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3. ROBOTIC VERSUS OPEN URETERONEOCYSTOSTOMY: A SINGLE INSTITUTION COMPARATIVE OUTCOME ANALYSIS

Author

Isac W, Kaouk J, Altunrende F, Hillyer SP, Laydner H, Long JA, Kassab A, Khalifeh A, Panumatrassamee K, Eyraud R, Falcone T, Haber GP, Stein RJ, AUTORINO, Riccardo, Isac, W, Kaouk, J, Altunrende, F, Autorino, Riccardo, Hillyer, Sp, Laydner, H, Long, Ja, Kassab, A, Khalifeh, A, Panumatrassamee, K, Eyraud, R, Falcone, T, Haber, Gp, and Stein, Rj

Published
2013

4. Robotic bladder diverticulectomy: Technique and surgical outcomes

Author

Altunrende F, Patel NS, White MA, Khanna R, Laydner H, Yang B, Haber GP, Kaouk JH, Stein RJ, AUTORINO, Riccardo, Altunrende, F, Autorino, Riccardo, Patel, N, White, Ma, Khanna, R, Laydner, H, Yang, B, Haber, Gp, Kaouk, Jh, and Stein, Rj

Published
2012

21. Where do we really stand with LESS and NOTES?

Author

Gettman MT, White WM, Aron M, Averch T, Box G, Cadeddu JA, Canes D, Cherullo E, Desai MM, Frank I, Gill IS, Gupta M, Haber GP, Humphreys MR, Irwin BH, Kaouk JH, Kavoussi LR, Landman J, Liatsikos EN, Lima E, Ponsky LE, Rane A, Ribal M, Rabenhalt R, Rao P, Richstone L, Sawyer MD, Sotelo R, Stolzenburg JU, Tracy CR, Stein RJ, Endourological Society NOTES, LESS Working Group, European Society of Urotechnology NOTES, AUTORINO, Riccardo, Universidade do Minho, Gettman, Mt, White, Wm, Aron, M, Autorino, Riccardo, Averch, T, Box, G, Cadeddu, Ja, Canes, D, Cherullo, E, Desai, Mm, Frank, I, Gill, I, Gupta, M, Haber, Gp, Humphreys, Mr, Irwin, Bh, Kaouk, Jh, Kavoussi, Lr, Landman, J, Liatsikos, En, Lima, E, Ponsky, Le, Rane, A, Ribal, M, Rabenhalt, R, Rao, P, Richstone, L, Sawyer, Md, Sotelo, R, Stolzenburg, Ju, Tracy, Cr, Stein, Rj, Endourological Society, Note, LESS Working, Group, and European Society of Urotechnology, Note

Subjects
Urologic Diseases, White (horse), Ciências da Saúde [Ciências Médicas], Ciências Médicas::Ciências da Saúde, business.industry, Urology, Endoscopy, Urologic Surgical Procedure, Terminology as Topic, Medicine, Humans, Urologic Surgical Procedures, Laparoscopy, business, Humanities
Abstract

[Excerpt] Urologists are increasingly aware of new surgical concepts including natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS) [1–5]. In 2008, the Urology LESS and NOTES Working Group was formed under the auspices of the Endourological Society. In addition to having a stated goal of increasing awareness about LESS and NOTES, the working group also wanted to define nomenclature, guide scientific evaluation, and provide opportunities for safe clinical implementation [6]. In 2010, the European Society of Urotechnology similarly formed a working group dedicated to LESS and NOTES. In this paper, we report progress on the stated goals and make new recommendations for the future of LESS and NOTES in urology. To date, progress has been made with all stated goals. Nomenclature for LESS and NOTES has been clearly defined [7,8]. In addition, most urologists are now aware of the concepts of LESS and NOTES [1,3,4,8]. Society in general is also interested and largely supportive of the LESS and NOTES concepts [9,10]. Although savvy patients may be interested in LESS and NOTES procedures, we are always obligated to place the needs of the patient first when determining surgical approach. It may sound very appealing to the patient to have no visible surgical scars, but the same patient is less interested in the so-called scarless approach if the risk of complications or morbidity is significantly increased [9–11]. As such, the development of these nascent approaches should be methodical and the recommendations based on objective data. [...]

