscopy. Distances and angles were measured intra-operatively with rigid and flexible nephroscope, and correlated with pre-operative imaging. RESULTS 19 patients underwent PCNL(13supine, 6prone) Stone load was comparable in both groups. Overall stone clearance after single PCNL was 74%. Regardless of abdominal thickness and approach, all lower pole and renal pelvic stones were reached with mean excursion of 140 mm in supine & 105 mm in prone position. Mean entry angle was 59 for supine, and 35 for prone. In supine PCNL, the upper pole was reached in 4 of 11 tracts, with mean-excursion of 172mm& entry angle of 33. Similarly, 2 of 11 supine PCNL reached middle pole. Conversely, all prone PCNL tracts reached upper & middle pole with decreased excursion & angle. CONCLUSION: PCNL in prone position can reach renal pelvis and 3 poles via lower pole puncture. PCNL trajectory may be a tool to predict success in supine PCNL by estimating chance of reaching mid & upper pole. Skin to upper pole distance larger than 185mm and entry angle more than 48 degrees decrease chance of upper pole access.published_or_final_versionThe 29th World Congress of Endourology & SWL WCE, Kyoto, Japan, 30 November–3 December 2011. In Journal of Endourology, v. 25 suppl 1, p. A145, abstract no. MP23-1

Initial results of selective renal parenchymal clamping with an adjustable kidney clamp in nephron-sparing surgery: an easy way to minimise renal ischaemia

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Psychometric Properties of Functional Assessment of Cancer Therapy-Prostate (FACT-P) in Chinese Patients with Prostate Cancer

Purpose: The aim of the study was to assess the validity, reliability and sensitivity of the FACT-P (Version 4) in Chinese males with prostate cancer. Methods: Construct validity was assessed using Spearman's correlation test against the 12-item Short Form Health Survey (SF-12v2). Internal consistency and test-retest reliability was assessed using Cronbach's α coefficient and intra-class correlation coefficient, respectively. Sensitivity was determined by performing known group comparisons by independent t-test. Results: FACT-P subscale scores had a moderate correlation with the corresponding SF-12v2 domain score that conceptually measures the similar construct providing evidence for adequate construct validity. Internal consistency was acceptable (α: 0.687-0.900) for all subscales aside from the Prostate Cancer Subscale (α: 0.505) and Trial Outcome Index (α: 0.562). FACT-P subscale and total scores showed good test-retest reliability (range: 0.753-0.913). All total scales and most of the subscales were sensitive in detecting differences between subjects with different levels of functional impairment but not different cancer stages or levels of prostate-specific antigen. Conclusions: The measure is a valid and reliable measure to assess the health-related quality of life of Chinese males with prostate cancer. The FACT-P is sensitive to detect difference between subjects with varying functional status.postprin

Elder Chinese Martial Art Practitioners Have Higher Radial Bone Strength, Hand-Grip Strength, and Better Standing Balance Control

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Review of the microbiology and antibiotic sensitivities of fournier’s gangrene in a local centre: 12 years' experience

Oral (Free Paper) Session 4 - Stone, Infection & Nephrology: no. OP.4-4OBJECTIVE: To review the local microbiology & antibiotic sensitivities of organisms found in cultures from patients with Fournier’s gangrene in a local centre over 12 years …postprin

Novel use of Tachosil® in Bilateral Nerve-sparing Robot-assisted Laparoscopic Radical Prostatectomy (biNS-RaLRP)

Oral (Free Paper) Session 2I - Uro-Oncology: Prostate & Kidney: no. OP.2-4OBJECTIVE: To investigate the novel use of Tachosil® (an absorbable fibrin sealant patch) in biNS-RaLRP with conventional athermal dissection technique …postprin

Is pre-operative MRI really a Must for Robotic-assisted Laparoscopic Radical Prostatectomy (RaLRP)?

Oral (Free Paper) Session 2 - Uro-Oncology: Prostate & Kidney: no. OP.2-2OBJECTIVE: To evaluate MRI with endorectal coil (ER-MRI) in detecting laterality of tumor and T staging on patients with localized prostate cancer before RaLRP …postprin