You have accessJournal of UrologyLaparoscopic Partial Nx and Single Port Surgery1 Apr 2010V959 INTRACORPOREAL RETRACTION DURING SINGLE PORT TRANSUMBILICAL LAPAROSCOPIC SURGERY Albert Mikhail, Arsenio Figueroa, L. Jonathan Bryant, Kirk Tamaddon, Jay Yew, Linconln Maynes, and Gary Chien Albert MikhailAlbert Mikhail Los Angeles, CA More articles by this author , Arsenio FigueroaArsenio Figueroa Fontana, CA More articles by this author , L. Jonathan BryantL. Jonathan Bryant Fontana, CA More articles by this author , Kirk TamaddonKirk Tamaddon Los Angeles, CA More articles by this author , Jay YewJay Yew Downey, CA More articles by this author , Linconln MaynesLinconln Maynes Riverside, CA More articles by this author , and Gary ChienGary Chien Los Angeles, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1864AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES With the advent of newer technology and instrumentation, single incision surgery has become increasingly apparent. We therefore present our experience with intracorporeal retraction during single port transumbilical endoscopic surgery. METHODS Fifteen patients underwent single incision laparoscopic surgery including one patient that underwent a laparoscopic nephroureterctomy, 7 laparoscopic nephrectomies, and 6 laparoscopic pyeloplasties, and 1 ureterolysis. During these procedures a single Triport system (Advanced Surgical Concepts, Dublin Ireland) was used in 13 cases. Ports were placed using a Hassan technique. For Right sided cases or cases where a drain was to be placed an additional 5 mm port was also used. Intracorporeal retraction was achieved with bolstering sutures placed in the lower and/or upper poles then taken through the anterior abdominal wall in a pulley system fashion. With each pull to elevate the kidney, the suture was locked in place with clips. In some cases, the bolstering suture was brought out of the peritoneal cavity via a suture passer and anchored with a hemostat with each upward pull. Also vessel loops were used for ureteral retraction as well. RESULTS Fifteen patients (6 female and 9 male) with an average age of 44.9 + 18.6 (16-74) years underwent a laparoscopic surgery via single incision technique comprising 10 left sided and 5 right sided cases. Average BMI was 28.2 + 3.6 (21.5-33.65) kg/m2. Average operative time was 194.7 + 46.3 (137-285) minutes with an average blood loss of 96.7 + 157.2 (25-650) ml. Mean length of hospitalization was 1.4 + 0.7 (1-3) days. Average follow up was 7.3 + 2.9 (2-11) months. Two patients required conversion to standard laparoscopic surgery due to bleeding (1 nephrectomy case) technical difficulty (1 pyeloplasty case). No post operative complications occurred. CONCLUSIONS Single incision surgery offers patients an aesthetic improvement to standard laparoscopic incisions with potentially less post operative analgesic requirements. Its learning curve may prevent its wide spread use, however, with newer techniques for intracorporeal retraction and judicious use of an additional 5mm port for Right sided tumors, this single incision technique may be deemed feasible. Longer follow-up with a larger cohort of patients will be required to verify the durability of this procedure with regards to pain control and overall feasibility. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e373 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Albert Mikhail Los Angeles, CA More articles by this author Arsenio Figueroa Fontana, CA More articles by this author L. Jonathan Bryant Fontana, CA More articles by this author Kirk Tamaddon Los Angeles, CA More articles by this author Jay Yew Downey, CA More articles by this author Linconln Maynes Riverside, CA More articles by this author Gary Chien Los Angeles, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Purpose: We present an age-stratified prospective assessment of urinary and sexual function of 300 patients after robot-assisted laparoscopic prostatectomy (RALP).Materials and Methods: Subjective assessment data of continence and potency were collected for different age groups (<50, 50-59, and >= 60 years old) preoperatively, and at 1, 3, 6, and 12 months after RALP. Health-related quality of life questionnaires evaluated return of baseline urinary and sexual function at the same time intervals.Results: The three age groups included 21, 129, and 150 patients (aged <50, 50-59, and >60 years old, respectively). Using Kaplan-Meier curves, younger men achieved subjective continence significantly earlier than older age groups when age groups were compared using a 60-year-old cut-off point (P = 0.02). However, subjective continence was noted to be equal among all age groups after 1 year of follow-up. Time to recovery of subjective potency among age groups shows a significant difference in favor of the younger age group (P = 0.01) Objective urinary function is equal between age groups at all time points, while objective sexual function assessment showed a trend toward better results in the younger age group.Conclusions: Younger men will likely have an earlier return of continence and potency compared to older men after RALP. However, continence outcomes were noted to be equal among age groups after I year of follow-up, while younger men continue to report superior potency outcomes compared to older men over the first postoperative year. Such findings are valuable in counseling older men undergoing this procedure.

