BOOK
Hinman's Atlas of Urologic Surgery E-Book
Joseph A. Smith | Stuart S. Howards | Glenn M. Preminger | Roger R. Dmochowski
(2016)
Additional Information
Book Details
Abstract
Depend on Hinman’s for up-to-date, authoritative guidance covering the entire scope of urologic surgery. Regarded as the most authoritative surgical atlas in the field, Hinman's Atlas of Urologic Surgery, 4th Edition, by Drs. Joseph A. Smith, Jr., Stuart S. Howards, Glenn M. Preminger, and Roger R. Dmochowski, provides highly illustrated, step-by-step guidance on minimally invasive and open surgical procedures, new surgical systems and equipment, and laparoscopic and robotic techniques. New chapters keep you up to date, and all-new commentaries provide additional insight from expert surgeons.
- Features 10 new chapters, including Radical Cystectomy in the Male, Robotic Urinary Diversion, Laparoscopic and Robotic Simple Prostatectomy, Transrectal Ultrasound-Directed Prostate Biopsy, Transperineal Prostate Biopsy, Prostate Biopsy with MRI Fusion, Focal Therapies in the Treatment of Prostate Cancer, Brachy Therapy, Male Urethral Sling, and Botox Injection for Urologic Conditions.
- Includes new commentaries in every chapter from today’s leading urologists.
- Offers a step-by-step incremental approach, highlighted by new illustrations, photos, and images.
- Keeps you current with significant revisions to all female sling chapters, urethroplasty chapters, and more.
- Helps you find what you need quickly with a clear, easy-to-use format – now reorganized to make navigation even easier.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Hinman's Atlas of Urologic Surgery | i | ||
| Copyright Page | iv | ||
| Dedication | v | ||
| Contributors | vi | ||
| Foreword | xix | ||
| Preface | xx | ||
| Contents | xxi | ||
| Video Contents | xxv | ||
| 2 Kidney: Excision | 61 | ||
| 8 Surgical Approaches for Open Renal Surgery, Including Open Radical Nephrectomy | 61 | ||
| Anatomic Basis for Renal Incisions | 61 | ||
| Abdominal and Chest Wall | 61 | ||
| Retroperitoneal Space | 61 | ||
| Three-Dimensional Relationships | 61 | ||
| Choice of Surgical Approach | 61 | ||
| Anterior Approaches | 61 | ||
| Midline Transperitoneal Incision (Laparotomy) | 61 | ||
| Subcostal Incision | 62 | ||
| Extraperitoneal Approach—Left Side. | 62 | ||
| Transperitoneal Approach—Right Side. | 66 | ||
| Chevron Incision | 68 | ||
| Modified Thoracoabdominal, Extraperitoneal Hockey-Stick Incision | 68 | ||
| Flank Approaches | 70 | ||
| Twelfth Rib Supracostal Incision | 71 | ||
| Eleventh Rib Transcostal Incision | 72 | ||
| Thoracoabdominal Incision | 73 | ||
| Intraoperative and Postoperative Complications | 74 | ||
| Injury to the Vasculature of the Gut | 74 | ||
| Injury to the Liver and Spleen | 75 | ||
| Injury to the Duodenum | 75 | ||
| Injury to the Pancreas | 75 | ||
| Pulmonary Complications | 75 | ||
| Suggested Readings | 75 | ||
| 9 Open Partial Nephrectomy | 76 | ||
| Preoperative Considerations | 76 | ||
| Preparation and Exposure | 76 | ||
| Enucleation for Small Cortical Tumors | 76 | ||
| Wedge Resection for Large Cortical Tumors | 76 | ||
| Segmental Nephrectomy for Large Polar Tumors | 78 | ||
| Heminephrectomy for Large Tumors | 80 | ||
| Postoperative Problems | 80 | ||
| Urinary Leak and Fistula | 80 | ||
| Postoperative Bleeding | 80 | ||
| Renal Insufficiency | 81 | ||
| Suggested Readings | 81 | ||
| 10 Open and Laparoscopic Nephroureterectomy | 82 | ||
| Preoperative Considerations | 82 | ||
| Diagnosing Upper Tract Malignancy | 82 | ||
| Staging of Malignancy | 82 | ||
| Role of Neoadjuvant Chemotherapy | 82 | ||
| Lymphadenectomy | 82 | ||
| Use of Intraoperative Intravesical Chemotherapy | 82 | ||
| Overview of Techniques for Nephroureterectomy | 82 | ||
| Nephrectomy | 83 | ||
| Techniques of Open Nephroureterectomy Nephrectomy | 83 | ||
| Two-Incision Approach | 83 | ||
| Single-Incision Approach | 84 | ||
| Techniques of Laparoscopic Nephroureterectomy | 84 | ||
| Pure Laparoscopic Technique | 84 | ||
| Hand-Assisted Laparoscopic Nephroureterectomy | 88 | ||
| Robot-Assisted Laparoscopic Nephroureterectomy | 91 | ||
| Hybridization of Laparoscopic and Robotic Nephroureterectomy | 92 | ||
| Retroperitoneal Laparoscopic Approach | 92 | ||
| Distal Ureterectomy | 92 | ||
| Open Approaches | 92 | ||
| Intravesical Technique | 92 | ||
| Extravesical Technique | 93 | ||
| Laparoscopic Approaches | 93 | ||
| Extravesical Transection Without a Bladder Cuff | 93 | ||
| Extravesical With a Bladder Cuff | 94 | ||
| Transvesical Bladder Cuff Technique | 94 | ||
| Endoscopic Approaches | 94 | ||
| Transurethral Resection of the Ureteral Orifice (Pluck Technique) | 94 | ||
| Ureteral Intussusception (Stripping Technique) | 95 | ||
| Ureteral Unroofing Technique | 95 | ||
| Postoperative Care | 96 | ||
| Suggested Readings | 96 | ||
| 11 Vena Caval Thrombectomy | 97 | ||
| Preoperative Considerations | 97 | ||
| Pulmonary Embolism, Anticoagulation, and IVC Filters | 97 | ||
| Preoperative Angioembolization | 97 | ||
| Preoperative Consultations | 97 | ||
| Tumor Thrombus Level | 97 | ||
| Bland Thrombus Group | 97 | ||
| Level I Vena Caval Thrombectomy | 97 | ||
| Level II Vena Caval Thrombectomy | 98 | ||
| Level III and IV Vena Caval Thrombectomy: Intraabdominal Approach | 102 | ||
| Level III and IV Vena Caval Thrombectomy: Combined Intraabdominal and Intrathoracic Approach | 105 | ||
| Bypass Techniques for Inferior Vena Cava Surgery | 106 | ||
| Veno-Venous Bypass | 106 | ||
| Cardiopulmonary Bypass With and Without Deep Hypothermic Arrest | 108 | ||
| Patching, Replacing and Interrupting the Inferior Vena Cava | 109 | ||
| Patch Cavoplasty | 109 | ||
| Vena Caval Replacement | 109 | ||
| Inferior Vena Cava Filtration and Permanent Interruption for Bland Thrombus | 110 | ||
| Perioperative Complications | 111 | ||
| Air Embolism | 111 | ||
| Acute Pulmonary Embolism | 111 | ||
| Massive Hemorrhage | 111 | ||
| Hepatic Dysfunction | 111 | ||
| Organ Ischemia | 111 | ||
| Suggested Readings | 111 | ||
| 12 Laparoscopic Nephrectomy | 112 | ||
| Preoperative Considerations | 112 | ||
| Preoperative Preparations | 112 | ||
| Patient Positioning and Protection | 112 | ||
| Obtaining Access and Establishing Pneumoperitoneum | 112 | ||
| Trocar Positioning | 113 | ||
| Steps for Left Nephrectomy | 114 | ||
| Steps for Right Nephrectomy | 114 | ||
| Hilar Dissection and Ligation of the Renal Artery and Vein | 115 | ||
| Superior Dissection and the Adrenal Gland | 117 | ||
| Lateral Dissection | 118 | ||
| Ureteral Dissection, Occlusion, and Division | 118 | ||
| Specimen Entrapment and Removal | 118 | ||
| Hemostasis and Closure | 119 | ||
| Postoperative Care | 119 | ||
| Intraoperative Procedure Specific Complications | 119 | ||
| Right-Sided Nephrectomy | 119 | ||
| Left-Sided Nephrectomy | 120 | ||
| Retroperitoneal Simple Nephrectomy | 120 | ||
| Suggested Readings | 121 | ||
| 13 Laparoscopic and Robotic-Assisted Laparoscopic Partial Nephrectomy | 122 | ||
| Preprocedure Steps | 122 | ||
| Positioning | 122 | ||
| Port Placement | 123 | ||
| Dissection and Mobilization | 123 | ||
| Clamping | 124 | ||
| Mass Excision | 125 | ||
| Postoperative Care | 126 | ||
| Complications | 126 | ||
| Suggested Readings | 127 | ||
| 14 Percutaneous Resection of Upper Tract Urothelial Carcinoma | 128 | ||
| Preoperative Preparation and Planning | 128 | ||
| Patient Positioning and Surgical Incision | 128 | ||
| Operative Technique | 128 | ||
| Nephrostomy Tract Access | 128 | ||
| Tumor Resection | 128 | ||
| Upper Urinary Tract Instillation for Topical Therapy | 128 | ||
| Postoperative Care and Complications | 130 | ||
| Suggested Readings | 130 | ||
| 3 Kidney: Reconstruction | 131 | ||
| 15 Open Pyeloplasty | 131 | ||
| Preoperative Planning and Preparation | 131 | ||
| Patient Positioning and Surgical Incision | 131 | ||
| Operative Technique | 132 | ||
| Dismembered Pyeloplasty (Anderson-Hynes) | 133 | ||
| Foley Y-V Plasty | 135 | ||
| Pelvic Flap Pyeloplasty | 135 | ||
| Intubated Ureterotomy (Davis) | 135 | ||
| Drains | 136 | ||
| Nephropexy | 138 | ||
| Closure | 138 | ||
| Postoperative Care and Complications | 138 | ||
| Complications | 140 | ||
| Suggested Readings | 140 | ||
| 16 Surgery of the Horseshoe Kidney | 141 | ||
| Embryology | 141 | ||
| Vascular Anatomy | 141 | ||
| Indications for Surgery | 141 | ||
| Shock-Wave Lithotripsy | 141 | ||
| Percutaneous Approach and Ureteroscopy | 141 | ||
| Nephrolithotomy | 141 | ||
| Ureteroscopy | 142 | ||
| Laparoscopic Approach | 142 | ||
| Access and Exposure | 143 | ||
| Pyeloplasty | 143 | ||
| Endopyelotomy | 144 | ||
| Nephrectomy | 144 | ||
| Partial Nephrectomy | 144 | ||
| Laparoendoscopic Single Site (LESS) Approach | 144 | ||
| Robotic Approach | 144 | ||
| Open Approach | 145 | ||
| Pyeloplasty | 145 | ||
| Nephrectomy | 145 | ||
| Partial Nephrectomy | 146 | ||
| Suggested Readings | 148 | ||
| 17 Repair of Renal Injuries | 149 | ||
| Surgical Approach to Renal Exploration | 149 | ||
