저자 아무 승인 있다.

여기에 설명 된 모든 메서드는 베이징 병원의 윤리 위원회에 의해 승인 되었습니다. 수술을 위한 표시 nonneurogenic 남성 LUT에 대 한 비뇨기과의 유럽 협회 지침을 따르면 됩니다. 금기 의심된 전립선 암 또는 detrusor 역 기능을 포함합니다.
1입니다. 작업에 대 한 악기
<ol><li>W. 160의 최대 전원 LBO 크리스탈 레이저의 가용성 보장</li>
	<li>자가 방광 대 대는 endfiring 레이저 섬유와 염 분 솔루션을 사용 합니다.</li>
	<li>26F 레이저 resectoscope을 사용 하 여 좋은 비전을 얻으려고 절제 효율을 향상 시켜줍니다.</li>
</ol>2입니다. 준비 작업
<ol><li>정 맥 항생제를 preoperatively 제공 (세 나트륨 100 mL 0.9%sodium 염화 솔루션 작업 전에 30 분 1.5 g의 정 맥 행정) 모든 환자에 게.</li>
	<li>마 취를 하기 전에 작업 테이블에 누워 있는 환자를 확인 합니다. 참고: 전신은 효과적이 고이 작업에 대 한 적절 한, 빡빡한 마지막으로 환자의 일반 상태에 따라 마 취의 모드를 결정 합니다.</li>
	<li>Dorsa 쇄 석 술 위치에 살 균 방식에서 환자 드러 워 진. 어떤 피부 준비를 수행 하지 마십시오.</li>
</ol>3. 절차 단계
<ol><li>
중간 엽의 Vaporesection
	<ol>
<li>캐비티 전체 방광과 전립선 요도 신중 하 게는 resectoscope를 통해 후 검토 방광 팽창 합니다. 참고: 이 단계 비뇨기과 양자 ureteral 오리 피스와 verumontanum를 포함 하 여 몇 가지 주요 해부학 노래를 찾을 수 있습니다.</li>
		<li>처음 두 줄을 표시 합니다. 이 라인에서 5 시와 7 시 방광 목에 중간과 측면 돌출부, 마지막으로 verumontanum의 인접 마진에서 종료 사이의 경계를 따라 계속 확인 하십시오.</li>
		<li>설정된 레이저 통해 전립선 조직을 Vaporize W. 80에서 파이버가이 라인을 따라 레이저 증발에 의해 때까지 파워 화이트 주기적 섬유 볼 수 있습니다. 참고: 이것은 전립선 캡슐의 징조입니다. 두 줄 한 줄은 verumontanum에 인접 한에 병합 됩니다.</li>
		<li>레이저 파워에서 설정 80 ~ 100 마크 W. 여러 라인 레이저 파이버를 통해 중간 엽의 표면에. 다음 기화 기술을 통해이 라인에 따라 여러 덩어리로 구동축 중간 엽을 나눕니다. 그런 다음 중간 엽에서 각 청크 분할. 마지막으로, 전체 중간 엽을 제거 합니다.</li>
	</ol>
</li>
	<li>
측면 돌출부의 Vaporesection
	<ol>