Purpose: Laparoscopic partial nephrectomy (LPN) is a complex procedure frequently reserved for small, peripherally located renal tumors. Deep, infiltrating lesions often necessitate collecting system repair (CSR), mandating further intracorporeal suturing and reconstruction. We compared our experience with LPN where CSR was and was not required after tumor resection.Patients and Methods: Between October 2002 and December 2005, 84 patients underwent LPN. Tumor excision with pelvicaliceal system injury occurred in 52 patients, whereas 32 patients required no CSR. Perioperative and pathologic data were compared in the two groups.Results: Tumors with CSR were larger (mean 2.9 cm v 2.1 cm for non-CSR procedures; P = 0.001) and had larger pathologic specimen weights (mean 58.2 g v 21.8 g; P = 0.05). Blood loss (mean 210 mL) and hospital stay (mean 2.7 days) were similar in the two groups. Warm ischemia time (WIT) (mean 36.6 v 27.7 minutes; P < 0.001) and operative time (mean 238 v 207 minutes; P = 0.03) were longer in the CSR group. The intraoperative hemorrhage rate (7.7% v 9.4%; P = 0.34) and rate of conversion to open surgery (7.7% v 9.4%; P = 0.29) were similar, as were the incidences of postoperative bleeding (7.7% v 3.1%; P = 0.28) and urinary leakage (1.9% v 0; P = 0.62).Conclusion: Laparoscopic partial nephrectomy involving CSR is a technically demanding procedure that necessitates longer WIT and overall surgical time. However, when performed by an experienced laparoscopic surgeon, comparable complication rates and blood loss are observed. Technical variations for hemostasis, such as argon-beam coagulation and FloSeal and the use of the LapraTy clip for pelvicaliceal and parenchymal suture repair may facilitate LPN for more deeply invasive tumors.

Objectives To determine whether ischemia preconditioning (IPC) confers resilience to subsequent renal warm ischemia (WI) in a single-kidney porcine model. Methods After right nephrectomy was performed, 20 female pigs were randomized to 5 groups: group 1: 60 minutes IPC followed by 90 minutes WI; group 2: 25 minutes IPC followed by 90 minutes WI; group 3: no IPC and 90 minutes WI; group 4: 60 minutes IPC, no WI; and group 5: no IPC, no WI (sham control procedure). Ischemia preconditioning was performed for 60 minutes (4 minutes clamping followed by 11 minutes reperfusion) or 25 minutes (10 minutes clamping followed by 15 minutes reperfusion). Serum creatinine values were obtained preoperatively and on postoperative day (POD) 1, 3, 8, and 15. Results Mean serum creatinine values were comparable between groups on POD 1, with the exception of group 1, which was significantly worse than group 5 (control). On POD 3, renal function was similar between groups 1 and 2, and both were significantly worse than groups 4 and 5. On POD 8, renal dysfunction in group 1 was significantly worse than in group 3. All four animals from group 1 were killed after POD 8 because of overwhelming renal insufficiency. Conclusions Ischemia preconditioning did not suggest increased renal resilience to the kidney after subsequent prolonged WI. Our results further suggest that the protection provided by IPC in smaller animals is not appreciated in a larger-animal, single-kidney model. The additive effect of further ischemic insults was more deleterious to the remaining renal unit.

Background and Purpose: The LapraTy clip (LTc) is a useful tool for supplementing knot-tying during reconstructive laparoscopic surgery. However, data regarding its safety and efficacy are scarce. We critically assessed the in-vitro performance of the LTc over different sizes of two suture materials commonly used during reconstructive procedures.Materials and Methods: The gliding resistance (GR) of one or two LTcs was tested on various sizes of both Polysorb and Prolene sutures. The GR of each suture was then compared with its breaking strength. Forces were measured using a Vernier Force Sensor.Results: The GR of one LTc was significantly lower than the breaking strength of all Polysorb and Prolene suture sizes with the exception of 7-0 Prolene, with which the suture broke before the LTc slipped off. When two LTcs were placed sequentially, the GR increased significantly compared with a single LTc and was equal to or greater than the breaking strength for Polysorb 3-0 to 5-0 and Prolene 3-0 to 6-0. The percentage of GR over breaking strength was inversely related to suture size and was significantly greater with Prolene than with the Polysorb suture of the same size.Conclusions: Our results provide a better understanding of the resistive force an LTc offers before slipping and therefore failing. The results observed with Prolene sutures are encouraging and must be further investigated in an animal study to confirm the safety of the LTc when used during reconstructive procedures.