Published
2011

22. Robot assisted laparoscopic partial nephrectomy: techniques and outcomes

Author

Altunrende F, Laydner H, White MA, Yang B, Khanna R, Hillyer S, Isac W, Spana G, Stein RJ, Haber GP, Kaouk JH, AUTORINO, Riccardo, Altunrende, F, Autorino, Riccardo, Laydner, H, White, Ma, Yang, B, Khanna, R, Hillyer, S, Isac, W, Spana, G, Stein, Rj, Haber, Gp, and Kaouk, Jh

Published
2011

25. Selection of a port for use in laparoendoscopic single-site surgery

Author

Khanna R, White MA, Laydner HK, Isac W, Yang B, Altunrende F, Hillyer SP, Spana G, Haber GP, Kaouk JH, Stein RJ, AUTORINO, Riccardo, Khanna, R, White, Ma, Autorino, Riccardo, Laydner, Hk, Isac, W, Yang, B, Altunrende, F, Hillyer, Sp, Spana, G, Haber, Gp, Kaouk, Jh, and Stein, Rj

Published
2011

26. Pure and hybrid natural orifice transluminal endoscopic surgery (NOTES): current clinical experience in urology

Author

AUTORINO, Riccardo, Haber GP, White MA, Khanna R, Altunrende F, Yang B, Forest S, Stein RJ, Kaouk J.H., Autorino, Riccardo, Haber, Gp, White, Ma, Khanna, R, Altunrende, F, Yang, B, Forest, S, Stein, Rj, and Kaouk, J. H.

Subjects
Adult, Young Adult, Vagina, Feasibility Studies, Humans, Endoscopy, Female, Kidney Diseases, Middle Aged, Nephrectomy
Abstract

An exciting era of discovery in the field of scarless urological surgery has just begun. Hybrid natural orifice transluminal endoscopic surgery (NOTES) nephrectomy has been reported by a few groups in the last two years. Recently, our group at the Cleveland Clinic was able to demonstrate the feasibility of a transvaginal pure NOTES nephrectomy. During this pioneering period, a critical appraisal of results and a scrupulous determination of benefits are of utmost importance. Further studies are awaited to define the actual role of NOTES in the management of urological diseases.

Published
2010

27. Robotic laparoendoscopic single-site surgery

Author

White MA, Haber GP, Khanna R, Altunrende F, Yang B, Stein RJ, Kaouk JH, AUTORINO, Riccardo, White, Ma, Haber, Gp, Autorino, Riccardo, Khanna, R, Altunrende, F, Yang, B, Stein, Rj, and Kaouk, Jh

Subjects
Male, Prostatectomy, Humans, Female, Laparoscopy, Equipment Design, Robotics
Abstract

Laparoscopic surgery is frequently used in urology and the introduction of the da Vinci surgical system has served to further increase the demand for these procedures. Yet, laparoscopy is not without its drawbacks including port site complications, such as bleeding, hernia, internal organ damage and scarring. To further decrease morbidity of standard laparoscopy, newer techniques such as laparoendoscopic single-site surgery (LESS) are currently being investigated. LESS is technically challenging and reduces instrument triangulation and robust retraction, and is associated with a steep learning curve. To help overcome current limitations we have introduced the da Vinci surgical system to LESS and report our experience with robotic laparoendoscopic single-site surgery.

