Biomedical subjects

K Kerbl

Publications and source records attributed to K Kerbl.

43 records · Page 3Linked to original sources

PubMed1993

Laparoscopic surgery in urology: current applications.

Urologic applications of laparoscopy have increased exponentially in the past few years, and newer techniques continue to be described. This article considers the latest advances in the field and attempts to place laparoscopy in proper perspective in urologic therapy. From modest diagnostic maneuvers, urologic laparoscopy has progressed to ablation of large solid organs and complex reconstructive procedures. Reproducible clinical success has been achieved in localization of undescended testicles, varicocelectomy, dissection of pelvic lymph nodes, drainage of lymphoceles, and nephrectomy. Clinical reports on use of this technique for orchiectomy, ureterolysis, nephropexy, partial nephrectomy, nephroureterectomy, bladder diverticulectomy, dissection of retroperitoneal lymph nodes, and ileal conduit urinary diversion have been published. Exciting and rapid development of more advanced techniques is under way in the laboratory. Even at this early stage, when urologic applications of minimally invasive surgery are still being defined, it is likely that laparoscopy will have a lasting impact on the practice of urology.

Cryptorchidism↗

PubMed1993

Basic techniques of laparoscopic surgery.

Laparoscopic urology has only recently become a technique of interest to many urologists. In this article, an overview of the basics common to all laparoscopic procedures is presented. In addition, the current applications of laparoscopy to urology are discussed.

Cryptorchidism↗

PubMed1993

Laparoscopic nephrectomy: current status.

In this manuscript we describe our initial experience with 22 patients who underwent laparoscopic nephrectomy at our institution. Of the 22 patients, 16 patients had benign disease, and 6 patients had malignant disease. Of the 6 patients with malignancy, 3 patients underwent laparoscopic nephroureterectomy for transitional cell cancer of the upper urinary tract. In 21 patients, a transabdominal approach was utilized, whereas 1 patient underwent laparoscopic nephrectomy using an entirely retroperitoneal approach. Laparoscopic nephrectomy showed lengthy operative times, but resulted in reduced postoperative discomfort, shortened hospital stay, and rapid convalescence. As laparoscopic nephrectomy has been performed with reproducible success by various other groups worldwide, further refinements in surgical technique, paired with advances in laparoscopic instruments designed for stapling and suturing, will most likely result in an increasing application of the principles of laparoscopy to diseases of the kidney, renal pelvis and ureter.

Humans↗

PubMed1993

Retroperitoneal endoscopic adrenalectomy: an experimental study.

Laparoscopic approaches to adrenalectomy have been limited by the retroperitoneal (RP) location of the adrenal glands and their relative inaccessibility transabdominally. We developed a technique for endoscopic adrenalectomy in a domestic swine model using insufflation of the RP space with CO2 and retroperitoneoscopy. The technique for retroperitoneal endoscopic adrenalectomy was first developed in an acute study of three animals. A chronic survival study was then undertaken in six pigs. Unilateral right (n = 3) or left (n = 3) adrenalectomy was performed. Mean RP insufflation time was 14.5 min (range, 7-30 min), and mean dissection time after insufflation was 100 min (range, 80-120 min). Two additional animals died under anesthesia after RP insufflation and placement of the trocars for retroperitoneoscopy but before dissection of the adrenal gland. One death was unexplained at autopsy. The other death was associated with a right-sided pneumothorax attributable to penetration of the diaphragm by a trocar. The remaining six pigs recovered uneventfully from the procedure. Autopsies performed 37 to 51 days postoperatively showed minimal scarring of the adrenalectomy bed. The results suggest that posterior adrenalectomy using RP CO2 insufflation and direct retroperitoneoscopy is potentially applicable to the treatment of small adrenal lesions in humans.

Adrenalectomy↗

PubMed1993

Renal failure and uraemia leading to the diagnosis of prune belly syndrome in a 34-year-old man.

The case of a 34-year-old male is reported, who was transferred to the Regional Medical Center in Wels in an uraemic state and subsequently was diagnosed as having prune belly syndrome. Surprisingly, his past history revealed no serious health problems until 6 months before admission. Furthermore, some interesting aspects of the prune belly syndrome such as the controversial views regarding pathogenesis and treatment are briefly discussed.

Adult↗

PubMed1988

Primary non-Hodgkin lymphoma of prostate.

Since 1877, 42 cases of non-Hodgkin lymphoma of the prostate have been reported in the medical literature, whereby the occurrence of a primary process could only be assumed in a very few of these. We report a case of primary non-Hodgkin lymphoma of the prostate, including a review of literature, and point out the difficulties involved in diagnosing such cases.

Adult↗

PubMedDate not supplied

Laparoscopic repair of diaphragmatic defect by total intracorporeal suturing: clinical and technical considerations.

OBJECTIVE: The use of laparoscopy in urology is increasing. Tumor of the kidney or adrenal gland and, in some cases, metastatic disease can involve the diaphragm. We describe the application of laparoscopic suturing techniques in the case of diaphragmatic involvement with a renal tumor. METHODS: After resection of the tumor and a small area of the diaphragm, a chest tube was placed under laparoscopic guidance. The tube was kept clamped until the end of the procedure. Decreasing intraabdominal pneumoperitoneum pressure made suturing easier with less tension on the edges of the diaphragmatic incision. Nonabsorbable interrupted horizontal mattress sutures were placed to close the diaphragmatic defect. RESULTS: The repair was uneventful; no intraoperative complications occurred. Extubation was done at the end of the procedure in the operating room. The chest tube was removed on postoperative day 2, and the patient was discharged on postoperative day 3. CONCLUSIONS: Laparoscopic repair of the diaphragm should be commensurate with traditional open surgical principles. In this regard, it is essential that surgeons interested in performing "advanced" laparoscopic oncologic surgery become facile in laparoscopic suturing.

Diaphragm↗