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Query: UMLS:C0403608 (ureter)
 9,655 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Laparoscopic nephrectomy was performed in 15 male pigs, the procedure was successful in 14. Extraction of the intact kidney through a 5-cm lower abdomen incision was done in 7 animals; complete destruction and evacuation of the kidney was accomplished by a round-knife suction device through a 1-cm port in another 7 pigs. Grossly, the specimen consisted of sausage-like tubular renal tissue and a small amount of tissue debris. Pathology revealed that the glomerular and tubular structures were well preserved, no interstitial hematoma could be found. Four ports were usually used, one 1-cm umbilical camera port, one 0.5-cm port for ureter traction, and two 1-cm working ports along the midclavicular line. All the pigs recovered uneventfully. The average operation time was 3 h 20 min. The application of endo-GIA (United States Surgical Corporation) for renal hilum reduced the operative time to 2 h 20 min. Complications included renal vein tear during endoclip application and cutting in the first case, mild subcutaneous emphysema in 2 cases. This first pig received exploratory laparotomy for the repair and ligation of the renal vein. No more major complications occurred with increasing experience. From this porcine experiment, we conclude that the combination of laparoscopy, a tissue destroyer and an endobag for the entrapment of kidney seem to be a promising technique for clinical nephrectomy.
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PMID:Laparoscopic nephrectomy in a porcine model. 850 92

The extensive laparoscopic tubectomy programs organized by the Indian government during 1978-1981 as a measure to curb the population explosion brought some unanticipated problems for the authors. One of these, surgical emphysema, gave the authors the opportunity to explore laparoscopically extraperitoneal appearances. So deliberate retroperitoneal surgical emphysema was created, to isolate the ureter so as to locate the stone in it, and to study the feasibility of its removal via laparoscopy itself. The procedure entails minimal trauma and gives the considerable advantage of clear vision for total removal of stone(s). This procedure offers an alternative to the conventional method and to other, newer methods. The conventional method involves wide exposure with attendant morbidity and prolonged hospital stay. Other newer methods require high-tech multimode prerequisites, such as a extracorporeal shock-wave lithotriptor, ultrasound, screening, software, endourological instruments (including lithotriptor), necessarily supplemented by technical experts in each field. Hence such methods require an institutional arrangement at an exorbitant cost to the patient.
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PMID:An attempt at a percutaneous retroperitoneoscopic approach to ureterolithotomy. 821 30

A 59-year-old female was referred to our institute for urinary tract infection with septicemia, thrombocytopenia, and hyperglycemia. Plain abdominal X-ray and computed tomography (CT) showed emphysema at the left renal parenchyma and urinary tract along with the perirenal inflammatory changes. These findings suggested emphysematous pyelonephritis in the early phase of occurrence in a diabetic patient. Transurethral catheterization of the left ureter was immediately performed, and occluded cloudy urine was drained. Ureteral stent was left indwelt transurethrally for easy accession in case of occlusion. E. coli was cultured in drained urine. Administration of antibiotics, insulin, and anti-coagulant was performed, and drained urine became clear in several hours. General condition and laboratory findings were improved normally in a week, and CT did not reveal the emphysematous change of the left renal unit at the 11th hospital day.
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PMID:[A case of emphysematous pyelonephritis successfully treated by transurethral retrograde drainage]. 1523 83

During the past 5000 years, ancient nomenclature and dogmas regarding the etiology of protrusions have accumulated. Whereas, in the abdomen, the Latin "hernia" supplanted Greek, it, based on content, persists in the pelvis as cystocele, rectocele, etc. Russell (Lancet 1:1519-1523, 1902) championed the congenital saccular theory of herniae, denying they could ever be acquired pathologically. Barring technical error, removal of the sac would cure. Despite dissent in the 1920s by Harrison, Keith, and Andrews, Russell's concepts held late into the twentieth century. We now know that pathology - systemic connective tissue disease - plays an important role in adult herniation. Tensionless prosthetic repair is usually required since the healing of damaged musculo-aponeurotic structures in abdomen or pelvis is impaired. Laparoscopists have declared sliding extraperitoneal prolapse of sacless kidney, ureter, bladder, and fat pad to be herniae. Similar vaginal protrusions should be denoted likewise. It is time gynecologists and herniologists join in the effort to develop antidotes for combating this pernicious co-morbidity which has been shown also to cause aneurysms, diverticulosis coli, skin changes, and emphysema. Prophylaxis should include exercise and going without cigarettes.
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PMID:Archaic terms and dogmas impeding care of abdominal and pelvic herniation. 1750 28

Left laparoscopic nephrectomy was performed in 16 dogs to describe the surgical techniques and initial experiences associated with operation time and surgery complications. The renal vein and artery were occluded by three ligating clips, respectively, and the ureter was sectioned after ligation with ligating clips at the level of the iliac vessels. A morcellation technique was used to remove the kidney from the abdominal cavity after placing it into a specimen retrieval bag. Total operation time and time spent for each different surgical stage in the first five operations were compared with those in the last five of the 16 operations. The factors that affected the differences of total operation time were examined, including sex, bodyweight, number of operations, incision length, and surgical stages. Six intra-operative complications occurred including splenic hemorrhage (3 cases), torn specimen retrieval bag during kidney morcellation (1 case), and subcutaneous emphysema (2 cases). Surgical time for laparoscopic nephrectomy was affected primarily by the time spent for renal vascular pedicle section and could be decreased as the number of cases increased. Thus, laparoscopic nephrectomy using ligating clips and morcellation for kidney removal could be considered where nephrectomy is indicated in dogs.
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PMID:Laparoscopic nephrectomy in dogs: an initial experience of 16 experimental procedures. 2405 89

A 49-year-old male with untreated diabetes mellitus type 2 experienced eyesight deterioration and general malaise, and was treated for uveitis and orbital cellulitis. Later, he was taken to a local hospital via ambulance for a consciousness disorder and was diagnosed with bilateral infectious endophthalmitis, a right ureteral stone, and emphysematous pyelonephritis. He was then referred to our hospital for further examination and treatment. We immediately initiated intravenous antibiotic therapy with meropenem and glycemic control with continuous subcutaneous insulin infusion, and placed a ureteral and percutaneous drain tube into the right ureter and the emphysema, respectively. We performed a diagnostic and therapeutic vitrectomy on the patient's left eye. Urinary, blood, and vitreous cultures were positive for Klebsiella aerogenes. Abdominal contrast-enhanced computed tomography showed bilaterally comparable renal contrast enhancement. On the 60th hospital day, we performed endoscopic combined intrarenal surgery (ECIRS) and completely removed the urinary stone. Although he lost light sensitivity in his right eye, his left eyesight improved, and his blood glucose level was adequately managed by oral medication. Three months after the surgery, he was discharged from our hospital and he showed no sign of recurrence of the infection at ten months after surgery.
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PMID:[A Case of Emphysematous Pyelonephritis Complicated by Bacterial Endophthalmitis in which Multidisciplinary Therapy Led to Preservation of the Kidney]. 3327 55