Published
2010

29. Novel robotic da Vinci instruments for laparoendoscopic single-site surgery

Author

Haber GP, White MA, Escobar PF, Kroh MD, Chalikonda S, Khanna R, Forest S, Yang B, Altunrende F, Stein RJ, Kaouk J.H., AUTORINO, Riccardo, Haber, Gp, White, Ma, Autorino, Riccardo, Escobar, Pf, Kroh, Md, Chalikonda, S, Khanna, R, Forest, S, Yang, B, Altunrende, F, Stein, Rj, and Kaouk, J. H.

Published
2010

31. Editorial comment

Author

AUTORINO, Riccardo, Noble M, Stein RJ, Autorino, Riccardo, Noble, M, and Stein, Rj

Published
2010

35. Low-cost reusable instrumentation for laparoendoscopic single-site nephrectomy: assessment in a porcine model

Author

Autorino, R, Kim, FJ, Rane, A, De Sio, M, Stein, RJ, Micali, S, Correia-Pinto, J, Kaouk, JH, and Lima, E

Subjects
Nefrectomia, Sus scrofa, Laparoscópios, Animais
Abstract

PURPOSE: To test different sets of prebent instruments and a new reusable access device for laparoendoscopic single-site (LESS) surgery. MATERIALS AND METHODS: Three surgeons with previous experience in LESS performed 12 nephrectomies in six pigs. In all procedures, a multichannel access device (X-CONE) and a 5-mm extra-long telescope were used. Four sets of prebent instruments with different profiles (S-portal) were tested: Standard (one straight scissors and one curved grasper), Cuschieri, Carus, and Leroy set (each of them consisting of two curved instruments with different configurations). Assessment was performed based on both objective (procedure time; time to manage the pedicle; time to free kidney) and subjective parameters (entry/exit of instruments; triangulation; dissection up/down; dissection lateral; retraction; interdependence). The subjective assessment tool used was a Likert type scale (1 = easy to 5 = prohibitive). The access device was assessed by using objective (time to complete insertion of device after skin incision) and subjective (significant air leakage, movement constraint) parameters. RESULTS: Time to insertion of the X-CONE was

Published
2011

36. Current status and future perspectives in laparoendoscopic single-site and natural orifice transluminal endoscopic urological surgery

Author

Autorino, R, Stein, RJ, Lima, E, Damiano, R, Khanna, R, Haber, GP, White, MA, Kaouk, JH, and Universidade do Minho

Subjects
Urologic Diseases, Procedimentos Cirúrgicos Urológicos, Science & Technology, Urologic surgical procedures, Urology, Natural orifice transluminal endoscopic surgery (NOTES), Scarless surgery, Laparoscopes, Laparoscopia, Cicatrix, Humans, Doenças Urológicas, Laparoscopy, Laparoendoscopic single-site surgery (LESS)
Abstract

Objective of this study is to provide an evidence-based analysis of the current status and future perspectives of scarless urological surgery. A PubMed search has been performed for all relevant urological literature regarding natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS). In addition, experience with LESS and NOTES at our own institution has been considered. All clinical and investigative reports for LESS and NOTES procedures in the urological literature have been considered. A wide variety of clinical procedures in urology have been successfully completed by using LESS techniques. Thus far, experience with NOTES has largely been investigational, although early clinical reports are emerging. Further development of instrumentation and platforms is necessary for both techniques to become more widely adopted throughout the urological community.

Published
2010

38. Laparoendoscopic single-site surgery in urology: worldwide multi-institutional analysis of 1076 cases

Author

Kaouk, JH, primary, Autorino, R, additional, Kim, FJ, additional, Han, DH, additional, Lee, SW, additional, Yinghao, S, additional, Cadeddu, JA, additional, Derweesh, IH, additional, Richstone, L, additional, Cindolo, L, additional, Branco, A, additional, Greco, F, additional, Allaf, M, additional, Sotelo, R, additional, Liatsikos, E, additional, Stolzenburg, JU, additional, Rane, A, additional, White, WM, additional, Han, WK, additional, Haber, GP, additional, White, MA, additional, Molina, WR, additional, Jeong, BC, additional, Lee, JY, additional, Linhui, W, additional, Best, S, additional, Stroup, SP, additional, Rais-Bahrami, S, additional, Schips, L, additional, Fornara, P, additional, Pierorazio, P, additional, Giedelman, C, additional, Lee, JW, additional, Stein, RJ, additional, and Rha, KH, additional