| Exposure, Important Landmarks, and Renal Hilar Control | 149 | ||
| Renal Hilum Vessel Isolation | 149 | ||
| Entering the Retroperitoneal Hematoma and Renal Exposure | 149 | ||
| Reconstructive Principles | 149 | ||
| Traumatic Renal Vascular Injuries | 150 | ||
| Drains and Ureteral Stents | 151 | ||
| Postoperative Care | 151 | ||
| Suggested Readings | 153 | ||
| 18 Surgery for Renal Vascular Disease and Principles of Vascular Repair | 155 | ||
| General Vascular Surgical Principles | 155 | ||
| Surgery for Renal Vascular Disease | 155 | ||
| Surgical Indications | 156 | ||
| Renovascular Hypertension | 156 | ||
| Ischemic Nephropathy | 156 | ||
| Preoperative Preparation | 156 | ||
| Intraoperative | 156 | ||
| Aortorenal Bypass | 157 | ||
| Extraanatomic Bypass Techniques | 158 | ||
| Splenorenal Bypass | 158 | ||
| Hepatorenal Bypass | 159 | ||
| Iliorenal Bypass | 159 | ||
| Ex Vivo Repair With Autotransplant | 160 | ||
| Postoperative Care and Complications | 160 | ||
| Suggested Readings | 161 | ||
| 19 Renal Transplant Recipient | 162 | ||
| Adult | 162 | ||
| Preparation | 162 | ||
| Instruments | 162 | ||
| Position | 162 | ||
| Technique | 162 | ||
| End-to-Side Anastomosis to External Iliac Vein | 163 | ||
| End-to-End Anastomosis to Internal Iliac Artery | 163 | ||
| Alternative: End-to-Side Arterial Anastomosis | 164 | ||
| Multiple Renal Arteries | 165 | ||
| Short Right Renal Vein | 165 | ||
| Small Children’s Kidneys Into Adults | 167 | ||
| Children | 167 | ||
| Position and Incision | 167 | ||
| Technique | 167 | ||
| Ureteral Implantation | 168 | ||
| Extravesical Technique | 168 | ||
| Transvesical Technique | 170 | ||
| Double Ureter | 172 | ||
| Tubes and Drains | 172 | ||
| Operative and Postoperative Support | 172 | ||
| Postoperative Problems From Renal Transplantation | 172 | ||
| Nephrectomy After Failed Transplantation | 173 | ||
| Suggested Readings | 174 | ||
| 20 Endoscopic Management of Ureteral Strictures | 175 | ||
| Patient Selection and Preoperative Planning | 175 | ||
| Antegrade Endopyelotomy | 175 | ||
| Patient Positioning | 175 | ||
| Obtaining Percutaneous Access | 175 | ||
| Endopyelotomy Technique | 176 | ||
| Postoperative Care | 177 | ||
| Postoperative Follow-Up | 177 | ||
| Suggested Readings | 177 | ||
| 21 Percutaneous Endopyeloplasty | 178 | ||
| Technique | 178 | ||
| Conclusions | 181 | ||
| Suggested Readings | 181 | ||
| 22 Laparoscopic and Robotic Pyeloplasty | 182 | ||
| Introduction | 182 | ||
| Preoperative Evaluation and Preparation | 182 | ||
| Surgical Approach | 182 | ||
| Surgical Technique | 182 | ||
| Transperitoneal Dismembered Pyeloplasty | 182 | ||
| Operating Room, Positioning, and Access | 182 | ||
| Surgical Steps | 183 | ||
| Mobilization of Colon and Exposure of UPJ (Fig. 22.5). | 183 | ||
| Dissection of Proximal Ureter, UPJ, and Renal Pelvis (Fig. 22.6). | 183 | ||
| Transection of UPJ, Spatulation of the Ureter, and Treatment of Stones (Fig. 22.7). | 184 | ||
| Anastomosis and Ureteral Stent Placement (Figs. 22.8 through 22.12). | 185 | ||
| Drain Placement and Closure. | 186 | ||
| Special Modifications and Technical Variations | 186 | ||
| Non-Dismembered Pyeloplasty | 186 | ||
| Crossing Accessory Lower Pole Vessel | 186 | ||
| Transmesocolic Pyeloplasty | 186 | ||
| Laparoscopic/Robotic Single-Site Pyeloplasty (R-LESS) | 187 | ||
| Postoperative Care and Complications | 187 | ||
| Suggested Readings | 188 | ||
| 23 Laparoscopic Live Donor Nephrectomy | 189 | ||
| Preoperative Preparation and Planning | 189 | ||
| Preoperative Assessment | 189 | ||
| Patient Preparation | 189 | ||
| Operating Room Preparation and Instrumentation | 189 | ||
| Patient Positioning, Surgical Incision, and Operative Technique | 189 | ||
| Conventional Laparoscopic Donor Nephrectomy | 189 | ||
| Left Laparoscopic Donor Nephrectomy | 189 | ||
| Right Laparoscopic Donor Nephrectomy | 193 | ||
| Hand-Assisted Laparoscopic Donor Nephrectomy | 194 | ||
| Left Hand–Assisted Laparoscopic Donor Nephrectomy | 194 | ||
| Right Hand–Assisted Laparoscopic Donor Nephrectomy | 194 | ||
| Laparoendoscopic Single-Site Donor Nephrectomy | 194 | ||
| Technique | 195 | ||
| Robot-Assisted Laparoscopic Donor Nephrectomy | 195 | ||
| Left Robot-Assisted Laparoscopic Donor Nephrectomy | 195 | ||
| Right Robot-Assisted Laparoscopic Donor Nephrectomy | 195 | ||
| Unique and Postoperative Considerations | 196 | ||
| Adjunctive Measures Used During Laparoscopic Donor Nephrectomy | 196 | ||
| Postoperative Considerations | 196 | ||
| Conclusions | 196 | ||
| Suggested Readings | 196 | ||
| 24 Open Stone Surgery | 197 | ||
| Introduction | 197 | ||
| Anatrophic Nephrolithotomy | 197 | ||
| Preoperative Planning and Preparation | 197 | ||
| Patient Positioning and Surgical Incision | 197 | ||
| Operative Technique | 197 | ||
| Closure | 198 | ||
| Postoperative Care and Complications | 200 | ||
| Pyelolithotomy | 200 | ||
| Preoperative Preparation, Planning, Position, and Incision | 200 | ||
| Operative Technique | 200 | ||
| Extended Pyelolithotomy and Residual Calyceal Stones | 200 | ||
| Coagulum Technique | 201 | ||
| Closure | 201 | ||
| Postoperative Care and Complications | 201 | ||
| Suggested Readings | 203 | ||
| 4 Endoscopic and Percutaneous Renal Surgery | 204 | ||
| 25 Anatomic Basis for Renal Endoscopy | 204 | ||
| Pelvicalyceal System: Endourologic Implications | 204 | ||
| Anatomic Background | 204 | ||
| Findings and Clinical Implications | 204 | ||
| Presence of Perpendicular Minor Calices | 204 | ||
| Position of the Calices Relative to the Lateral Kidney Margin | 204 | ||
| Position of the Calices Relative to the Polar Regions and to the Kidney Mid-Zone | 204 | ||
| Anatomic Relationships of Intrarenal Vessels (Arteries and Veins) With the Kidney Collecting System | 206 | ||
| Relevance for the Intrarenal Access by Puncture | 206 | ||
| Material Studied for the Anatomic Background | 206 | ||
| Intrarenal Access Through an Infundibulum | 206 | ||
| Superior Pole. | 206 | ||
| Middle Kidney. | 206 | ||
| Inferior Pole. | 206 | ||
| Intrarenal Access Through the Renal Pelvis | 208 | ||
| Intrarenal Access Through a Calyceal Fornix | 208 | ||
| Relevance for Endopyelotomy | 208 | ||
| Vascular Background | 209 | ||
| Anterior Vascular UPJ Relationships | 209 | ||
| Posterior Vascular UPJ Relationships | 210 | ||
| Incision at the UPJ Stenosis Based on the Vascular Anatomy | 211 | ||
| Suggested Readings | 212 | ||
| 26 Percutaneous Renal Access | 214 | ||
| Indications | 214 | ||
| Preoperative Evaluation | 214 | ||
| Anatomic Considerations | 214 | ||
| Standard Lower Pole Access | 215 | ||
| Cystoscopy, Ureteral Catheterization | 215 | ||
| Patient Positioning | 215 | ||
| Imaging Setup—Fluoroscopic | 215 | ||
| Selection of Puncture Site and Needle Access | 215 | ||
| Placement of Access Wires | 217 | ||
| Tract Dilation | 217 | ||
| Special Access Situations | 218 | ||
| Supracostal/Upper Pole Access | 218 | ||
| Calyceal Diverticulum/Obstructed Calyx | 219 | ||
| Multiple Access | 220 | ||
| Nondilated Puncture | 220 | ||
| Miniaturization of Standard Access | 221 | ||
| Complications | 221 | ||
| Suggested Readings | 222 | ||
| 27 Percutaneous Nephrolithotomy | 223 | ||
| Indications | 223 | ||
| Preoperative Evaluation | 223 | ||
| Operating Room Setup and Equipment | 223 | ||
| Patient Positioning | 223 | ||
| Retrograde Access | 226 | ||
| Percutaneous Puncture | 226 | ||
| Nephroscopy | 228 | ||
| Stone Extraction | 228 | ||
| Manual | 228 | ||
| Lithotrites | 229 | ||
| Rigid | 229 | ||
| Ultrasonic. | 229 | ||
| Ballistic. | 229 | ||
| Combined. | 229 | ||
| Flexible | 229 | ||
| Ho:YAG Laser. | 229 | ||
| EHL. | 229 | ||
| Lithotripsy Technique | 229 | ||
| Troubleshooting | 230 | ||
| Exit Strategy—Nephrostomy Tube, Stent, or Tubeless? | 230 | ||
| Complications | 231 | ||
| Postoperation and Follow-Up | 231 | ||
| Suggested Readings | 232 | ||
| 28 Laparoscopic Access | 234 | ||
| Transperitoneal Laparoscopic Access | 234 | ||
| Choosing Sites of Access | 234 | ||
| Initial Access | 234 | ||
| Veress Needle | 234 | ||
| Open Entry Technique | 235 | ||
| Visualizing Trocar | 236 | ||
| Port Placement | 236 | ||
| Retroperitoneal Laparoscopic Access | 238 | ||
| Choosing Site of Access | 238 | ||
| Patient Positioning | 238 | ||
| Initial Access | 238 | ||
| Retroperitoneal Space Creation | 238 | ||
| Port Placement | 239 | ||
| Operative Landmarks | 239 | ||
| Suggested Readings | 240 | ||
| 29 Renal Cryosurgery | 241 | ||
| Preliminaries | 241 | ||
| Indications | 241 | ||
| Isotherms | 241 | ||
| Laparoscopic Renal Cryoablation | 241 | ||
| Instruments | 241 | ||
| Procedure (Video 29.1) | 241 | ||
| Percutaneous Renal Cryoablation | 247 | ||
| Considerations | 247 | ||
| Instruments | 247 | ||
| Procedure (Video 29.2) | 247 | ||
| Suggested Readings | 247 | ||
| 30 Renal Radiofrequency Ablation | 248 | ||
| Renal Radiofrequency Ablation | 248 | ||
| Preoperative Preparation and Planning | 248 | ||