<li>Cystoscope 180 ° 회전 하 여 12 시에 전립선의 꼭대기에서 방광 목에는 티슈를 기체 화할. 레이저 섬유 12 시에 요 실 금 수술 후 소변을 일으킬 수 있는 꼭대기에 너무 가까이 게 하지 마십시오. 참고: 이 기술은 전립선 지붕 주위 조직의 절제 율을 향상 시킵니다.</li>
		<li>두 측면 돌출부의 낮은 마진을 명확 하 게 식별 vaporesection 완료 되 면.</li>
		<li>측면 돌출부를 제거 하기 전에 verumontanum의 근 위 끝에 3 시와 9 시에 방광 목에서 발생 하는 또 다른 2 유사한 홈을 설정 합니다.</li>
		<li>측면 선의 조직을 제거 합니다. 80 ~ 100 W에서 레이저 파워를 설정 하 고 왼쪽된 엽 통해 레이저 섬유의 왼쪽된 엽 기화 기술을 통해이 라인에 따라 여러 조각으로 분할 하는 표면에 여러 줄 표시. 그런 다음 엽에서 각 청크 분할 하 고 마지막으로 전체 왼쪽된 엽을 제거 합니다. 오른쪽 엽을 제거 하려면이 절차를 반복 합니다.</li>
		<li>캡슐의 기존 경계를 따라 나머지 선 조직을 제거 합니다.</li>
	</ol>
</li>
	<li>
채널 트리밍
	<ol>
<li>선, 구멍의 무결성을 향상의 꼭대기 주위 돌기 조직 일부 트림을 기억 하십시오.</li>
		<li>합병증을 피하기 위해 자가 (즉, 캡슐 구멍 뚫 기 또는 괄약근 부상), 외부 요도 괄약근 근처 조직 트림 낮은 80 와트 보다는 더 적은 힘을 절제 보다는 증발 기법을 사용 합니다.</li>
	</ol>
</li>
	<li>
Hemostasis 그리고 도관 법
	<ol>
<li>물 흐름에 의해 조직 덩어리를 제거 하는 resectoscope의 인터페이스와 일치 하는 유리 주사기를 사용 합니다. 방광 및 전립선 포 resectoscope를 통해 잔여 조직의 증거가 다는 것을 확인 하 고 그대로 ureteral orifices의 식별 합니다.</li>
		<li>수술 부위의 주위 출혈을 막으려고 낮은 레이저 파워 (30 ~ 50 W)를 사용 합니다. 일반적으로 3 ~ 5 mm 섬유와 만족 hemostasis 효과 얻으려고 혈관 사이 적절 한 거리를 유지.</li>
		<li>요도에서 resectoscope를 제거 합니다. 충분히 lidocaine 젤에 의해 요도 윤 활 후 22 프랑스 폴 리 카 테 터를 요도 구멍에서 30 mL 물으로 부드럽게 방광 구멍을 풍선에 놓습니다.</li>
	</ol>
</li>
	<li>
수술 후 관리
	<ol>
<li>그들은 완전히 마 취에서 깨어날 때까지 약 3 h postoperatively 관리 단위에서에서 침대에 누워 환자를 하자. 한편, 환자 모니터와 의료 산소는이 시간 동안 사용할 수 있는지 확인 합니다.</li>
		<li>완전히 깨어나 자 마자 병 동에 환자를 반환 합니다. 환자가 음식을 좀 물 좀 마실을 시작 하자. 소변 출력을 기록 하 고 소변의 색에 주의.</li>
	</ol>
</li>
</ol>

