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Biomedical subjects

G L Taverna

Publications and source records attributed to G L Taverna.

5 recordsLinked to original sources

Experimental and clinical urinary diversion.

In order to achieve an appropriate technical experience and explore clinical feasibility of laparoscopic urinary diversion, the authors planned a laboratory experiment. In ten male pigs weighing about 25 kilograms cystoprostatectomy was performed. Ureterocutaneostomy or ureterosigmoidostomy were carried out next. For ureterocutaneostomy a channel was bluntly dissected through the abdominal wall. The ureter was grasped by a clamp passed through the stroma, drawn outside and anstomosed to the skin. Operative time was about 30 minutes. For ureterosigmoidostomy a longitudinal incision of approximately 1 cm was made through the wall of the sigmoid colon in order to reach the mucosa. A very small opening in the angle of the incision was made. A suture was placed in the ureteral tip and secured to the colon wall. Finally, the ureter was covered in its bed with antireflux technique. Operative time was about 180 minutes. Laparoscopic ureterocutaneostomy was also successfully applied in a compromised patient to resolve a particular clinical situation.

Aged

Bladder laparoscopic surgery.

The advances made in laparoscopic surgery during the last five years have made possible the performance of a variety of bladder level procedures as suspension of the bladder neck, removal of bladder diverticulum and cystectomy. Laparoscopic bladder-neck suspension is purposed by different Authors as a minimally invasive procedure that can be provide efficacious results as like as open surgery, reducing post-operative disconfort. All different laparoscopic technique provide good results at short-term follow-up. A longer follow-up period is required for the evaluation of the effective efficacy of this treatment. In according with other authors, our experience with laparoscopic bladder diverticulectomy demonstrates the feasibility and the potentiality of this technique. Up to now this procedure has been employed in the treatment of diverticula involved in urinary infection or residual urine. At the beginning, laparoscopic cystectomy has been purposed in patients with begin disease; more recently, laparoscopy has been disease; more recently, laparoscopy has been employed for cystectomy in case of bladder cancer. The few cases described demonstrate that the technique is feasible but, until now, laparoscopic cystectomy has been reported just in female patients.

Cystectomy

[Cavernosography].

Dynamic cavernosography remains today an important step in diagnosis of veno-occlusive impotence, as support to cavernosometry: cavernosometry facilitate the diagnosis and the evaluation of venous-defect, but a contemporary show-timed cavernosography takes many informations about the site of venous-escape; these date allow to perform a correct selective vein ligation or percutaneous procedures, recently introduced in the clinical practice as an alternative or in association with vein ligation. Static cavernous-spongiosography, instead, has many indications in neoplasms and severe malformations.

Adult

[Orchiopexy].

The Authors illustrate their experience in the treatment of a case of left criptorchidism using laparoscopic technique associated with traditional surgery (Fowler-Stephens technique) without important complications during and after the procedure. The non palpable testis was located in the peritoneal cavity. The first step consists in a laparoscopic clip ligation of the spermatic vessels with the intent of improve the vasal collateral blood flow. After a 6 months interval, the patient underwent laparoscopic orchidopexy.

Adult

Urological laparoscopy: our preliminary results.

From the beginning of urological applications of laparoscopy, this technique has found many clinical indications. In our center, after an experimental training in animals, we performed 48 operations using laparoscopy: 18 pelvic lymphadenectomies (15 for prostate cancer, 2 for bladder tumor and 1 for penis carcinoma), 11 ligatures of the spermatic vein (3 bilateral), 4 orchidopexies, 10 excisions of renal cysts, 4 nephrectomies and 1 adrenalectomy. For cryptorchidism, laparoscopy is a less invasive alternative to surgical exploration; in case of prostate cancer, laparoscopic pelvic node dissection has a lower incidence of complications and requires few days of hospitalisation. The excision of renal cysts by laparoscopy, in case of large symptomatic pathology, is an efficacious operation with low morbidity. In case of nephrectomy for small wrinkled kidneys or severe hydronephrosis, long execution time makes cost/benefit ratio somewhat debatable; adrenalectomy, instead, is easier than nephrectomy and offers many advantages in comparison with traditional surgical approach. All indications will be better evaluated at a later date, with the indispensable learning period and the continuous progress of technical equipment.

Genital Diseases, Male