You have accessJournal of UrologyModerated Poster 21, Monday, May 21, 2007, 8:00 - 10:00 am1 Apr 2007704: Adult Stentless Laparoscopic Pyeloplasty: A Feasible Operation Kevin C. Zorn, Albert A. Mikhail, Marcelo A. Orvieto, Ofer N. Gofrit, Glenn S. Gerber, and Arieh L. Shalhav Kevin C. ZornKevin C. Zorn More articles by this author , Albert A. MikhailAlbert A. Mikhail More articles by this author , Marcelo A. OrvietoMarcelo A. Orvieto More articles by this author , Ofer N. GofritOfer N. Gofrit More articles by this author , Glenn S. GerberGlenn S. Gerber More articles by this author , and Arieh L. ShalhavArieh L. Shalhav More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)30944-3AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "704: Adult Stentless Laparoscopic Pyeloplasty: A Feasible Operation." The Journal of Urology, 177(4S), p. 236 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 177Issue 4SApril 2007Page: 236 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Kevin C. Zorn More articles by this author Albert A. Mikhail More articles by this author Marcelo A. Orvieto More articles by this author Ofer N. Gofrit More articles by this author Glenn S. Gerber More articles by this author Arieh L. Shalhav More articles by this author Expand All Advertisement PDF DownloadLoading ...

PURPOSE:It is generally accepted that simultaneous occlusion of the renal artery and vein during warm ischemia is more damaging than occlusion of the artery alone. Pneumoperitoneum during laparoscopy may impair venous backflow, negating the benefits of clamping the artery alone. We evaluated the effect of laparoscopic vs open surgery on the recovery of renal function after clamping of the renal artery and vein, and the artery alone in a solitary kidney porcine model. MATERIALS AND METHODS:Right laparoscopic nephrectomy was performed in 36 pigs. After a 12-day recovery period the animals were randomized into 3 groups, including 1) 120-minute warm ischemia with renal artery and vein occlusion, 2) 120-minute warm ischemia with artery alone occlusion and 3) control sham surgery. The groups were further subdivided into an open and a laparoscopic arm. Serum creatinine was assessed preoperatively, and on postoperative days 1, 3, 8 and 15. RESULTS:Artery alone clamping resulted in a significantly lower serum creatinine increase on postoperative days 1 and 3 in the open arm compared to the laparoscopic arm. Compared to open renal artery and vein clamping the increase in serum creatinine for open artery alone clamping was also significantly lower on postoperative days 1 and 3. No significant difference in postoperative serum creatinine was found between the laparoscopic artery alone, and the renal artery and vein arms at any time point. No significant serum creatinine changes were observed in the control sham surgery group compared to preoperative values at all followup time points. CONCLUSIONS:In this porcine model clamping of the artery alone during open surgery better protected the kidney from warm ischemia compared to renal artery and vein occlusion. This benefit was not observed during laparoscopic surgery. We speculated that the presence of pneumoperitoneum causes at least partial occlusion of the renal vein, thus, negating the benefit of renal artery clamping only.