| RFA Techniques | 248 | ||
| Percutaneous RFA | 248 | ||
| Laparoscopic RFA | 250 | ||
| Follow-Up and Complications | 250 | ||
| Follow-Up | 250 | ||
| Complications | 251 | ||
| Suggested Readings | 251 | ||
| 5 Adrenal Excision | 252 | ||
| 31 Robotic, Laparoscopic, and Open Approaches to the Adrenal Gland (Benign) | 252 | ||
| Anatomic Considerations | 252 | ||
| Preoperative Preparation and Planning | 252 | ||
| Patient Positioning, Surgical Incision, and Operative Techniques | 255 | ||
| Choice of Surgical Approach | 256 | ||
| Robotic-Assisted Laparoscopic Transperitoneal Approach | 257 | ||
| Positioning, Incisions, and Port Placement | 257 | ||
| Surgical Steps: Left | 258 | ||
| Surgical Steps: Right | 259 | ||
| Closure | 260 | ||
| Alternative Sequence: Early Venous Control | 260 | ||
| Laparoscopic Transperitoneal Approach | 260 | ||
| Positioning, Incisions, and Port Placement | 260 | ||
| Surgical Steps | 261 | ||
| Laparoscopic or Robotic Retroperitoneal Approach | 262 | ||
| Positioning | 263 | ||
| Incisions and Port Placement | 263 | ||
| Adrenal Gland Exposure | 264 | ||
| Surgical Steps: Left | 264 | ||
| Surgical Steps: Right | 264 | ||
| Closure | 265 | ||
| Open Transabdominal Approach | 265 | ||
| Surgical Steps: Left | 265 | ||
| Surgical Steps: Right | 266 | ||
| Postoperative Care and Complications | 266 | ||
| Suggested Readings | 267 | ||
| 32 Open and Laparoscopic Approaches to the Adrenal Gland (Malignant) | 268 | ||
| Preoperative Considerations | 268 | ||
| Adrenal Imaging | 268 | ||
| Computed Tomography | 268 | ||
| Magnetic Resonance Imaging | 268 | ||
| Positron Emission Tomography | 268 | ||
| Sonography | 268 | ||
| Adrenocortical Carcinoma | 268 | ||
| Pheochromocytoma | 269 | ||
| Metastasectomy | 269 | ||
| Operative Technique | 269 | ||
| Open Adrenal Excision | 269 | ||
| Transabdominal Approach | 269 | ||
| Thoracoabdominal Approach | 270 | ||
| Laparoscopic Adrenal Excision | 270 | ||
| Transabdominal Laparoscopic Approach | 270 | ||
| Postoperative Care and Complications | 272 | ||
| Suggested Readings | 274 | ||
| 6 Ureteral Reconstruction and Excision | 275 | ||
| 33 Ureteroneocystostomy | 275 | ||
| Approach to the Bladder | 275 | ||
| Transvesical Techniques | 275 | ||
| Ureteral Mobilization (Fig. 33.2) | 275 | ||
| Intraextravesical (Politano-Leadbetter) Technique (Fig. 33.3) | 275 | ||
| Modification of the Intraextravesical (Politano-Leadbetter) Technique | 277 | ||
| Ureteral Advancement (Glenn-Anderson) Technique (Fig. 33.4) | 277 | ||
| Transtrigonal (Cohen) Technique | 277 | ||
| Unilateral Ureteroneocystostomy (Fig. 33.5) | 277 | ||
| Bilateral Ureteroneocystostomy (Fig. 33.6) | 280 | ||
| Sheath Approximation (Gil Vernet) Technique | 281 | ||
| Spatulated Nipple Technique (Fig. 33.7) | 281 | ||
| Choice of Transvesical Technique (Fig. 33.8) | 281 | ||
| Extravesical Techniques | 282 | ||
| Extravesical Tunnel, Open (Lich-Gregoir) Technique (Fig. 33.9) | 282 | ||
| External Tunnel (Barry) Technique (Fig. 33.10) | 282 | ||
| Detrusorrhaphy (Hodgson-Firlit-Zaontz Technique) (Fig. 33.11) | 284 | ||
| Intraextravesical Technique (Paquin) | 284 | ||
| Postoperative Problems | 284 | ||
| Obstruction | 284 | ||
| Persistent or Recurrent Vesicoureteral Reflux | 287 | ||
| Contralateral Vesicoureteral Reflux | 288 | ||
| Reoperation | 288 | ||
| Psoas Hitch | 288 | ||
| Complications | 289 | ||
| Acknowledgment | 290 | ||
| Suggested Readings | 290 | ||
| 34 Bladder Flap Repair (Boari) | 291 | ||
| Suggested Readings | 293 | ||
| 35 Ureteral Stricture Repair and Ureterolysis | 294 | ||
| Ureteroureterostomy | 294 | ||
| Transureteroureterostomy | 294 | ||
| Graft and Flap Ureteroplasty | 294 | ||
| Ureterolysis | 296 | ||
| Laparoscopic Ureterolysis | 296 | ||
| Omental Wrap | 299 | ||
| Suggested Readings | 301 | ||
| 36 Ureteroureterostomy and Transureteroureterostomy | 302 | ||
| Preoperative Preparation and Planning | 302 | ||
| Patient Positioning and Surgical Incision | 302 | ||
| Operative Technique | 302 | ||
| Ureteroureterostomy | 302 | ||
| Transureteroureterostomy | 302 | ||
| Postoperative Care and Complications | 303 | ||
| Suggested Readings | 305 | ||
| 37 Ileal Ureteral Replacement | 306 | ||
| Patient Preparation | 306 | ||
| Incision and Identification of Ureteral Defect | 306 | ||
| Intact, Isoperistaltic Ileal Segment | 306 | ||
| Yang-Monti Tube | 307 | ||
| Bilateral Ureteral Replacement | 308 | ||
| Postoperative Management | 308 | ||
| Suggested Readings | 309 | ||
| 38 Ureterolithotomy | 310 | ||
| Preoperative Planning | 310 | ||
| Open Ureterolithotomy | 310 | ||
| Laparoscopic Ureterolithotomy | 310 | ||
| Cystourethroscopy | 310 | ||
| Proximal Ureter | 310 | ||
| Distal Ureter | 310 | ||
| Stone Removal | 311 | ||
| Postoperative Problems and Follow-Up | 313 | ||
| Suggested Readings | 314 | ||
| 39 Endoscopic Management of Vesicoureteral Reflux | 315 | ||
| Preparation | 315 | ||
| Double Hydrodistention Implantation Technique | 315 | ||
| Complications of Endoscopic Injection | 315 | ||
| Suggested Readings | 317 | ||
| 7 Endoscopic Ureteral Surgery | 318 | ||
| 40 Ureteroscopic Instrumentation | 318 | ||
| Preoperative Preparation and Planning | 318 | ||
| Patient Positioning and Equipment Positioning | 318 | ||
| Operative Technique: Instruments Required | 318 | ||
| Cystoscopes | 318 | ||
| Guidewires | 318 | ||
| Catheters | 319 | ||
| Ureteral Dilators | 319 | ||
| Ureteral Access Sheaths | 319 | ||
| Ureteroscopes | 320 | ||
| Intracorporeal Lithotriptors | 321 | ||
| Basket and Stone Retrieval Devices | 321 | ||
| Ureteral Occluding Devices | 321 | ||
| Postoperative Drainage | 323 | ||
| Conclusion | 323 | ||
| Suggested Readings | 323 | ||
| 41 Ureteroscopic Management of Ureteral Calculi | 325 | ||
| Ureteroscopy for Lower Ureteral Stones (Below Iliac Vessels) | 325 | ||
| Ureteroscopy for Upper Ureteral Stones (Above Iliac Vessels) | 326 | ||
| Suggested Readings | 328 | ||
| 42 Ureteroscopic Management of Renal Calculi | 329 | ||
| Preoperative Planning and Considerations | 329 | ||
| Operative Technique | 329 | ||
| Postoperative Care | 330 | ||
| Conclusions | 330 | ||
| Suggested Readings | 330 | ||
| 43 Ureteroscopic Endopyelotomy and Endoureterotomy | 332 | ||
| Patient Selection | 332 | ||
| Preoperative Preparation | 332 | ||
| Ureteroscopic Endopyelotomy: the Procedure | 332 | ||
| Holmium:Yttrium-Aluminum-Garnet Laser | 332 | ||
| Electrocautery | 335 | ||
| Cold Knife | 335 | ||
| Ureteroscopic Endoureterotomy: the Procedure | 335 | ||
| Ureteroscopic Treatment of Ureteroenteric Strictures: The Procedure | 336 | ||
| Postoperative Care | 336 | ||
| Suggested Readings | 337 | ||
| 44 Ureteroscopic Management of Upper Tract Urothelial Carcinoma | 338 | ||
| Preoperative Planning | 338 | ||
| Endoscopic Technique | 338 | ||
| Posttreatment and Surveillance | 340 | ||
| Suggested Readings | 342 | ||
| 45 Endoscopic Incision of Ureteroceles | 343 | ||
| Preoperative Preparation and Planning | 343 | ||
| Patient Positioning and Surgical Incision: Dorsal Lithotomy | 343 | ||
| Operative Technique | 343 | ||
| Postoperative Care and Complications | 344 | ||
| Suggested Reading | 344 | ||
| 8 Bladder: Excision | 345 | ||
| 46 Transurethral Resection of Bladder Tumors | 345 | ||
| Transurethral Resection | 345 | ||
| Postoperative Problems | 346 | ||
| Suggested Readings | 346 | ||
| 47 Partial Cystectomy | 347 | ||
| Preoperative Preparation and Planning | 347 | ||
| Patient Positioning and Surgical Incision | 347 | ||
| Operative Technique | 348 | ||
| Postoperative Care | 351 | ||
| Postoperative Complications | 351 | ||
| Suggested Readings | 352 | ||
| 48 Radical Cystectomy in Male Patients | 353 | ||
| Preoperative Preparation and Planning | 353 | ||
| Instruments and Sutures | 353 | ||
| Patient Positioning and Surgical Incision | 353 | ||
| Position | 353 | ||
| Sterile Preparation | 354 | ||
| Incision | 354 | ||
| Operative Technique | 354 | ||
| Mobilization of Bowel and Exposure | 354 | ||
| Identification and Dissection of the Ureters | 354 | ||
| Division of Posterior Plane and Pedicles | 355 | ||
| Anterior Dissection and Urethral Dissection | 356 | ||
| Urethrectomy | 356 | ||
| Nerve-Sparing Modifications | 356 | ||
| Preparation for Orthotopic Urinary Diversion | 357 | ||
| Remove the Specimen | 357 | ||
| Postoperative Care and Complications | 357 | ||
| Suggested Readings | 359 | ||
| 49 Radical Cystectomy in Female Patients | 360 | ||
| Preoperative Preparation and Planning | 360 | ||
| Patient Positioning and Surgical Incision | 360 | ||
| Operative Technique | 360 | ||
| Mobilization of Bowel and Exposure | 360 | ||
| Identification of Ureters | 360 | ||
| Posterior Dissection | 360 | ||
| Division of Posterolateral Pedicle | 360 | ||
| Anterior Dissection and Urethral Dissection With Urethrectomy | 362 | ||
| Vaginal-Sparing Approach | 362 | ||
| Orthotopic Urinary Diversion | 363 | ||
| Final Steps | 363 | ||
| Postoperative Care | 365 | ||
| Suggested Readings | 365 | ||