Published
2011
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39. Complications and conversions of upper tract urological laparoendoscopic single-site surgery (less): multicentre experience: results from the NOTES Working Group

Author

Irwin, BH, primary, Cadeddu, JA, additional, Tracy, CR, additional, Kim, FJ, additional, Molina, WR, additional, Rane, A, additional, Sundaram, CP, additional, Raybourn, Iii JH, additional, Stein, RJ, additional, Gill, IS, additional, Kavoussi, LR, additional, Richstone, L, additional, and Desai, MM, additional

Published
2011
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42. Reported stress and its relationship to tobacco use among U.S. military personnel.

Author

Stein RJ, Pyle SA, Haddock CK, Pston WSC, Bray R, Williams J, Stein, Risa J, Pyle, Sara A, Haddock, C Keith, Poston, W S Carlos, Bray, Robert, and Williams, Jason

Abstract

In addition to common stressors, members of the U.S. Armed Forces experience a high level of stress unique to their status as service members. In an effort to combat stress, many military personnel report high levels of nicotine use. This study investigated the relationship between tobacco use and perceived stress among military members in all four armed services. Results indicate that those who use tobacco products specifically to reduce stress report significantly higher stress levels than those who do not use tobacco. Moreover, current users and those who both smoked and used smokeless tobacco were far more likely to report experiencing "a lot" of stress from a variety of sources than former or never users. Tobacco users also engaged more frequently in negative coping behaviors and relied less on the positive coping strategies used more often by former or never smokers. These findings are consistent with the larger body of literature suggesting that tobacco is not only an ineffective stress-reducing strategy, it also likely perpetuates a stress response in users. It is, therefore, critical that the military improve effective means of coping among nicotine-using troops. [ABSTRACT FROM AUTHOR]

Published
2008
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43. Spontaneous Live Birth with a Maternal History of Intravenous Use of Pentazocine and Tripelennamine (T's and Blues)

Author

Schaffer, MI, Lin, R-L, Wu Chen, NB, Trojan, C, Teas, S, and Stein, RJ

Abstract

A 24-year-old black female presented a live birth of six-months gestation. The 700-g neonate survived for 11 h. After toxicology revealed the presence of pentazocine and tripelennamine (T's and Blues), the mother admitted to using this combination intravenously 9 h previous to admission. Concentrations of pentazocine and tripelennamine were simultaneously determined by gas-liquid chromatography (GLC) combined with nitrogen selective detection. Analyses were performed on a 3% OV-101 column, with the added internal standard, dexbrompheniramine. Both pentazocine and tripelennamine were qualitatively confirmed by their electron impact mass spectra. Concentrations of pentazocine and tripelennamine in various fluids and tissues were determined.

Published
1983
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44. The General Toxicology Unknown II. A Case Report: Doxylamine and Pyrilamine Intoxication

