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Biomedical subjects

P V S Kumar

Publications and source records attributed to P V S Kumar.

4 recordsLinked to original sources
PubMed2003

Endoluminal ultrasonography before retrograde endopyelotomy: can the results match laparoscopic pyeloplasty?

OBJECTIVE: To present the results of endopyelotomy using endoluminal ultrasonography (EUS) to identify crossing vessels, as the success rates of endopyelotomy are generally lower than pyeloplasty, especially in patients with crossing vessels. PATIENTS AND METHODS: Forty-one consecutive patients who underwent EUS before a planned retrograde endopyelotomy were analysed retrospectively. EUS was used to direct the endopyelotomy incision for patients with crossing vessels. Treatment was considered successful if the patient was asymptomatic and unobstructed or improved on renography. The results were compared to those from 18 patients treated by laparoscopic pyeloplasty, some of whom had undergone EUS. RESULTS: Crossing vessels were identified in 27 of the 41 patients (66%). Primary treatment consisted of endopyelotomy for 26 patients and laparoscopic pyeloplasty for 15. The overall success rate for 24 endopyelotomy patients with an adequate follow-up (mean 19 months) was 71%, with more success in patients with no crossing vessels (11 of 13 (85%) vs six of 11 (55%)). Of the 18 patients treated by laparoscopic pyeloplasty (mean follow-up 15.1 months) 17 were successful. CONCLUSION: The results for endopyelotomy were disappointing in patients with crossing vessels, despite using EUS. The results suggest that patients with crossing vessels should be treated by laparoscopic pyeloplasty. More data are needed to compare endopyelotomy with laparoscopic pyeloplasty in patients with no crossing vessels.

Adolescent↗
PubMed2002

A computer assisted surgical trainer for transurethral resection of the prostate.

PURPOSE: We developed a realistic and reusable computer assisted surgical training system for transurethral resection of the prostate. MATERIALS AND METHODS: A disposable prostate model is housed in a model abdomen. A software program that provides a 3-dimensional (D) illustration of the prostate model was developed. Resectoscope position with reference to the model is tracked by infrared emitting diodes attached to it, which in turn are monitored by an optical tracker. Movement of the loop in relation to the resectoscope is measured by a potentiometer attached to the working element. RESULTS: Resectoscope position was shown on the monitor superimposed on a 3-D image of the prostate model in real time. A 2-D image showed the amount of tissue resected and the proximity of the loop to the capsule. A series of thumbnail images were shown and the highlighted image represented the current position of the resectoscope. It is intended that this system should be interactive, providing continuous feedback on the progress of resection and acting as an interactive training aid. During the course of validating the system several problems were noted, mainly with model movement and permanent deformation of the model during resection. CONCLUSIONS: This system can exist as a stand-alone training aid after the problems have been addressed. The potential application of an in vivo system for routine transurethral prostate resection has great implications for training and quality control.

Computer Simulation↗