| 50 Urethrectomy | 366 | ||
| Urethrectomy in the Male | 366 | ||
| Postoperative Problems | 369 | ||
| Urethrectomy in the Female | 370 | ||
| Treatment of Distal Urethral Tumors | 370 | ||
| Complications | 370 | ||
| Suggested Readings | 370 | ||
| 51 Pelvic Lymphadenectomy | 372 | ||
| Lymphadenectomy in the Male | 372 | ||
| Lymphadenectomy in the Female Pelvis | 373 | ||
| Postoperative Problems | 373 | ||
| Lymphocele | 373 | ||
| Nerve Injury | 374 | ||
| Thrombus Formation | 374 | ||
| Pelvic Exenteration | 375 | ||
| Preoperative Preparation: | 375 | ||
| Total Pelvic Exenteration in Male Patients | 376 | ||
| Total Pelvic Exenteration in Female Patients | 383 | ||
| Postoperative Problems | 383 | ||
| Lymphocele | 383 | ||
| Nerve Injury | 383 | ||
| Thrombus Formation | 383 | ||
| Suggested Readings | 384 | ||
| 52 Excision of Vesical Diverticulum | 385 | ||
| Preoperative Management | 385 | ||
| Combined Intravesical and Extravesical Approach | 385 | ||
| Intravesical Approach | 386 | ||
| Robotic and Laparoscopic Diverticulectomy | 389 | ||
| Suggested Readings | 390 | ||
| 53 Cystolithotomy | 391 | ||
| Indications | 391 | ||
| Technique | 391 | ||
| Suggested Readings | 392 | ||
| 54 Laparoscopic/Robotic Radical Cystectomy | 393 | ||
| Patient and Preoperative Preparation | 393 | ||
| Preoperative Preparation and Checklist | 393 | ||
| Anesthesia and Patient Positioning | 393 | ||
| Positioning of Operating Room Equipment and Personnel | 393 | ||
| Technique | 393 | ||
| Port Placement | 393 | ||
| Mobilization of the Sigmoid and Left Colon | 394 | ||
| Development of the Left Paravesical Space | 394 | ||
| Identification, Mobilization and Division of the Left Ureter | 394 | ||
| Identification of the Left Iliac Vessels | 394 | ||
| Perform the Left Pelvic Lymphadenectomy | 394 | ||
| Development of the Right Paravesical Space | 395 | ||
| The Right Ureter and Right Pelvic Lymphadenectomy | 395 | ||
| Identification, Ligation, and Division of the Superior Vesical Arteries | 396 | ||
| Tagging Both Ureters | 396 | ||
| Transferring the Left Ureter Through the Sigmoid Mesentery | 396 | ||
| Tagging the Distal Ileum | 396 | ||
| Development of the Prerectal and Posterior Vesical Space | 396 | ||
| Division of the Remaining Inferior Vesical Vessels | 399 | ||
| Preservation of the Neurovascular Bundles | 400 | ||
| Mobilizing the Urachus | 400 | ||
| Ligating the Dorsal Venous Complex | 401 | ||
| Dissection, Ligation, and Division of the Urethra | 401 | ||
| Specimen Extraction | 401 | ||
| Creation of Ileal Conduit or Neobladder Urinary Diversion | 402 | ||
| Placement of Abdominal Drains or Suprapubic Tube | 402 | ||
| Robot-Assisted Cystectomy in Female Patients | 402 | ||
| Management of the Urethra | 402 | ||
| Division of the Infundibulopelvic Ligament | 402 | ||
| Hysterectomy, Bilateral Salpingo-Oophorectomy, and Vaginal Dissection | 402 | ||
| Posterior Dissection of the Bladder | 402 | ||
| Vaginal Reconstruction | 403 | ||
| Postoperative Care | 403 | ||
| Suggested Readings | 403 | ||
| 9 Continent Reconstruction | 404 | ||
| 55 Ileocecal Reservoir | 404 | ||
| Introduction and Historical Perspective | 404 | ||
| Preoperative Planning and Indications and Contraindications to the Indiana Pouch | 404 | ||
| Surgical Technique for the Indiana Pouch | 405 | ||
| Blood Supply | 405 | ||
| Mobilization of Right Colon | 405 | ||
| Appendectomy | 405 | ||
| Opening the Right Colon | 405 | ||
| Tapering of Catheterizable Efferent Limb | 405 | ||
| Continence Mechanism | 405 | ||
| Ureteroenteric Anastomoses | 406 | ||
| Maturing the Catheterizable Channel to the Anterior Abdominal Wall | 407 | ||
| Postoperative Management | 408 | ||
| Postoperative Complications | 409 | ||
| Early Complications | 409 | ||
| Late Complications | 409 | ||
| Special Considerations: Catheter Teaching and Routine | 409 | ||
| Suggested Readings | 409 | ||
| 56 Appendicovesicostomy | 410 | ||
| Implantation Into the Bladder | 410 | ||
| Stomal Maturation | 411 | ||
| Alternative to the Appendix: Transversely Tubularized Bowel Segments (Yang-Monti Channel) | 411 | ||
| Postoperative Problems | 411 | ||
| Suggested Readings | 412 | ||
| 57 Ureterosigmoidostomy and Mainz Pouch II | 413 | ||
| Background | 413 | ||
| Patient Selection | 413 | ||
| Preoperative Preparation | 413 | ||
| Surgical Technique | 413 | ||
| Ureterosigmoidostomy (Goodwin Technique) | 413 | ||
| Mainz Pouch II (Sigma Rectum Pouch) | 415 | ||
| Intraoperative Decision Making | 423 | ||
| Troubleshooting | 423 | ||
| Postoperative Care | 424 | ||
| Outcomes | 424 | ||
| Suggested Readings | 424 | ||
| 58 Ileal Orthotopic Bladder Substitution | 425 | ||
| Patient Selection | 425 | ||
| Preoperative Patient Preparation | 425 | ||
| Surgical Technique | 425 | ||
| Preparation of the Ileal Segment for the Bladder Substitute | 426 | ||
| Ureteroileal Anastomosis | 426 | ||
| Construction of the Bladder Substitute | 428 | ||
| Postoperative Care | 429 | ||
| Experience and Complications | 429 | ||
| Renal Function | 430 | ||
| Functional Outcome | 430 | ||
| Suggested Readings | 430 | ||
| 59 Robotic Urinary Diversion | 431 | ||
| Preoperative Preparation | 431 | ||
| Patient Positioning and Port Placement | 431 | ||
| Operative Technique | 432 | ||
| Radical Cystectomy | 432 | ||
| Mobilization and Division of the Ureters | 432 | ||
| Retrovesical Dissection in Male Patients | 432 | ||
| Lateral Dissection of the Bladder and Control of Vascular Pedicles | 432 | ||
| Anterior Dissection, Control of the Dorsal Vein Complex, and Transection of the Urethra | 432 | ||
| Anterior Pelvic Exenteration in Female Patients | 434 | ||
| Extended Lymphadenectomy | 435 | ||
| Robotic Ileal Conduit Urinary Diversion | 437 | ||
| Distal Ileal Division | 437 | ||
| Defining the Conduit, Proximal Ileal Division, and Discard Segment | 438 | ||
| Restoration of Bowel Continuity | 438 | ||
| Ureteroenteric Anastomoses | 440 | ||
| Fashioning the Stoma and Exiting the Abdomen | 440 | ||
| Robotic Orthotopic Ileal Neobladder | 441 | ||
| Measurement of Bowel Segments | 441 | ||
| Bowel Division and Discard Segment | 442 | ||
| Bowel Detubularization and Creation of the Posterior Plate | 443 | ||
| Urethra-to-Pouch Anastomosis and Cross-Folding of the Pouch | 444 | ||
| Ureteral-Afferent Limb Anastomoses | 445 | ||
| Testing the Pouch and Laparoscopic Exit | 445 | ||
| Robotic Continent Cutaneous Diversion: Indiana Pouch | 445 | ||
| Positioning and Port Placement | 445 | ||
| Bowel Division and Restoration of Continuity | 447 | ||
| Detubularization of the Colonic Segment and Creation of the Posterior Plate | 451 | ||
| Ureteral Anastomosis and Closure of the Pouch | 451 | ||
| Tailoring of the Efferent Limb and Creation of the Stoma | 452 | ||
| Laparoscopic Exit and Drains | 452 | ||
| Postoperative Care | 452 | ||
| Outcomes and Complications | 454 | ||
| Suggested Readings | 456 | ||
| 10 Bladder Augmentation | 457 | ||
| 60 Ileocystoplasty | 457 | ||
| Ileocystoplasty Technique | 457 | ||
| Postoperative Care | 457 | ||
| Suggested Readings | 460 | ||
| 61 Colocystoplasty | 461 | ||
| Technique | 461 | ||
| Results | 461 | ||
| Conclusions | 464 | ||
| Suggested Readings | 464 | ||
| 62 Ureterocystoplasty | 465 | ||
| Technique | 465 | ||
| Summary | 467 | ||
| Suggested Reading | 467 | ||
| 11 Vesicovaginal Fistula Repair | 469 | ||
| 63 Transvaginal Repair of Vesicovaginal Fistula | 469 | ||
| Preoperative Preparation and Planning | 469 | ||
| Patient Positioning and Surgical Incision | 469 | ||
| Instruments | 469 | ||
| Patient Positioning and Exposure | 469 | ||
| Operative Technique | 469 | ||
| Important Concepts | 469 | ||
| Traditional Approach | 470 | ||
| Approach Using Excision of Cuff Scar | 470 | ||
| Latzko Procedure | 470 | ||
| Obstetric Fistula | 472 | ||
| Use of Flaps | 472 | ||
| Peritoneal Flap | 472 | ||
| Labial Fat Pad Flap or Modified Martius Flap | 472 | ||
| Island Flap (Lehoczky) | 472 | ||
| Gracilis Myocutaneous Flap | 473 | ||
| Postoperative Care and Complications | 473 | ||
| Suggested Readings | 473 | ||
| 64 Transvesical Repair of Vesicovaginal Fistula | 474 | ||
| Timing | 474 | ||
| Preoperative Preparation and Planning | 474 | ||
| Instruments | 474 | ||
| Patient Positioning | 474 | ||
| Operative Technique | 474 | ||
| Open Approach | 474 | ||
| Incision | 474 | ||
| O’Conor Technique | 475 | ||
| Gil-Vernet Technique | 475 | ||
| Minimally Invasive Options | 475 | ||
| Robotic Approach | 475 | ||
| Instruments. | 475 | ||
| Port Placement. | 475 | ||
| Vesicovaginal Approach | 475 | ||
| Extravesical Approach | 475 | ||
| Bladder Closure | 475 | ||
| Postoperative Care and Complications | 478 | ||
| Suggested Readings | 478 | ||
| 65 Transperitoneal Vesicovaginal Fistula Repair | 479 | ||
| Suggested Readings | 482 | ||
| 66 Female Vesical Neck Closure | 483 | ||
| Indications | 483 | ||
| Preoperative Evaluation | 483 | ||
| Abdominal Approach | 483 | ||
| Urethral Approach | 484 | ||