Background and Purpose: Several experienced practitioners of open surgery with limited or no laparoscopic background have adopted robot-assisted laparoscopic radical prostatectomy (RLRP) as an alternative to open radical prostatectomy (RRP), demonstrating outcomes comparable to those in large RRP and laparoscopic prostatectomy series. Thus, the significance of prior laparoscopic skills seems unclear. The learning curve, with respect to operative time and complications, in the hands of a devoted laparoscopic surgeon has not been critically assessed. We evaluated the learning curve of a highly experienced laparoscopic surgeon in achieving expertise with RLRP. Patients and Methods: We prospectively evaluated 150 consecutive patients undergoing RLRP by a single surgeon between March 2003 and September 2005. The first 25 cases were performed with the assistance of a surgeon experienced in open RRP. Data were compared for the first, second, and third groups of 50 cases. Demographic data were similar for the three groups. Urinary and sexual function data were evaluated subjectively and objectively using the RAND-36v2 Survey and the UCLA PCI preoperatively and at 3, 6, and 12 months postoperatively. Results: The mean operative time, blood loss, and conversion rate decreased significantly with increasing experience. All open conversions occurred during the first 25 cases. Intraoperative and postoperative complication rates were similar among groups. Although the differences were not significant, urinary and sexual function recovery improved with experience. Conclusion: The RLRP learning curve for a fellowship-trained laparoscopic surgeon seems to be similar to that of laparoscopically naive yet experienced practitioners of open RRP. The RLRP is safe and reproducible and even during the learning curve can produce results similar to those reported in large RRP series. The importance of assistance by an experienced open RRP surgeon during the learning curve cannot be overemphasized.

OBJECTIVES To assess the efficacy, reliability, and performance of the LapraTy clip (LTc) as a substitute for knot tying during reconstructive surgery in a porcine model.METHODS Twenty-four farm pigs were divided in two groups, each undergoing two surgical procedures: group A, transperitoneal laparoscopic cavotomy and small-bowel enterotomy with repair, and group B, laparoscopic partial nephrectomy and cystotomy with repair. In all animals LTc were used to replace knot tying. Tissue specimens were harvested and examined at 2, 4, and 8 weeks postoperatively to assess success of reconstruction and tissue reaction.RESULTS There were no major complications. Animals in group A showed no clinical signs of caval obstruction. No intraperitoneal collections or significant narrowing were noted at the enterotomy sites. Animals in group B showed no evidence of fluid collections around the partially resected kidneys or the cystotomy sites, and all repairs were intact. Pathologic examination revealed that all LTc were encapsulated by fibroblasts and giant cells typical of a foreign body-type granulomatous reaction. No evidence of clip migration into the epithelium was noted in any of the tissues examined.CONCLUSIONS In an animal model, the LTc is a safe and efficient alternative to knot tying during laparoscopic reconstructive surgery. We are currently evaluating the clinical applicability of the LTc in a variety of urologic conditions. We believe that other surgical specialties should evaluate this device as well. (c) 2007 Elsevier Inc.

OBJECTIVES:Medical therapy often fails to cure benign retroperitoneal fibrosis (RPF), necessitating a surgical approach. Preoperative and postoperative adjuvant medical therapy and the timing of surgical intervention are not well-established. We surveyed centers of laparoscopic excellence to determine the current practices in the treatment of RPF.METHODS:Surveys were sent to all institutions with Endourological Society-recognized fellowships. The data collected were analyzed for trends in the treatment of RPF. Additional information was collected from participating institutions to better characterize the experience with laparoscopic ureterolysis and adjunctive medical management.RESULTS:Of the surveys sent out, 17 completed surveys were returned (41%). A total of 73 patients had been treated for RPF. Most centers (13 of 17) used a conventional laparoscopic approach with rare conversion to hand assistance. The medical management of RPF was directed by urologists, rheumatologists, or other specialists in 59%, 24%, and 18% of institutions, respectively. Steroid therapy was administered preoperatively by 15 of 17 centers. Postoperatively, 10 of 17 centers continued treatment with steroids and/or cytotoxic agents. Eight institutions provided data on 46 renal units in the second part of the study. The success rate of laparoscopic ureterolysis per renal unit was 83% (38 of 46). No difference was seen in the outcomes of patients who received adjuvant medical therapy compared with those who did not (16 of 19 versus 22 of 27; P = 0.48) after a mean follow-up of 17.7 months.CONCLUSIONS:The results of this study have shown that no uniform treatment algorithm exists for RPF at centers of laparoscopic excellence. Most institutions recommended an attempt at steroids followed by laparoscopic ureterolysis. Laparoscopic ureterolysis had a high success rate, and adjuvant medical therapy did not appear to contribute to the success rate.

Radiofrequency ablation (RFA) has emerged as a minimally invasive nephron-sparing treatment for small (<4-cm) renal tumors. Post-RFA complications have been reported. We describe a patient who developed complete renal-pelvic obstruction after RFA. To our knowledge, this is the first such case to be reported and the second reported renal-unit loss as the result of collecting-system obstruction after RFA.