Author

Wu Chen, NB, Schaffer, MI, Lin, R-L, Kurland, ML, Donoghue, ER, and Stein, RJ

Abstract

A general toxicology unknown case is presented to demonstrate our systematic approach. A 20-year-old male was found dead with multiple suicide notes. Overdose was suspected but substances were not known. Blood alcohol was negative. Urine was analyzed by enzymemultiplied immunoassay technique and was negative for all drugs assayed. Urine was then extracted with ethyl acetate:hexane (1:1) at pH 10 and back-extracted into 1.0Nsulfuric acid. The acidic layer was adjusted to pH 10, and re-extracted with ethyl acetate: hexane (1:1). The residue was analyzed by gas chromatography (GC) on a 3% OV-101 column. It was found to be negative for all commonly screened substances. However, several unknown peaks were observed. Electron impact mass spectra of these unknown peaks were obtained and searched for in our computer library of more than 25 000 mass spectra. These unknown peaks were identified as doxylamine and pyrilamine by gas chromatography/mass spectrometry. The base peak and molecular ion for pyrilamine were at m/z121 and 285, respectively. The base peak for doxylamine was at m/z58. No molecular ion was observed for doxylamine. Both doxylamine and pyrilamine are antihistamines, but are promoted and used in the management of insomnia. Quantitation was performed on a GC using dexbrompheniramine as an internal standard. Blood concentrations for doxylamine and pyrilamine were 0.7 and 7.0 mg/L, respectively. Concentrations in other tissues were determined. Death was caused by combined doxylamine and pyrilamine intoxication; the manner of death was suicide.

Published
1983
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45. The General Toxicology Unknown I. The Systematic Approach

Author

Wu Chen, NB, Schaffer, MI, Lin, R-L, Kurland, ML, Donoghue, ER, and Stein, RJ

Abstract

The general toxicology unknown often presents challenges and interests to toxicologists. A systematic analytical approach to search for drugs or poisons is presented here. The preliminary screening analyses were as follows: alcohol by gas chromatography (GC), ethchlorvynol colorimetric analysis, enzyme multiplied immunoassay technique (EMIT), basic drug screening by GC, and neutral and weakly acidic drug screening by GC. Other additional analyses were performed depending on the special circumstance of each individual case and the results of these preliminary analyses. Positive findings were confirmed by computerized gas chromatography/mass spectrometry when practical. Quantitation was performed by GC whenever possible.

Published
1983
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46. Analysis of Blood and Tissue for Amoxapine and Trimipramine

Author

Wu Chen, NB, Schaffer, MI, Lin, R-L, Hadac, JP, and Stein, RJ

Abstract

A method for the identification and quantitation of two tricyclic antidepressants, amoxapine (Asendin®) and trimipramine (Surmontil®) is presented here. Samples were extracted with hexane at pH 10, back-extracted with 1.0Nsulfuric acid. The acidic layer was adjusted to pH 10 and re-extracted with hexane. Electron impact mass spectra were obtained. The base peak and molecular ion for amoxapine were at m/z245 and 313, respectively. The base peak and molecular ion for trimipramine were at m/z58 and 294, respectively. There were three forensic toxicology cases involving amoxapine in Cook County, IL, in 1980 and 1981. The concentrations of amoxapine in blood for these three cases were 1.66 mg/L, 7.16 mg/L, and 2.95 mg/L, respectively.

Published
1983
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47. A Purinethol®(6-Mercaptopurine) Fatality in a Case of Prescription Negligence: A Gas Chromatographic Determination of 6-Mercaptopurine

Author

Lin, R-L, Stein, RJ, and Schaffer, MI

Abstract

A 64-year-old white female was given Purinethol®(6-mercaptopurine) in place of propylthiouracil. A gas chromatographic method for the determination of 6-mercaptopurine in blood and other biological tissues has been developed. Samples were extracted with chloroform/isopropanol (4:1) at pH 7.0 and back-extracted into 0.SN sodium hydroxide (NaOH). The NaOH fraction was neutralized and buffered at pH 7.0 and extracted with chloroform/isopropanol (4:1). Quantitation was made by gas chromatography following methylation of the drug with trimethylanilinum hydroxide on an OV-101 or OV-225 column, using an internal standard. 6-Mercaptopurine was identified in all tissues by gas chromatography/mass spectrometry. The derivatized drug was identified by its electron impact mass spectrum as a dimethylated compound that has a molecular ion at m/e180, which is also the base peak. The highest concentration of Purinethol was found in blood (110 mg/L). Concentrations in other tissues have been given. This is probably the first reported death by Purinethol.

Published
1982
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