| Vaginal Approach | 486 | ||
| Postoperative Care | 486 | ||
| Complications | 489 | ||
| Suggested Readings | 489 | ||
| 12 Prostate: Benign | 491 | ||
| 67 Transurethral Resection and Transurethral Incision of the Prostate | 491 | ||
| Indications | 491 | ||
| Preoperative Management of TURP and TUIP | 491 | ||
| Patient Positioning | 491 | ||
| TURP Surgical Procedure | 491 | ||
| TURP Technique | 492 | ||
| TURP Complications and Their Management | 495 | ||
| Postoperative Management | 496 | ||
| Clinical Efficacy | 496 | ||
| TUIP Surgical Procedure | 496 | ||
| Complications | 498 | ||
| TUIP Postoperative Management | 498 | ||
| Suggested Readings | 499 | ||
| 68 Laser Treatment of Benign Prostatic Disease | 500 | ||
| Introduction | 500 | ||
| Basics of Laser Therapy for Benign Prostatic Hyperplasia | 500 | ||
| Techniques of Surgical Laser Removal of Prostatic Tissue | 500 | ||
| Holmium Laser Enucleation of the Prostate | 500 | ||
| Potassium Titanyl Phosphate Photovaporization of the Prostate | 500 | ||
| Preoperative Preparation and Planning | 500 | ||
| Anesthetic Techniques | 502 | ||
| Patient Positioning | 502 | ||
| Operative Technique: Enucleation | 502 | ||
| Holmium Laser Settings | 502 | ||
| Inspection of the Bladder and Prostatic Fossa | 502 | ||
| Bladder Neck Incision and Enucleation of the Median Lobe | 502 | ||
| Lateral Lobe Enucleation | 503 | ||
| Incision of the Anterior Commissure | 503 | ||
| Division of the Apical Mucosal Bridge | 504 | ||
| Completion of the Lateral Lobe Enucleation | 505 | ||
| Tissue Morcellation | 505 | ||
| Final Inspection of the Prostatic Fossa | 506 | ||
| Postoperative Care | 506 | ||
| Operative Technique: Vaporization | 506 | ||
| Greenlight Laser and Laser Settings | 506 | ||
| Inspection of the Bladder and Prostatic Fossa | 507 | ||
| Lateral Grooves to the Capsule | 507 | ||
| Laser Vaporization of the Median Lobe and Lateral Lobes | 507 | ||
| Obtaining Hemostasis | 508 | ||
| Case Conclusion | 508 | ||
| Postoperative Care | 508 | ||
| Complications | 508 | ||
| Perioperative | 508 | ||
| Long-Term Results | 509 | ||
| Transurethral Incision of the Prostate | 509 | ||
| Technique | 509 | ||
| Conclusions | 509 | ||
| Suggested Readings | 509 | ||
| 69 Suprapubic Prostatectomy | 510 | ||
| Preoperative Considerations | 510 | ||
| Procedure | 510 | ||
| Positioning and Prep (Fig. 69.1) | 510 | ||
| Incision and Exposure | 510 | ||
| Cystotomy and Exposure | 511 | ||
| Dissection and Removal of the Adenoma | 511 | ||
| Hemostasis and Repair | 511 | ||
| Intraoperative Hemostatic Procedures | 516 | ||
| Capsular Plication (O’Conor) | 517 | ||
| Purse-String Partition Closure (Malament) | 517 | ||
| Postoperative Care | 517 | ||
| Postoperative Complications | 517 | ||
| Suggested Readings | 518 | ||
| 70 Retropubic Prostatectomy | 519 | ||
| Preoperative Management | 519 | ||
| Positioning and Approach | 519 | ||
| Incision | 519 | ||
| Transverse Capsular Incision (Millin Technique) | 519 | ||
| Enucleation of Adenoma | 519 | ||
| Trigonization of the Bladder Neck | 522 | ||
| Closure of the Capsule | 522 | ||
| Alternative Capsular Incision (Vesicocapsular Technique) | 523 | ||
| Enucleation of the Adenoma | 523 | ||
| Trigonization of the Bladder Neck | 523 | ||
| Closure of the Bladder and Capsule | 526 | ||
| Postoperative Management | 527 | ||
| Suggested Readings | 527 | ||
| 71 Laparoscopic and Robotic Simple Prostatectomy | 528 | ||
| Patient Preparation | 528 | ||
| Indications | 528 | ||
| Preoperative Preparation and Planning | 528 | ||
| Laparoscopic Approach | 528 | ||
| Endoscope, Instruments, and Surgical Materials | 528 | ||
| Positioning of Equipment and Personnel in the Operating Room | 528 | ||
| Patient Positioning | 528 | ||
| Surgical Technique | 528 | ||
| Placement of Trocars | 528 | ||
| Access to the Pre-Bladder Space | 529 | ||
| Prostatic Capsule Incision and Dissection of the Adenoma | 529 | ||
| Adenoma Removal and Trigonization of the Fossa | 532 | ||
| Closing and Drain Placement | 533 | ||
| Robotic Approach | 533 | ||
| Patient Positioning | 533 | ||
| Positioning Equipment and Personnel in the Operating Room | 533 | ||
| Endoscope, Instruments, and Surgical Materials | 533 | ||
| Surgical Technique | 533 | ||
| Trocar Placement | 534 | ||
| Development of the Extraperitoneal Space | 534 | ||
| Prostatic Capsule Incision and Dissection of the Adenoma | 535 | ||
| Removing the Adenoma and Trigonization of the Fossa | 535 | ||
| Closing and Drain Placement | 538 | ||
| Complications | 538 | ||
| Postoperative Care | 539 | ||
| Suggested Readings | 539 | ||
| 13 Prostate: Malignancy | 540 | ||
| 72 Anatomy and Principles of Excision of the Prostate | 540 | ||
| Surgical Approaches | 540 | ||
| Relationship to Adjacent Structures | 540 | ||
| Arterial Blood Supply to the Prostate | 540 | ||
| Venous Drainage of the Prostate | 542 | ||
| Lymphatic Drainage | 542 | ||
| Innervation | 542 | ||
| Pelvic Fascia | 544 | ||
| Suggested Readings | 545 | ||
| 73 Transrectal Ultrasound-Directed Prostate Biopsy | 546 | ||
| Indications | 546 | ||
| Preprocedural Management | 546 | ||
| Antibiotics | 546 | ||
| Equipment | 546 | ||
| TRUS Probe | 546 | ||
| Prostate Biopsy Device | 546 | ||
| Surgical Procedure, 12-Core Prostate Biopsy | 546 | ||
| Setting | 546 | ||
| Positioning | 546 | ||
| Probe Insertion and Orientation | 546 | ||
| Prostate Nerve Block | 547 | ||
| Prostate Volume Measurement | 547 | ||
| Prostate Biopsy | 547 | ||
| Special Consideration During Apical Biopsy | 550 | ||
| Postprocedural Management | 550 | ||
| Complications | 550 | ||
| Suggested Readings | 551 | ||
| 74 Transperineal Prostate Biopsy | 552 | ||
| Preoperative Preparation and Planning | 552 | ||
| Patient Positioning and Surgical Incision | 552 | ||
| Operative Technique | 552 | ||
| Postoperative Care and Complications | 555 | ||
| Future Developments | 556 | ||
| Tips and Tricks | 556 | ||
| Suggested Readings | 556 | ||
| 75 Prostate Biopsy With MR Fusion | 557 | ||
| Indications for MR-Fusion Prostate Biopsy | 557 | ||
| MR Imaging, Prostate Contouring, Three-Dimensional Reconstruction of the Prostate and Identification of Regions of Interest for Biopsy | 557 | ||
| MR-Fusion Biopsy Platforms | 557 | ||
| Patient Preparation and Positioning for Biopsy | 558 | ||
| Ultrasonic Evaluation of the Prostate and Injection of Local Anesthetic | 559 | ||
| Real-Time Ultrasonic Image Capture and Prostate Segmentation, Followed by Global Alignment of the MR and Ultrasound Images | 559 | ||
| Prostate Biopsy Mapping and Biopsy | 559 | ||
| Suggested Readings | 561 | ||
| 76 Radical Retropubic Prostatectomy | 562 | ||
| Instruments | 562 | ||
| Position | 562 | ||
| Operative Technique | 562 | ||
| Incision | 562 | ||
| Exposure | 562 | ||
| Retractor Placement | 562 | ||
| Pelvic Node Dissection | 562 | ||
| Endopelvic Fascia | 562 | ||
| Incising the Puboprostatic Ligaments | 564 | ||
| Bunching of the Dorsal Venous Complex | 564 | ||
| Division of the Dorsal Venous Complex | 564 | ||
| Apical Prostatic Dissection | 565 | ||
| Division of the Anterior Urethra | 565 | ||
| Placement of the Urethral Sutures | 566 | ||
| Division of the Posterior Urethra and Rectourethralis Muscle | 566 | ||
| Preservation and Dissection of the Neurovascular Bundles | 566 | ||
| Ligation of Lateral Prostatic Pedicles | 567 | ||
| Dissection of the Seminal Vesicles and Vas Deferens | 568 | ||
| Bladder Neck Dissection | 568 | ||
| Bladder Neck Reconstruction | 569 | ||
| Bladder Neck Anastomosis | 569 | ||
| Alternative Urethral Suture Method | 569 | ||
| Drain Placement and Wound Closure | 569 | ||
| Perioperative and Postoperative Care | 569 | ||
| Intraoperative Problems | 569 | ||
| Postoperative Problems | 571 | ||
| Suggested Readings | 572 | ||
| 77 Radical Perineal Prostatectomy | 573 | ||
| Preoperative Preparation and Planning | 573 | ||
| Instruments and Equipment | 573 | ||
| Surgical Approach | 573 | ||
| Step 1: Positioning | 573 | ||
| Step 2: Incision | 573 | ||
| Step 3: Division of Central Tendon | 573 | ||
| Step 4: Rectal Isolation and Mobilization | 574 | ||
| Step 5: Division of the Rectourethralis | 574 | ||
| Step 6: Thompson Retractor and Pearly Gates of Young | 575 | ||
| Step 7: Nerve Sparing | 575 | ||
| Unilateral or Wide Dissection | 575 | ||
| Step 8: Apical Dissection | 577 | ||
| Step 9: Division of the Puboprostatic Ligament | 577 | ||
| Step 10: Bladder Neck Dissection | 577 | ||
| Step 11: Prostate Pedicles and Seminal Vesicles | 578 | ||
| Step 12: Vesicourethral Anastomosis | 580 | ||
| Step 13: Closure | 581 | ||
| Postoperative Care | 582 | ||
| Suggested Readings | 582 | ||
| 78 Pelvic Lymph Node Dissection | 583 | ||
| Preoperative Considerations | 583 | ||
| Overview | 583 | ||
| Anatomical Templates | 583 | ||
| Minimal Number of LNs for an Adequate PLND | 583 | ||
| Therapeutic Benefit | 584 | ||
| Patient Positioning, Surgical Incision, and Operative Technique | 584 | ||
| Open Standard PLND | 584 | ||