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이 연구는 국가 키 R & D 프로그램의 중국 (2017YFC0840100 및 2017YFC0840102)에 의해 후 원했다.

여기, 우리는 PVRP와 함께 우리의 경험을 공유. 첫째, PVRP 적절 한 경계와 함께 전립선 캡슐의 더 나은 노출 고 캡슐 구멍 뚫 기의 위험을 감소. 둘째, 조직 제거 수술 캡슐, 특히 12 시에, 전립선 요도의 지붕 주위 조직 절제를 용이 하 게 하 고 만족 스러운 조직 제거 속도 제공 합니다 groove와 함께 밖으로 실행 되어야 한다. 셋째, 처음를 취득 한 전립선 요도에 넓은 채널 강화 요원 시각화 중간 엽을 ?...

비록 transurethral 절제술 (TURP) 전립선의 양성 전립선 증식 (BPH) 수술 치료의 황금 표준으로 아직도 받아들여진다, 레이저 수술 점차 인기가 더 덜 자가 더 나은 환자 관용 때문 혈액 손실, 만족 스러운 효능 및 짧은 수술 후 회복1,2,3. 현재, 전세계 BPH 치료에 대 한 가장 일반적으로 사용 되는 레이저는 리튬 칼륨 titanyl 인산 염 또는 리튬 triborate (LBO) 크리스탈4,5에 의해 생성 됩니다. 전통적으로,이 sidefiring 레이저 holmium 레이저 같은 레이저의 다른 유형에 비해과 툴 륨 레이저로 분류 됩니다.
전립선 (PVP) 수술의 Photoselective 증발 때문에 염 분 관개6,7, TURP 증후군을 거부할 수 있는 상당히 고 레이저에 의해 더 낮은 요로 증후군 (LUT)의 신뢰할 수 있는 효능의 다른 유형에 비해 PVP는 연구8,,910의 시리즈에 의해 확인 되었다. 그러나, PVP 측면 발사 레이저 방출 연관도 약 20%의 에너지 손실 및 레이저 섬유11,,1213의 짧은 수명을 포함 하 여 몇 가지 단점이 있다. 또한, PVP 놓친된 전체 조직 증발 때문에 전립선 암 진단의 가능성을 증가 시킵니다.
Photoselective Vaporesection의는 전립선 (PVRP)는 최종 발사 섬유의 소개 성공적으로 대부분 위에서 언급 한 PVP의 단점의 극복. 첫째, 팁 intraoperatively 전송 레이저 에너지 손실 없이 거의 조직에 가능 하다. 둘째 때 섬유 파편 수집 끝에, 그것은 단순히 영향을 받는 부분을 제거 하 여 이상적인 출력 전력을 유지 하기 위해 간단 합니다. 마지막으로, 레이저 절제 수술 후 pathologic 시험 견본의 컬렉션을 수 있습니다. 따라서 BPH 치료에서이 프로토콜을 사용 하 여 수 조직 제거 율 향상, 수술 시간을 절약 하 고 자가 안전을 향상.

<table><tbody><tr><td>FLARE surgical Laser Fiber</td><td>REALTON</td><td></td><td>The FLARE Surgical laser Fiber is a 600 micron fiber with an straight tip that transmits the laser energy directly. this product is packaged sterile for disposable use and should not be re-sterilized or reused. Dispose of properly after use.</td></tr><tr><td>AURORA Surgical Green Laser System</td><td>REALTON</td><td>pvp-160-021</td><td>The AURORA Surgical green laser system is a diode-pumped, frequency-doubled Nd:YAG solid state laser. The AURORA Surgical green laser system features a &amp;ldquo;Plug and Play&amp;rdquo; capability that self-adjusts to the facility&amp;rsquo;s individual voltage requirements, eliminating the need for electrical modifications. The laser system also includes an air-cooled internal mechanism, ensuring safe operating temperatures with no external water connections. Laser energy emission and system status selection is activated through a surgeon-controlled, color-coded footswitch or system touch screen feature located in the laser console.</td></tr></tbody></table>

photoselective vaporesection of the prostate via an end-firing lithium triborate crystal laser

친절 한 전립선 hyperplasia (BPH)으로 인 한 낮은 요로 증상 (LUT)의 발생은 노화 남성 인구에서 높은 발병 률과 일반적인 문제 이다. 비록 그것이 생명을 위협 하는 질병, BPH 삶의 질에 심각한 영향을 미칠 문제를 발생 합니다. 여기, BPH는 전립선 (PVP)의 photoselective 증발의 변형으로 볼 수 있는 치료에 전립선 (PVRP)의 photoselective vaporesection 라는 새로운 기술을 소개 합니다. 이 이렇게 적은 레이저 에너지 손실, 자가 적은 합병증 뿐만 아니라 더 많은 조직 절제 율을 포함 하 여 PVP 기법에 비해 몇 가지 장점을 제공 합니다.

PVRP 수술 환자는 35의 총은 우리의 연구 중 하나에 포함 됐다. 환자 세 72.1 ± 7.1 년 (범위 53-85 년) 이었다.
수술 데이터는 표 1에 나열 됩니다. 평균 레이저 방출 시간 평균 수술 시간의 약 50%를 차지 한다. 대부분의 환자에서 혈액 손실이 < 200 mL 이었다. 그러나, 평균 일부 온건한 경우 출혈로 인해 이탈. 환자의 거의 90...

Watch this Scientific Journal Video about Photoselective Vaporesection of the Prostate via an End-firing Lithium Triborate Crystal Laser at JoVE.com

Photoselective Vaporesection of the Prostate via an End-firing Lithium Triborate Crystal Laser

여기 선물이 양성 전립선 증식 (BPH)의 치료에 대 한 Photoselective Vaporesection 전립선 (PVRP)을 수행 하는 프로토콜.

