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Biomedical subjects

Eric Gerber

Publications and source records attributed to Eric Gerber.

5 recordsLinked to original sources

Laparoscopic retrieval of retroperitoneal vas deferens in vasovasostomy for postinguinal herniorrhaphy obstructive azoospermia.

OBJECTIVE: Iatrogenic injury to the vas deferens is a well-documented complication of inguinal hernia repair. Recently obstruction related to the use of polypropylene mesh for hernia repair has been reported. We describe a case using laparoscopy to mobilize the retroperitoneal vas and deliver it to the healthy vas proximal to the vas trapped in the cicatrix induced by mesh thus allowing a tension-free microsurgical repair. DESIGN: Case report. SETTING: Outpatient male infertility practice. PATIENT(S): Obstructed azoospermic men with polypropylene mesh. INTERVENTION(S): Laparoscopic retrieval of retroperitoneal vas segment for primary microsurgical anastomosis. MAIN OUTCOME MEASURE(S): Patency of vas and presence of sperm. RESULT(S): A tension-free, patent anastomosis was performed. CONCLUSION(S): Polypropylene mesh-induced fibrosis of the vas deferens can result in obstructive azospermia. Laparoscopy can be used to permit a microsurgical bypass of the obstructed segment.

Hernia, Inguinal↗

Bladder wall lipoma.

Bladder wall lipoma is a rare finding that includes mature, well-encapsulated fatty tissue within the submucosa of the bladder wall. We present a case of a submucosal bladder wall lipoma that was discovered incidentally during a workup for microhematuria. This lesion was seen during cystoscopy and removed using cold cup biopsy forceps. This lipoma should be differentiated from pelvic lipomatosis in that it was confined to the submucosa of the bladder wall and did not cause compression of the pelvic viscera or its structures.

Biopsy, Needle↗

Laparoscopic adrenalectomy for isolated adrenal metastasis.

BACKGROUND: Laparoscopic adrenalectomy is accepted by many as the standard of care for the majority of adrenal masses less than 8 cm. The question exists whether laparoscopic removal of metastatic lesions to the adrenal is more difficult than laparoscopic removal of primary adrenal lesions. METHODS: We performed a retrospective analysis of all laparoscopic adrenalectomies performed at a single institution from 1998 to 2001, comparing laparoscopic adrenalectomies for primary lesions of the adrenal gland versus isolated metastatic lesions to the adrenal gland. RESULTS: Fourteen laparoscopic adrenalectomies were attempted, 10 for primary disease and 4 for metastatic disease. All 10 laparoscopic procedures were completed successfully for primary disease (average operative time=218 minutes, average tumor size=4 cm, median hospital stay=2 days). Only one of the 4 laparoscopic adrenalectomies for metastatic disease was completed successfully (average operative time=332 minutes, average tumor size=7.3 cm, median hospital stay=2 days). No major complications occurred in either group. CONCLUSIONS: We feel laparoscopic adrenalectomy is the preferred approach for primary adrenal masses less than 8 cm. Based on our experience and a review of the literature, isolated metastatic lesions to the adrenal gland appear less amenable to laparoscopic removal than do primary lesions of the same size.

Adrenal Gland Neoplasms↗