| Instruments | 584 | ||
| Position | 584 | ||
| Incision | 585 | ||
| Exposure | 585 | ||
| Retractor Placement | 585 | ||
| Standard PLND | 585 | ||
| Hemostasis | 586 | ||
| Robot-Assisted Standard PLND | 586 | ||
| Instruments | 586 | ||
| Position | 586 | ||
| Incision | 586 | ||
| Port Placement | 588 | ||
| Exposure and Retraction | 588 | ||
| Standard PLND | 589 | ||
| Salvage PLND | 589 | ||
| Complications and Postoperative Care | 593 | ||
| Intraoperative Complications | 593 | ||
| Postoperative Complications | 594 | ||
| Postoperative Care | 594 | ||
| Acknowledgments | 594 | ||
| Suggested Readings | 594 | ||
| 79 Robotic-Assisted Laparoscopic Prostatectomy | 596 | ||
| Surgical Technique | 596 | ||
| Patient Positioning | 596 | ||
| Port Placement | 596 | ||
| Points of Technique: Initial Access to the Abdominal Cavity | 596 | ||
| Exposure of the Prostate | 596 | ||
| Points of Technique: Bladder Retraction Suture | 597 | ||
| Points of Technique: Opening of Endopelvic Fascia | 598 | ||
| Control of the Dorsal Vein Complex | 598 | ||
| Dissection of the Bladder Neck | 598 | ||
| Points of Technique: Large Middle Lobes | 600 | ||
| Seminal Vesicle Dissection | 600 | ||
| Point of Technique: Athermal Seminal Vesicle Dissection | 600 | ||
| Development of the Posterior Plane | 601 | ||
| Preservation of the Neurovascular Bundle | 601 | ||
| Points of Technique | 602 | ||
| Control of the Pedicle | 602 | ||
| Division of the Urethra | 603 | ||
| Points of Technique: Retraction of the Prostate | 603 | ||
| Vesicourethral Anastomosis | 603 | ||
| Points of Technique: Posterior Reconstruction Prior to Vesicourethral Anastomosis | 604 | ||
| Extended Pelvic Lymphadenectomy | 604 | ||
| Undocking of the Robot and Wound Closure | 605 | ||
| Postoperative Care | 605 | ||
| Salvage Robotic Prostatectomy | 605 | ||
| Points of Technique: Salvage Robotic Prostatectomy | 605 | ||
| Suggested Readings | 605 | ||
| 80 Cryotherapy | 606 | ||
| Mechanism of Action of Cryoablation | 606 | ||
| Patient Selection | 606 | ||
| Equipment | 606 | ||
| Intraoperative Ultrasound | 606 | ||
| Thermocouples / Thermosensors | 606 | ||
| Computer | 608 | ||
| Preoperative Preparation | 608 | ||
| Intraoperative Patient Preparation and Positioning | 608 | ||
| Freezing–Thawing Cycles | 610 | ||
| Postoperative Care | 610 | ||
| Suggested Readings | 610 | ||
| 81 Focal Therapies in the Treatment of Prostate Cancer | 611 | ||
| Transperineal Template Biopsy | 611 | ||
| Preparation | 611 | ||
| Indications | 611 | ||
| Anesthesia | 611 | ||
| Antibiotic Prophylaxis | 612 | ||
| Antiplatelets and Anticoagulants | 612 | ||
| Enema | 612 | ||
| Technique | 612 | ||
| Patient Position | 612 | ||
| Urethral Catheter | 612 | ||
| Probe | 612 | ||
| Sampling | 612 | ||
| Complications | 613 | ||
| Focal Therapy Procedural Techniques | 613 | ||
| High-Intensity Focused Ultrasound | 613 | ||
| HIFU Treatment Devices | 614 | ||
| Indications | 615 | ||
| Preparation | 615 | ||
| Bowel Preparation | 616 | ||
| Antimicrobial Prophylaxis | 616 | ||
| Anesthesia | 616 | ||
| Technique | 616 | ||
| Postoperative Management | 616 | ||
| Complications | 617 | ||
| Cryotherapy | 617 | ||
| Indications | 617 | ||
| Preparation | 617 | ||
| Bowel Preparation | 617 | ||
| Antimicrobial Prophylaxis | 617 | ||
| Anesthesia | 617 | ||
| Technique | 617 | ||
| Probe Placement | 617 | ||
| Thermal Monitoring Placement | 618 | ||
| Postoperative Management | 618 | ||
| Complications | 618 | ||
| Radiofrequency Ablation | 619 | ||
| Indications | 619 | ||
| Preparation | 619 | ||
| Bowel Preparation | 619 | ||
| Antimicrobial Prophylaxis | 619 | ||
| Anesthesia | 619 | ||
| Technique | 620 | ||
| Postoperative Management | 620 | ||
| Complications | 620 | ||
| Follow-Up | 620 | ||
| Vascular-Activated Photodynamic Therapy | 620 | ||
| 14 Female Genital Reconstruction | 629 | ||
| 83 Vaginal Reconstruction | 629 | ||
| Intestinal Vaginoplasty | 629 | ||
| Preoperative Preparation and Planning | 629 | ||
| Patient Positioning and Surgical Incision | 630 | ||
| Operative Technique | 630 | ||
| Postoperative Care and Complications | 632 | ||
| Suggested Readings | 633 | ||
| 84 Urethrovaginal Fistula Repair | 634 | ||
| Preoperative Preparation and Planning | 634 | ||
| Patient Positioning and Operative Technique | 634 | ||
| Postoperative Care and Complications | 636 | ||
| Suggested Readings | 637 | ||
| 85 Bulbocavernosus Muscle and Fat Pad Supplement | 638 | ||
| Labial Fibrofatty Tissue Flap/Modified Martius Flap | 638 | ||
| In Situ Martius Flap | 641 | ||
| Combined Martius and Labial Flap | 642 | ||
| Labial Island Flap | 644 | ||
| Suggested Readings | 645 | ||
| 86 Female Urethral Diverticulum | 647 | ||
| Introducton | 647 | ||
| Diagnosis | 647 | ||
| Signs and Symptoms | 647 | ||
| Physical Examination | 647 | ||
| Radiologic and Cystoscopic Evaluation | 647 | ||
| Indications for Surgery | 647 | ||
| Alternative Therapy | 647 | ||
| Marsupialization (Spence-Duckett) | 647 | ||
| Preoperative Preparation and Planning | 647 | ||
| Operative Technique | 648 | ||
| Postoperative Care and Complications | 653 | ||
| Suggested Readings | 654 | ||
| 87 Female Urethral Reconstruction | 655 | ||
| Distal Urethral Reconstruction | 655 | ||
| Distal Urethrectomy With Advancement Meatoplasty | 655 | ||
| 15 Urethral: Reconstruction | 686 | ||
| 92 Reconstruction of the Fossa Navicularis | 686 | ||
| Skin Flap Techniques | 686 | ||
| Cohney | 686 | ||
| Blandy-Tresidder | 686 | ||
| Brannen | 686 | ||
| De Sy | 686 | ||
| Transverse Ventral Skin Island Technique | 686 | ||
| Jordan | 686 | ||
| Graft Techniques | 689 | ||
| Devine | 689 | ||
| Other Modifications | 689 | ||
| Combined Flap and Graft Technique (Single-Stage) | 690 | ||
| Gelman | 690 | ||
| Staged Technique | 690 | ||
| Suggested Readings | 692 | ||
| 93 Reconstruction of Strictures of the Penile Urethra | 693 | ||
| Anatomic and Vascular Considerations | 693 | ||
| Distal Penile Circular Fasciocutaneous Flap (McAninch) | 693 | ||
| Longitudinal Ventral Penile Skin Flap With a Lateral Pedicle (Orandi) | 693 | ||
| Longitudinal Ventral Penile Skin Flap With a Ventral Pedicle (Turner-Warwick) | 698 | ||
| Dorsally Placed Graft (Barbagli) | 699 | ||
| Ventrally Placed Dorsal Buccal Mucosa Graft (Asopa) | 700 | ||
| Penile Invagination and One-Sided Dissection for Dorsal Onlay Graft Urethroplasty (Kulkarni) | 700 | ||
| Two-Stage Urethroplasty (Johanson) | 702 | ||
| Suggested Readings | 706 | ||
| 94 Reconstruction of Strictures of the Bulbar Urethra | 707 | ||
| Preoperative Preparation and Planning | 707 | ||
| Preoperative Evaluation | 707 | ||
| Surgical Planning | 707 | ||
| Patient Positioning and Surgical Incision | 708 | ||
| Operative Technique | 709 | ||
| Excision and Primary Anastomosis (Video 94.1) | 709 | ||
| Ventral Buccal Mucosal Graft Onlay Repair | 714 | ||
| Dorsal + Ventral Overlapping Buccal Mucosal Graft Repair | 715 | ||
| Other Techniques | 716 | ||
| Postoperative Care and Complications | 716 | ||
| Wound Closure and Immediate Postoperative Care | 716 | ||
| Catheter Duration and Postoperative Imaging | 717 | ||
| Complications of Bulbar Urethroplasty | 717 | ||
| Suggested Readings | 720 | ||
| 95 Reconstruction of Pelvic Fracture Urethral Distraction Defect | 721 | ||
| Preoperative Management and Planning | 721 | ||
| Acute Management | 721 | ||
| Subsequent Management | 721 | ||
| Patient Positioning and Surgical Incision | 721 | ||
| Definitive Repair of Pelvic Fracture Urethral Distraction Defect | 721 | ||
| Positioning | 721 | ||
| Equipment | 721 | ||
| Operative Technique | 721 | ||
| Step 1: Incision and Dissection of the Distal Urethra | 721 | ||
| Step 2: Excision of Scar Tissue and Identification of the Proximal Urethra | 722 | ||
| Step 3: Anastomosis of the Urethra | 723 | ||
| Step 4: Closure and Reduction of Tension on the Anastomosis and Postoperative Care | 724 | ||
| Postoperative Care and Complications | 724 | ||
| Complications | 724 | ||
| Suggested Readings | 729 | ||
| 96 York–Mason Closure of Rectourinary Fistula in the Male | 730 | ||
| Preoperative Preparation and Planning | 730 | ||
| Operative Technique | 730 | ||
| Postoperative Care and Complications | 730 | ||
| Suggested Readings | 731 | ||
| 97 Direct Vision Internal Urethrotomy | 732 | ||
| Preoperative Evaluation | 732 | ||
| Postoperative Care | 733 | ||
| Suggested Readings | 734 | ||
| 16 Urethral Sphincteric Procedures | 735 | ||
| 98 Autologous Pubovaginal Sling | 735 | ||
| Indications | 735 | ||
| Patient Preparation | 735 | ||
| Patient Positioning | 735 | ||
| Operative Technique | 735 | ||
| Retropubic Component | 735 | ||
| Retropubic Component | 737 | ||
| Cystoscopy | 738 | ||
| Sling Tensioning | 740 | ||
| Alternative Tension Options | 740 | ||
| Postoperative Care and Complications | 741 | ||
| Suggested Readings | 742 | ||
| 99 Tension-Free Vaginal Tape/Suprapubic Midurethral Sling | 743 | ||
| Introduction | 743 | ||