PURPOSE For men with high-volume or high-grade prostate cancer, wide excision of the ipsilateral neurovascular bundle is commonly performed. The concept of nerve reconstruction is intriguing as a feasible approach to preserve sexual function (SF). We sought to evaluate the functional, pathologic, and oncologic outcomes of men who underwent robot-assisted sural-nerve graft (SNG) interposition. PATIENTS AND METHODS Between February 2003 and May 2007, 1175 consecutive men underwent robot-assisted laparoscopic radical prostatectomy (RLRP). Database analysis identified 27 men who had SNG: 4 bilateral (BL) and 23 unilateral (UL). SF was prospectively evaluated preoperatively and at 1, 3, 6, 12, and 24 months postoperatively using validated questionnaires. Positive surgical margins (PSMs), biochemical recurrence (BCR), and potency were evaluated. RESULTS Compared with RLRP patients without SNG, patients with SNG were younger (57.2 v 61.8 years, P=0.02), had a higher Gleason score (P=0.02), and had a higher clinical and pathologic stage (P<0.001 for both). Mean surgical time was significantly longer (349 v 195 min, P<0.001) in patients with SNG. With a mean follow-up of 26.1 months, 11 (47.8%) patients with UL-SNG and zero men with BL-SNG regained potency. No significant difference in SF was observed between UL nerve sparing and no SNG (56%) compared with UL nerve sparing with UL-SNG (P=0.44). Rates of return-to-baseline SF (RTB-SF) at 6, 12, and 24 months were 11%, 36% and 45% for UL-SNG, respectively, which were also comparable to UL nerve sparing only (P>0.05). No patient (0%) in the BL-SNG group ever achieved RTB-SF status at any time point. PSMs were observed in 37% (10/27) of all patients. BCR occurred in nine patients (33.3%), seven of whom had PSM (78%); treatment failure occurred within 6 months of surgery, necessitating androgen deprivation therapy. CONCLUSION Despite optimism regarding SNG, long-term functional outcomes have been disappointing, particularly for BL nerve interposition. UL-SNG functional outcomes do not appear to improve outcomes when compared with men with UL nerve preservation. With the greater risk of PSM and BCR in patients who are considered candidates for SNG, newer treatment modalities are needed to cure their disease while preserving SF.

BACKGROUND AND PURPOSE Previous reports have suggested that a 2% to 5% device failure rate (FR) be quoted when counseling patients about robot-assisted laparoscopic radical prostatectomy (RLRP). We sought to evaluate our FR on the da Vinci system. PATIENTS AND METHODS Since February 2003, more than 800 RLRPs have been performed at our institution using a single three-armed robotic unit. A prospective database was analyzed to determine the device FR and whether it resulted in case abortion or open conversion. Intuitive Surgical Systems provided data concerning the system's performance, including its fault rate. Error messages were classified as recoverable and non-recoverable faults. RESULTS Between February 2003 and November 2006, 725 RLRP cases were available for evaluation. There were no intraoperative device failures that resulted in a case conversion. Technical errors resulting in surgeon handicap occurred in 3 cases (0.4%). Four patients (0.5%) had their procedures aborted secondary to system failure at initial set-up prior to patient entrance to the operating room. Data analysis retrieved from the da Vinci console reported on a total of 807 procedures since 2003. Only 4 cases (0.4%) were reported from the Intuitive Surgical database to result in either an aborted or a converted case, which compares favorably with our results. Since the last computer system upgrade (September 2005), the mean recoverable and non-recoverable fault rates per procedure were 0.21 and 0.05, respectively. CONCLUSIONS For all the advanced features the da Vinci system offers, it is surprisingly reliable. Throughout our RLRP experience, device failure resulted in case conversion, procedure abortion, and surgeon handicap in 0, 0.5%, and 0.4% of procedures, respectively. As such, a lowered device FR of 0.5% should be used when counseling patients undergoing RLRP. To avoid futile general anesthesia, a policy should be enforced to ensure that the da Vinci system is completely set up before the patient enters the operating room.

