Dr. Georges-A. de Boccard, co-founder of the SIPC is a pioneer in robot assisted microsurgery. He presented his experience at the 8th meeting of the Robotic Assisted Microsurgical & Endoscopic Society (RAMSES)
Yelena Akelina, DVM, MS is a Research Scientist and a Director/Instructor in Clinical Microsurgery at the Microsurgery Research and Training lab at the Department of Orthopaedic Surgery, Columbia University.
Dr. Sijo Parekattil is Board certified in urology, Co-Director of the PUR clinic at South Lake Hospital, Clermont, FL. He is one of the Founding members of the Robotic Assisted Microsurgical & Endoscopic Society (RAMSES)
Since the early days of the twentieth century, vasectomy gained attention with its eugenic and therapeutic applications. Soon it was adopted for purely contraceptive purpose in many European countries. Today, vasectomy is widely used as a contraceptive tool, and it is estimated that about 50 million men have relied on vasectomy for family planning. Above all, in the United States, vasectomy is chosen as contraceptive method by nearly 11% of married couples. With the success of vasectomy, the number of patient seeking for a repair grows parallel.
Risk of biochemical recurrence based on extent and location of positive surgical margins after robot-assisted laparoscopic radical prostatectomy
There are no published studies on the simultaneous effect of extent and location of positive surgical margins (PSMs) on biochemical recurrence (BCR) after robot-assisted laparoscopic prostatectomy (RALP). The aim was to report the incidence, extent, and location of PSMs over the inclusion period as well as the rates of BCR and cancer-related mortality, and determine if BCR is associated with PSM extent and/or location.
Retrospective review of 530 consecutive patients who underwent RALP between 2003 and 2012. Kaplan-Meier (KM) survival analyses and Cox regressions were performed to determine variables associated with BCR.
For the 530 operated patients, evaluated at a median of 92 months (IQR, 87–99), PSMs were observed in 156 (29%), of which 24% were focal. Out of 172 PSMs, 126 (73%) were focal and 46 (27%) were extensive. The KM survival using BCR as endpoint was 0.81 (CI, 0.78–0.85) at 5 years and was 0.67 (CI, 0.61–0.72) at 10 years; and using cancer-related mortality as endpoint was 0.99 (CI, 0.99–1.00) at 5 years and 0.95 (CI, 0.92–0.98) at 10 years. Multi-variable analysis revealed the strongest predictors of BCR to be Gleason score ≥ 8 (HR = 7.97; CI, 4.38–14.51) and 4 + 3 (HR = 3.88; CI, 2.12–7.07), lymph nodes invasion (HR = 3.42; CI, 1.70–6.91), pT stage 3b or 4 (HR = 3.07; CI, 1.93–4.90), and extensive apical PSMs (HR = 2.62; CI, 1.40–4.90) but not focal apical PSMs (HR = 0.86; CI, 0.49–1.50; p = 0.586).
Extensive apical PSMs significantly increased the risk of BCR, independently from pT stage, Gleason score and lymph nodes invasion, while focal apical PSMs had no significant effect on BCR.
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SIPC will take part at the annual meeting of the Swiss Urology Society from 6 to 8 September 2017 in Lugano, with this presentation:
Correlation between template guided transperineal biopsies and MRI diagnostic imaging
M. Martins Favre, C-H Rochat, I. Szalay-Quinodoz I, A Caviezel, S Tran, G-A De Boccard, S Rohner, S Regusci