| Preoperative Preparation and Planning | 743 | ||
| Patient Positioning and Surgical Incision | 743 | ||
| Operative Technique | 743 | ||
| Postoperative Care and Complications | 744 | ||
| Suggested Readings | 747 | ||
| 100 Transobturator Midurethral Sling | 748 | ||
| Preoperative Preparation and Planning | 748 | ||
| Patient Positioning and Surgical Incision | 748 | ||
| Operative Technique | 748 | ||
| Postoperative Care and Complications | 750 | ||
| Pain | 751 | ||
| Sling Erosion Into the Urinary Tract | 751 | ||
| Sling Extrusion Into the Vaginal Canal | 751 | ||
| Voiding Dysfunction | 751 | ||
| Suggested Readings | 752 | ||
| 101 Bulking Agents for Incontinence | 753 | ||
| Preoperative Preparation and Planning | 753 | ||
| Operative Technique | 753 | ||
| Office-Based Transurethral Injection Technique | 753 | ||
| Operating Room Transurethral Injection Technique | 753 | ||
| Periurethral Injection Technique | 753 | ||
| Postoperative Care and Complications | 754 | ||
| Suggested Readings | 754 | ||
| 102 Artificial Urinary Sphincter | 755 | ||
| Indications | 755 | ||
| Preoperative Evaluation | 755 | ||
| Patient Positioning and Preparation | 755 | ||
| Device Preparation | 755 | ||
| Incision | 756 | ||
| Cuff Placement | 756 | ||
| Pressure-Regulating Balloon Placement | 757 | ||
| Scrotal Pump | 758 | ||
| Connections | 759 | ||
| Closure | 759 | ||
| Postoperative Considerations | 759 | ||
| Complications | 759 | ||
| Treatment of Urgency Incontinence | 760 | ||
| Suggested Readings | 760 | ||
| 103 Male Urethral Sling | 762 | ||
| Background | 762 | ||
| Patient Selection and Preoperative Preparation | 762 | ||
| Surgical Instruments | 762 | ||
| Patient Positioning | 762 | ||
| Surgical Steps | 762 | ||
| Postoperative Care and Complications | 765 | ||
| Comments on the Quadratic Sling | 765 | ||
| Comments About Combination Procedures | 765 | ||
| Suggested Readings | 766 | ||
| 104 Neuromodulation | 767 | ||
| Introduction | 767 | ||
| Patient Selection | 767 | ||
| Urge Urinary Incontinence or Overactive Bladder | 767 | ||
| Nonobstructive Urinary Retention | 767 | ||
| Fecal Incontinence | 767 | ||
| Contraindications | 767 | ||
| Special Considerations | 767 | ||
| Pelvic Pain | 767 | ||
| Pregnancy | 767 | ||
| Cardiac Pacemakers | 767 | ||
| Stage 1: Operative Technique | 767 | ||
| Preoperative Preparation | 767 | ||
| Positioning | 767 | ||
| Accessing S3 Spinal Foramen | 767 | ||
| Deployment of Tined Lead | 769 | ||
| Connections | 770 | ||
| Closure and Follow-Up | 771 | ||
| Operative Technique: Stage 2 | 771 | ||
| Explantation | 771 | ||
| Operative Technique: Percutaneous Nerve Evaluation | 772 | ||
| Preprocedure Preparation | 772 | ||
| Positioning | 772 | ||
| Assessing S3 Spinal Foramen | 772 | ||
| Deployment of Temporary Lead(s) | 772 | ||
| Connections and Dressings | 772 | ||
| Postprocedure Care | 772 | ||
| Complications | 772 | ||
| Infections | 772 | ||
| Revisions | 773 | ||
| Acknowledgement | 773 | ||
| Selected Readings | 773 | ||
| 105 Botox Injection for Urologic Conditions | 774 | ||
| Introduction | 774 | ||
| Patient Preparation | 774 | ||
| Procedure | 774 | ||
| Postprocedure | 775 | ||
| Suggested Readings | 775 | ||
| 17 Testis: Repair and Reconstruction | 777 | ||
| 106 Testis Biopsy | 777 | ||
| Principles of Operations on the Testis | 777 | ||
| Testis Biopsy | 777 | ||
| Postoperative Problems | 778 | ||
| Gonadal Biopsy for Intersexes | 778 | ||
| Suggested Readings | 779 | ||
| 107 Sperm Retrieval | 780 | ||
| Spermatic Cord Block | 780 | ||
| Testicular Biopsy | 780 | ||
| Percutaneous Epididymal Sperm Aspiration | 780 | ||
| Microscopic Epididymal Sperm Aspiration | 780 | ||
| Microsurgical Testicular Sperm Extraction | 781 | ||
| Suggested Readings | 782 | ||
| 108 Varicocele Ligation | 783 | ||
| Preoperative Planning | 783 | ||
| Subinguinal Approach | 783 | ||
| Inguinal Approach | 783 | ||
| Retroperitoneal Approach | 784 | ||
| Laparoscopic Approach | 786 | ||
| Postoperative Care and Complications | 787 | ||
| Suggested Readings | 788 | ||
| 109 Simple Orchiectomy | 789 | ||
| Simple Orchiectomy | 789 | ||
| Epididymis-Sparing Orchiectomy | 789 | ||
| Suggested Readings | 791 | ||
| 110 Vasectomy | 792 | ||
| Suggested Readings | 794 | ||
| 111 Vasovasostomy and Vasoepididymostomy | 795 | ||
| Patient Positioning | 795 | ||
| Instruments | 795 | ||
| Incisions and Preparation of the VAS Deferens | 795 | ||
| Modified One-Layer Closure | 795 | ||
| Two-Layer Anastomosis | 795 | ||
| Vasoepididymostomy | 796 | ||
| End-to-Side Vasoepididymostomy | 796 | ||
| End-to-End Vasoepididymostomy | 798 | ||
| Intussusception Vasoepididymostomy | 798 | ||
| Postoperative Care | 798 | ||
| Suggested Readings | 799 | ||
| 112 Spermatocelectomy | 800 | ||
| Suggested Readings | 801 | ||
| 113 Epididymectomy | 802 | ||
| Anatomy and Physiology of the Epididymis | 802 | ||
| Indication for Epididymectomy | 802 | ||
| Surgical Technique | 802 | ||
| Postoperative Care and Complications | 803 | ||
| Suggested Readings | 803 | ||
| 114 Undescended Testis | 804 | ||
| Introduction and Preoperative Considerations | 804 | ||
| Inguinal Orchiopexy (Open Technique) | 804 | ||
| Inguinal Dissection | 804 | ||
| Delivery of Testis and Cord Mobilization | 804 | ||
| Repair of the Hernia Defect | 804 | ||
| Creation of a Dartos Pouch | 804 | ||
| Relocation of the Testis | 806 | ||
| Closure | 806 | ||
| Troubleshooting | 807 | ||
| Scrotal Orchiopexy | 808 | ||
| Scrotal Dissection | 808 | ||
| Mobilization of Cord | 809 | ||
| Relocation of Testis | 809 | ||
| Troubleshooting | 809 | ||
| Exploration for Nonpalpable Testis | 809 | ||
| Diagnostic Laparoscopy for Nonpalpable Testis | 809 | ||
| Laparoscopy in Children: General Considerations | 809 | ||
| Positioning | 809 | ||
| Laparoscopic Orchiopexy | 810 | ||
| Localizing the Testis | 810 | ||
| Single-Stage Laparoscopic Orchiopexy | 811 | ||
| Creation of Peritoneal Flap | 811 | ||
| Dissection of Gubernaculum | 811 | ||
| Prentiss Maneuver and Relocation of the Testis | 811 | ||
| Closure | 812 | ||
| Laparoscopic Two-Stage Orchiopexy (Fowler-Stephens Orchiopexy) | 812 | ||
| First Stage: Laparoscopic Vessel Ligation | 812 | ||
| Second Stage: Relocation of the Testis | 812 | ||
| Complications of Laparoscopic Orchiopexy | 812 | ||
| Open Surgery for Nonpalpable Testis | 812 | ||
| Midline Transperitoneal Approach | 813 | ||
| Extended Inguinal Approach | 814 | ||
| Laroque Incision | 815 | ||
| High Ligation Orchiopexy (Fowler-Stephens Orchiopexy) | 815 | ||
| Open Surgical Technique | 816 | ||
| Postoperative Problems | 817 | ||
| Low Ligation Orchiopexy | 817 | ||
| Early Identification | 817 | ||
| Vessel Ligation | 817 | ||
| Redo Orchiopexy | 817 | ||
| Inguinal Dissection | 818 | ||
| Retroperitoneal Dissection | 818 | ||
| Relocation of the Testis | 818 | ||
| Microvascular Orchiopexy | 818 | ||
| Inguinal Dissection | 819 | ||
| Retroperitoneal Dissection and Mobilization of Spermatic Vessels | 819 | ||
| Preparation of Inferior Epigastrics | 819 | ||
| Microvascular Anastomosis | 819 | ||
| Relocation of the Testis | 820 | ||
| Cryptorchidism in Adults | 820 | ||
| Suggested Readings | 820 | ||
| 115 Reduction of Testicular Torsion | 821 | ||
| Manual Detorsion | 821 | ||
| Intraoperative Surgical Techniques | 821 | ||
| Patient Positioning | 821 | ||
| Incision | 821 | ||
| Assessment of Testicular Viability | 821 | ||
| Orchiopexy Steps | 821 | ||
| Nontunical Orchiopexy | 822 | ||
| Postoperative Care and Complications | 822 | ||
| Testicular Atrophy | 822 | ||
| Recurrent Torsion | 822 | ||
| Fertility Potential | 823 | ||
| Suggested Readings | 823 | ||
| 18 Testis: Malignancy | 824 | ||
| 116 Testis-Sparing Surgery for Benign and Malignant Tumors | 824 | ||
| Simple Orchiectomy | 824 | ||
| Epididymis-Sparing Orchiectomy | 825 | ||
| Testis-Sparing Surgery for Benign and Malignant Tumors | 825 | ||
| Suggested Readings | 827 | ||
| 117 Radical Orchiectomy | 828 | ||
| Surgical Procedure | 828 | ||
| Suggested Readings | 830 | ||
| 118 Retroperitoneal Lymph Node Dissection | 831 | ||
| Preoperative Staging and Surgical Planning | 831 | ||
| Indications for Primary Retroperitoneal Lymph Node Dissection | 831 | ||
| Preoperative Preparation | 831 | ||
| Primary and Postchemotherapy Retroperitoneal Lymph Node Dissection | 831 | ||
| Surgical Approaches and Technique | 831 | ||
| Paracaval Packet | 833 | ||
| Interaortocaval Packet | 833 | ||
| Paraaortic Packet | 834 | ||
| Gonadal Veins | 834 | ||
| Nerve-Sparing Technique | 834 | ||
| Templates | 834 | ||
| Right Modified Template | 834 | ||
| Left Modified Template | 835 | ||
| Bilateral Template | 835 | ||
| Closure and Postoperative Care | 835 | ||
| Suggested Readings | 836 | ||
| 119 Laparoscopic and Robotic Retroperitoneal Lymph Node Dissection | 837 | ||
| Staging | 837 | ||
| Indications | 837 | ||
| Patient Preparation | 837 | ||
| Node Dissection Templates | 837 | ||
| Nerve-Sparing Procedure | 837 | ||
