5ef2f83cd2b32fb2b87b21b5315eaa40 pmc_33919290.pdf 83faa7c0299a1a11d5e5129d28473e07f2d41c93 pmc_33919290.pdf 67dd4930f806c1b9473a9aa2b841c93d6c2fb7aad0612d9340c2c22592a56bc8 pmc_33919290.pdf Title: Role of the Laparoscopic Approach for Complex Urologic Surgery in the Era of Robotics Subject: (1) Introduction: The advent of robotic surgery led to the assumption that laparoscopic surgery would be replaced entirely. However, the high costs of robotic surgery limit its availability. The aim of the current study was to assess the feasibility of the 3D laparoscopic approach for the most complex urological procedures. (2) Materials and methods: We included in the current study all patients who had undergone complex 3D laparoscopic procedures in our department since January 2017, including radical nephrectomy (LRN) using a dual combined approach (19 patients), radical nephroureterectomy (LRNU) with bladder cuff excision (13 patients), and radical cystectomy (LRC) with intracorporeal urinary diversion (ICUD) (21 patients). (3) Results: The mean operative time was 345/230/478 min, the complications rate was 26%/30.76%/23.8% and positive surgical margins were encountered in 3/1/1 patients for the combined approach of LRN/LRNU/LRC with ICUD, respectively. A single patient was converted to open surgery during LRN due to extension of the vena cava thrombus above the hepatic veins. After LRC, sepsis was the most common complication and 8 patients were readmitted at a mean of 15.5 days after discharge. (4) Conclusions: In the era of robotic surgery, laparoscopy remains a plausible alternative for most complex oncological cases. Keywords: 3D laparoscopy; dual combined approach; radical cystectomy; radical nephroureterectomy; robotic surgery Author: Iulia Andras, Angelo Territo, Teodora Telecan, Paul Medan, Ion Perciuleac, Alexandru Berindean, Dan V. Stanca, Maximilian Buzoianu, Ioan Coman and Nicolae Crisan Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Thu Apr 22 05:51:33 2021 CEST ModDate: Thu Apr 22 05:57:25 2021 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 18 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 3314504 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- JFMOUW+URWPalladioL-Ital Type 1 Custom yes yes no 10 0 HQEILS+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 ITFWNC+URWPalladioL-Roma Type 1 Custom yes yes no 19 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 27 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 30 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 52 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 56 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 60 0 LRTYNE+CMSY10 Type 1 Builtin yes yes no 75 0 YVYBFX+VnURWPalladioL Type 1 Custom yes yes no 131 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-10-02 03:20:46 CEST RepresentationInformation: pmc_33919290.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2023-03-31 12:09:47 CEST Size: 3314504 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 315 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Patient Selection Destination: subsection.2.1 Item: Title: Surgical Technique Destination: subsection.2.2 Children: Item: Title: Dual Combined Approach for Renal Tumors with Invasion of the Renal Vein or Inferior Vena Cava (IVC) Destination: subsubsection.2.2.1 Item: Title: Nephroureterectomy with Bladder Cuff Excision Destination: subsubsection.2.2.2 Item: Title: Radical Cystectomy with Intracorporeal Urinary Diversion Destination: subsubsection.2.2.3 Item: Title: Follow-Up Destination: subsection.2.3 Item: Title: Results Destination: section.3 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.5 Info: Title: Role of the Laparoscopic Approach for Complex Urologic Surgery in the Era of Robotics Author: Iulia Andras, Angelo Territo, Teodora Telecan, Paul Medan, Ion Perciuleac, Alexandru Berindean, Dan V. Stanca, Maximilian Buzoianu, Ioan Coman and Nicolae Crisan Subject: (1) Introduction: The advent of robotic surgery led to the assumption that laparoscopic surgery would be replaced entirely. However, the high costs of robotic surgery limit its availability. The aim of the current study was to assess the feasibility of the 3D laparoscopic approach for the most complex urological procedures. (2) Materials and methods: We included in the current study all patients who had undergone complex 3D laparoscopic procedures in our department since January 2017, including radical nephrectomy (LRN) using a dual combined approach (19 patients), radical nephroureterectomy (LRNU) with bladder cuff excision (13 patients), and radical cystectomy (LRC) with intracorporeal urinary diversion (ICUD) (21 patients). (3) Results: The mean operative time was 345/230/478 min, the complications rate was 26%/30.76%/23.8% and positive surgical margins were encountered in 3/1/1 patients for the combined approach of LRN/LRNU/LRC with ICUD, respectively. A single patient was converted to open surgery during LRN due to extension of the vena cava thrombus above the hepatic veins. After LRC, sepsis was the most common complication and 8 patients were readmitted at a mean of 15.5 days after discharge. (4) Conclusions: In the era of robotic surgery, laparoscopy remains a plausible alternative for most complex oncological cases. Keywords: 3D laparoscopy; dual combined approach; radical cystectomy; radical nephroureterectomy; robotic surgery Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Thu Apr 22 05:51:33 CEST 2021 ModDate: Thu Apr 22 05:57:25 CEST 2021 ID: 0x7e3ea50ec30324c30c76677743ef5f09, 0x7e3ea50ec30324c30c76677743ef5f09 Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: ITFWNC+URWPalladioL-Roma FontSubset: true FirstChar: 2 LastChar: 252 FontDescriptor: FontName: ITFWNC+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: YVYBFX+VnURWPalladioL FontSubset: true FirstChar: 161 LastChar: 178 FontDescriptor: FontName: YVYBFX+VnURWPalladioL Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: JFMOUW+URWPalladioL-Ital FontSubset: true FirstChar: 45 LastChar: 121 FontDescriptor: FontName: JFMOUW+URWPalladioL-Ital Flags: Symbolic 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