최종 발사 리튬 Triborate 크리스탈 레이저를 통해 전립선의 Photoselective Vaporesection

The occurrence of lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) is a common problem with a high incidence in the aging ...

photoselective-vaporesection-prostate-via-an-end-firing-lithium

Universidad de Cartagena UDEC

Research

JoVE Journal

Medicine

7.9K 조회수.  Beijing Hospital, National Center of Gerontology. 여기 선물이 양성 전립선 증식 (BPH)의 치료에 대 한 Photoselective Vaporesection 전립선 (PVRP)을 수행 하는 프로토콜.

비디오: Photoselective Vaporesection of the Prostate via an End-firing Lithium Triborate Crystal Laser

Evaluation of Nanoparticle Uptake in Tumors in Real Time Using Intravital Imaging

Current technologies for tumor imaging, such as ultrasound, MRI, PET and CT, are unable to yield high-resolution images for the assessment of nanoparticle uptake in tumors at the microscopic level1,2,3, highlighting the utility of a suitable xenograft model in which to perform detailed uptake analyses. Here, we use high-resolution intravital imaging to evaluate nanoparticle uptake in human tumor xenografts in a modified, shell-less chicken embryo model. The chicken embryo model is particularly well-suited for these in vivo analyses because it supports the growth of human tumors, is relatively inexpensive and does not require anesthetization or surgery 4,5. Tumor cells form fully vascularized xenografts within 7 days when implanted into the chorioallantoic membrane (CAM) 6. The resulting tumors are visualized by non-invasive real-time, high-resolution imaging that can be maintained for up to 72 hours with little impact on either the host or tumor systems. Nanoparticles with a wide range of sizes and formulations administered distal to the tumor can be visualized and quantified as they flow through the bloodstream, extravasate from leaky tumor vasculature, and accumulate at the tumor site. We describe here the analysis of nanoparticles derived from Cowpea mosaic virus (CPMV) decorated with near-infrared fluorescent dyes and/or polyethylene glycol polymers (PEG) 7, 8, 9,10,11. Upon intravenous administration, these viral nanoparticles are rapidly internalized by endothelial cells, resulting in global labeling of the vasculature both outside and within the tumor7,12. PEGylation of the viral nanoparticles increases their plasma half-life, extends their time in the circulation, and ultimately enhances their accumulation in tumors via the enhanced permeability and retention (EPR) effect 7, 10,11. The rate and extent of accumulation of nanoparticles in a tumor is measured over time using image analysis software. This technique provides a method to both visualize and quantify nanoparticle dynamics in human tumors.

We present a novel approach to quantify nanoparticle localization in the vasculature of human xenografted tumors using dynamic, real-time intravital imaging in an avian embryo model.

Intravital 이미징을 사용하여 실시간으로 종양의 Nanoparticle의 이해 평가

Current technologies for tumor imaging, such as ultrasound, MRI, PET and CT, are unable to yield high-resolution images for the assessment of nanoparticle ...