| Laparoscopic Retroperitoneal Lymph Node Dissection | 838 | ||
| Positioning and Trocar Placement | 838 | ||
| Right-Sided Laparoscopic Retroperitoneal Lymph Node Dissection | 838 | ||
| Left-Sided Laparoscopic Retroperitoneal Lymph Node Dissection | 844 | ||
| Bilateral Template Laparoscopic Retroperitoneal Lymph Node Dissection | 846 | ||
| Robot-Assisted Retroperitoneal Lymph Node Dissection | 846 | ||
| Positioning and Trocar Placement | 846 | ||
| Right-Sided Robotic Retroperitoneal Lymph Node Dissection | 848 | ||
| Left-Sided Robotic Retroperitoneal Lymph Node Dissection | 849 | ||
| Bilateral Robotic Retroperitoneal Lymph Node Dissection | 850 | ||
| Management of Complications | 851 | ||
| Postoperative Care | 851 | ||
| Suggested Readings | 851 | ||
| 19 Penis: Correction and Reconstruction | 852 | ||
| 120 Circumcision and Dorsal Slit or Preputioplasty Circumcision | 852 | ||
| Circumcision | 852 | ||
| Sleeve (Double-Incision) Technique | 852 | ||
| Alternative Techniques | 853 | ||
| Gomco Clamp Technique | 853 | ||
| Plastibell Technique | 855 | ||
| Revision Circumcision | 855 | ||
| Postoperative Problems From Circumcision | 856 | ||
| Uncircumcision (Lynch and Pryor) | 856 | ||
| Conclusion | 857 | ||
| Dorsal Slit and Preputioplasty | 857 | ||
| Dorsal Slit for Phimosis | 857 | ||
| Dorsal Slit for Paraphimosis | 858 | ||
| Alternatives Including Preputioplasty | 858 | ||
| Conclusion | 858 | ||
| Suggested Readings | 859 | ||
| 121 Penile Curvature in Pediatric Patients | 860 | ||
| Penile Torsion | 860 | ||
| Preoperative Preparation | 860 | ||
| Surgical Repair | 860 | ||
| Lateral Penile Curvature and Chordee Without Hypospadias | 860 | ||
| Alternative 1: Tunica Albuginea Plication (Fig. 121.7, A) | 862 | ||
| Alternative 2: Dorsal Midline Plication (Fig. 121.8) | 863 | ||
| Alternative 3: Yachia Plication | 864 | ||
| Suggested Readings | 864 | ||
| 122 Hidden Penis | 865 | ||
| Operative Technique | 865 | ||
| Preoperative Appearance | 865 | ||
| Incision and Exposure | 865 | ||
| Degloving and Removal of Fibrous Dartos Bands and Scrotal Fat | 865 | ||
| Re-Creation of the Penopubic and Penoscrotal Angle | 865 | ||
| Skin Coverage | 867 | ||
| Rotational Flap | 867 | ||
| Z-Plasty | 867 | ||
| Scrotal Flap and Free Full-Thickness Skin Graft | 867 | ||
| Surgical Outcomes | 867 | ||
| Summary | 867 | ||
| Suggested Readings | 870 | ||
| 123 Insertion of Semirigid Penile Prostheses | 871 | ||
| Approaches for Insertion | 871 | ||
| Preparation | 871 | ||
| Instruments | 871 | ||
| Ventral Penile Approach | 871 | ||
| Perineal Approach | 873 | ||
| Subcoronal Approach | 873 | ||
| Dorsal Penile Shaft Approach | 875 | ||
| Ventral Approach | 876 | ||
| Pubic Approach | 876 | ||
| Postoperative Care | 876 | ||
| Suggested Readings | 877 | ||
| 124 Inflatable Penile Prosthesis Implantation | 878 | ||
| Types of Penile Prosthesis | 878 | ||
| Preoperative Preparation | 878 | ||
| Infection Prevention | 879 | ||
| Operating Room Equipment | 880 | ||
| Recommended Operating Room Setup | 880 | ||
| Instrumentation | 880 | ||
| Draping | 880 | ||
| Solutions | 880 | ||
| Surgical Approaches | 880 | ||
| Implantation of AMS 700 LGX or Coloplast Titan Inflatable Penile Prosthesis via Penoscrotal Approach | 880 | ||
| Preliminary Dissection and Cylinder Sizing | 880 | ||
| Cylinder and Reservoir Prep With Reservoir Placement | 881 | ||
| Cylinder Placement | 882 | ||
| Closing | 883 | ||
| Implantation of AMS LGX or Coloplast Titan Inflatable Penile Prosthesis via an Infrapubic Approach | 885 | ||
| Preliminary Dissection and Cylinder Sizing | 885 | ||
| Cylinder and Reservoir Prep With Reservoir Placement | 886 | ||
| Cylinder Placement and Pump Placement | 886 | ||
| Postoperative Care | 886 | ||
| Complications | 886 | ||
| Results of Penile Prosthesis Surgery | 886 | ||
| Conclusions | 887 | ||
| Suggested Readings | 887 | ||
| 125 Penile Arterial Revascularization | 888 | ||
| Instruments and Positioning | 888 | ||
| Securing the Epigastric Artery | 888 | ||
| Exposure of the Penile Vasculature | 888 | ||
| Epigastric Artery-Dorsal Artery Anastomosis | 889 | ||
| Other Procedures | 890 | ||
| Epigastric Artery—Dorsal Vein Anastomosis | 890 | ||
| Postoperative Problems | 890 | ||
| Suggested Readings | 891 | ||
| 126 Procedures for Peyronie Disease | 892 | ||
| Introduction | 892 | ||
| Surgical Approach to the Patient | 892 | ||
| Treatment Algorithm | 892 | ||
| Collagenase Injection | 892 | ||
| Injection Procedure | 893 | ||
| Modeling Procedures | 893 | ||
| Postprocedural Considerations | 893 | ||
| Surgical Interventions | 893 | ||
| 16-Dot Plication | 893 | ||
| Reinforcement of the Tunica Albuginea: Correction of Hourglass Deformity With Extratunical Grafting Procedure | 894 | ||
| Considerations | 895 | ||
| Tunica-Sparing Calcified Plaque Excision | 896 | ||
| Excision and Grafting | 896 | ||
| Incision and Vein Graft Technique (Lue) | 896 | ||
| Incision. | 896 | ||
| Vein Preparation. | 897 | ||
| Dermal Graft Technique (Devine) | 897 | ||
| Postoperative Considerations | 898 | ||
| Other Grafting Material | 898 | ||
| Prosthesis Implantation | 898 | ||
| Modeling | 898 | ||
| Plication | 898 | ||
| Plaque Incision With or Without Tunical Reinforcement | 898 | ||
| Postoperative Care and Considerations | 899 | ||
| Suggested Readings | 899 | ||
| 127 Operations for Priapism | 900 | ||
| Preoperative Preparation and Planning | 900 | ||
| Patient Positioning and Surgical Incision | 901 | ||
| Operative Technique | 901 | ||
| Percutaneous Distal Shunts | 901 | ||
| Winter (Corporoglanular) Shunt | 901 | ||
| Ebbehoj (Corporoglanular) Shunt | 901 | ||
| T-Shunt (Corporoglanular) | 901 | ||
| Open Distal Shunts | 902 | ||
| Al-Ghorab (Corporoglanular) Shunt | 902 | ||
| Burnett (Corporoglanular) Shunt | 903 | ||
| Open Proximal Shunts | 904 | ||
| Quackels (Corporospongiosal) Shunt | 904 | ||
| Vein Anastomotic Shunts | 906 | ||
| Grayhack (Cavernosaphenous) Shunt | 906 | ||
| Barry (Cavernodorsal Vein) Shunt | 906 | ||
| Penile Prosthesis Surgery | 906 | ||
| Postoperative Care and Complications | 907 | ||
| Suggested Readings | 907 | ||
| 128 Repair of Genital Injuries | 908 | ||
| Genital Skin Loss | 908 | ||
| Preoperative Planning | 908 | ||
| Positioning | 908 | ||
| Laceration and Avulsion Injuries | 908 | ||
| Burn Injuries | 908 | ||
| Bite Injuries | 908 | ||
| Genital Skin Grafting | 908 | ||
| Skin Grafting of the Penis | 909 | ||
| Preparation of the Penis | 909 | ||
| Full-Thickness Skin Grafts | 909 | ||
| Split-Thickness Skin Grafts | 909 | ||
| Unexpanded, Split-Thickness Skin Grafts | 909 | ||
| Securing the Penile Skin Graft | 909 | ||
| Alternative Technique: Staged Grafting in High-Risk Patients | 911 | ||
| Meshed Split-Thickness Skin Grafting of the Scrotum | 911 | ||
| Penile Fracture | 912 | ||
| 20 Penis: Hypospadias | 917 | ||
| 129 Pediatric Meatotomy and Distal Reconstruction | 917 | ||
| Meatotomy | 917 | ||
| 21 Penis: Malignancy | 928 | ||
| 131 Partial Penectomy | 928 | ||
| Preoperative Preparation and Planning | 928 | ||
| Patient Positioning and Surgical Incision | 928 | ||
| Operative Technique | 928 | ||
| Postoperative Care and Complications | 928 | ||
| Suggested Readings | 931 | ||
| 132 Total Penectomy | 932 | ||
| Preoperative Preparation and Planning | 932 | ||
| Patient Positioning and Surgical Incision | 932 | ||
| Operative Technique | 932 | ||
| Postoperative Care | 933 | ||
| Complications | 934 | ||
| Suggested Readings | 934 | ||
| 133 Ilioinguinal Lymphadenectomy | 935 | ||
| Surgical Indications | 935 | ||
| Standard Inguinal Lymph Node Dissection | 935 | ||
| Preoperative Preparation and Patient Positioning | 935 | ||
| Surgical Incision | 935 | ||
| Operative Technique | 935 | ||
| Superficial Inguinal Lymph Node Dissection | 935 | ||
| Deep Inguinal Lymph Node Dissection | 935 | ||
| Postoperative Care | 937 | ||
| Modified Inguinal Lymph Node Dissection | 937 | ||
| Rectus Abdominis Myocutaneous Flap | 938 | ||
| Pelvic Lymph Node Dissection | 939 | ||
| Unilateral Inguinal Lymph Node Dissection | 940 | ||
| Postoperative Complications | 940 | ||
| Dynamic Sentinel Node Biopsy | 940 | ||
| Minimally Invasive Inguinal Lymph Node Dissection | 941 | ||
| Suggested Readings | 941 | ||
| 134 Laser Treatment of the Penis | 942 | ||
| Choice of Laser | 942 | ||
| Diagnostic Indications | 942 | ||
| Penile Condylomata | 942 | ||
| Erythroplasia of Queyrat | 943 | ||
| Squamous Cell Carcinoma | 943 | ||
| Other Less Common Conditions | 944 | ||
| Pearly Penile Papules | 944 | ||
| Postprocedure Management | 944 | ||
| Suggested Readings | 946 | ||
| Index | 947 | ||
| A | 947 | ||
| B | 947 | ||
| C | 948 | ||
| D | 949 | ||
| E | 949 | ||
| F | 950 | ||
| G | 950 | ||
| H | 951 | ||
| I | 951 | ||
| K | 952 | ||
| L | 952 | ||
| M | 954 | ||
| N | 955 | ||
| O | 955 | ||
| P | 956 | ||
| R | 959 | ||
| S | 961 | ||
| T | 962 | ||
| U | 962 | ||
| V | 964 | ||
| W | 965 | ||
| Y | 965 | ||
| Z | 965 | ||
| Inside Back Cover | ibc1 |