OBJECTIVES:To determine the effect of prostate weight (PW) on robotic laparoscopic radical prostatectomy (RLRP) outcomes. The effect of PW on surgical and pathologic outcomes has been reviewed in open and laparoscopic prostatectomy series. Little is known about its effects during RLRP.METHODS:From February 2003 to November 2005, 375 men underwent RLRP. Patients were divided into four groups on the basis of the pathologic PW: group 1, less than 30 g; group 2, 30 g or more to less than 50 g; group 3, 50 g or more to less than 80 g; and group 4, 80 g or larger. The groups were compared prospectively. Continence and sexual function were assessed using validated questionnaires.RESULTS:Of the 375 patients, 20, 201, 123, and 31 had a PW of less than 30 g, 30 g or more to less than 50 g, 50 g or more to less than 80 g, and 80 g or larger, respectively. A significant difference was found in age and prostate-specific antigen values among the four groups (P <0.001). No significant differences in operative time, estimated blood loss, transfusion rate, hospital stay, length of catheterization, and complication incidence were observed among the four groups. The overall rate of positive surgical margins was significantly different among the groups (P = 0.002), demonstrating a trend of increasing positive surgical margins with a lower PW. Within the patients with Stage pT2, a significant increase in positive surgical margins was found with lower PWs (P = 0.026). The objective return of baseline and subjective sexual and urinary function, as determined by questionnaire scores, was not affected by the PW.CONCLUSIONS:RLRP can be performed safely and with similar perioperative outcomes in men, regardless of the PW. We found a significant inverse relationship between surgical margin status and PW, specifically in those with Stage pT2 disease.

We sought to evaluate post-operative return of urinary and sexual function in men undergoing robotic-assisted laparoscopic radical prostatectomy (RLRP). Prospective assessment of urinary continence and sexual function was performed in patients undergoing RLRP. Subjective assessment involved the use of the validated RAND-36 Item Health Survey/UCLA Prostate Cancer Index questionnaire. Questionnaires were completed pre-operatively and at 1, 3, 6 and 12 months post-operatively. Subset analyses were performed to assess the effect of age on functional outcomes. A total of 338 consecutive patients underwent RLRP between February 2003 and August 2005. Included patients for evaluation comprised of 21, 129, and 150 patients, aged <50, 50–59, and ≥60 years old, respectively. Kaplan–Meier curve analysis demonstrated that younger men (<60 years) achieved subjective continence significantly earlier than older age group (≥60 years) (P = 0.02). Continence rates, however, equalized among all age groups at 1 year follow-up. Younger men (<50 years) also demonstrated a quicker and greater return of sexual function (P = 0.01), which persisted through assessment at 1 year post-operatively. Our results suggest that younger men may have an earlier return of continence and potency when compared to men > 60 years. Despite this finding, continence outcomes appear to be equal among age groups after 1 year of follow-up. Moreover, men < 60 years continue to report superior potency outcomes compared to men > 60 years at 1 year post-operatively. Such findings are valuable in counseling patients undergoing RLRP.

You have accessJournal of UrologyModerated Poster 24, Monday, May 21, 2007, 10:00 am - 12:00 pm1 Apr 2007815: Da Vinci Robot Error and Failure Rate: Single Institution Experience on a Single 3-Arm Robot Unit of Over 700 Consecutive Robotic-Assisted Laparoscopic Radical Prostatectomies Kevin C. Zorn, Ofer N. Gofrit, Marcelo A. Orvieto, Albert A. Mikhail, Edward M. Gong, Arieh L. Shalhav, and Gregory P. Zagaja Kevin C. ZornKevin C. Zorn More articles by this author , Ofer N. GofritOfer N. Gofrit More articles by this author , Marcelo A. OrvietoMarcelo A. Orvieto More articles by this author , Albert A. MikhailAlbert A. Mikhail More articles by this author , Edward M. GongEdward M. Gong More articles by this author , Arieh L. ShalhavArieh L. Shalhav More articles by this author , and Gregory P. ZagajaGregory P. Zagaja More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)31055-3AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "815: Da Vinci Robot Error and Failure Rate: Single Institution Experience on a Single 3-Arm Robot Unit of Over 700 Consecutive Robotic-Assisted Laparoscopic Radical Prostatectomies." The Journal of Urology, 177(4S), p. 272 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 177Issue 4SApril 2007Page: 272 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Kevin C. Zorn More articles by this author Ofer N. Gofrit More articles by this author Marcelo A. Orvieto More articles by this author Albert A. Mikhail More articles by this author Edward M. Gong More articles by this author Arieh L. Shalhav More articles by this author Gregory P. Zagaja More articles by this author Expand All Advertisement PDF DownloadLoading ...