연구

의학

Probe-based Confocal Laser Endomicroscopy of the Urinary Tract: The Technique

Probe-based confocal laser endomicroscopy (CLE) is an emerging optical imaging technology that enables real-time in vivo microscopy of mucosal surfaces during standard endoscopy. With applications currently in the respiratory1 and gastrointestinal tracts,2-6 CLE has also been explored in the urinary tract for bladder cancer diagnosis.7-10 Cellular morphology and tissue microarchitecture can be resolved with micron scale resolution in real time, in addition to dynamic imaging of the normal and pathological vasculature.7
The probe-based CLE system (Cellvizio, Mauna Kea Technologies, France) consists of a reusable fiberoptic imaging probe coupled to a 488 nm laser scanning unit. The imaging probe is inserted in the working channels of standard flexible and rigid endoscopes. An endoscope-based CLE system (Optiscan, Australia), in which the confocal endomicroscopy functionality is integrated onto the endoscope, is also used in the gastrointestinal tract. Given the larger scope diameter, however, application in the urinary tract is currently limited to ex vivo use.11 Confocal image acquisition is done through direct contact of the imaging probe with the target tissue and recorded as video sequences. As in the gastrointestinal tract, endomicroscopy of the urinary tract requires an exogenenous contrast agent&mdash;most commonly fluorescein, which can be administered intravenously or intravesically. Intravesical administration is a well-established method to introduce pharmacological agents locally with minimal systemic toxicity that is unique to the urinary tract. Fluorescein rapidly stains the extracellular matrix and has an established safety profile.12 Imaging probes of various diameters enable compatibility with different caliber endoscopes. To date, 1.4 and 2.6 mm probes have been evaluated with flexible and rigid cystoscopy.10 Recent availability of a &lt; 1 mm imaging probe13 opens up the possibility of CLE in the upper urinary tract during ureteroscopy. Fluorescence cystoscopy (i.e. photodynamic diagnosis) and narrow band imaging are additional endoscope-based optical imaging modalities14 that can be combined with CLE to achieve multimodal imaging of the urinary tract. In the future, CLE may be coupled with molecular contrast agents such as fluorescently labeled peptides15 and antibodies for endoscopic imaging of disease processes with molecular specificity.

Probe-based confocal laser endomicroscopy enables real-time microscopy of the human urinary tract during cystoscopy, providing dynamic, intravital imaging of pathological states such as bladder cancer with cellular resolution. Endomicroscopy may augment the diagnostic accuracy of standard white light endoscopy and provide intraoperative image guidance to improve surgical resection.

요로의 프로브 기반 공 촛점 레이저 Endomicroscopy : 기술

Probe-based  confocal laser endomicroscopy (CLE) is an emerging optical imaging technology  that enables real-time in vivo microscopy of mucosal surfaces ...

Endotracheal Intubation in Mice via Direct Laryngoscopy Using an Otoscope

Mice, both wildtype and transgenic, are the principal mammalian model in biomedical research currently. Intubation and mechanical ventilation are necessary for whole animal experiments that require surgery under deep anesthesia or measurements of lung function. Tracheostomy has been the standard for intubating the airway in these mice to allow mechanical ventilation. Orotracheal intubation has been reported but has not been successfully used in many studies because of the substantial technical difficulty or a requirement for highly specialized and expensive equipment. Here we report a technique of direct laryngoscopy using an otoscope fitted with a 2.0 mm speculum and using a 20 G&#160;intravenous catheter as an endotracheal tube. We have used this technique extensively and reliably to intubate and conduct accurate assessments of lung function in mice. This technique has proven safe, with essentially no animal loss in experienced hands. Moreover, this technique can be used for repeated studies of mice in chronic models.

Endotracheal Intubation in Mice via Direct Laryngoscopy Using an Otoscope

We have developed a simple, reliable, and relatively inexpensive method for endotracheal intubation in mice via direct laryngoscopy using an otoscope with a 2.0 mm speculum. This technique is atraumatic and can be used for repeated measurements in chronic experiments. We find it superior to tracheostomy or previously reported nonsurgical techniques.

마우스의 기관 내 삽관<em&gt;를 통해</em이경 사용&gt; 직접 후두경

Mice, both wildtype and transgenic, are the principal mammalian model in biomedical research currently. Intubation and mechanical ventilation are ...

Surgical Treatment for Benign Prostatic Hyperplasia: Holmium Laser Enucleation of the Prostate (HoLEP).

Benign prostatic hyperplasia (BPH) commonly occurs among elderly males. The condition causes symptoms in the lower urinary tract, thereby reducing the quality of life. BPH includes 2 major treatments: medication and surgery. Surgical treatment is often the most effective and final intervention. Holmium laser enucleation of the prostate (HoLEP), one of the most efficient surgical procedures for BPH, is conducted transurethrally. During surgery, the most important and most difficult part is to locate the surgical capsule of the prostate, which is consistent to the idea of anatomic surgery. Different skills may be needed in treating different parts of the prostate. HoLEP tends to be efficient and safe with good hemostatic properties, and able to treat bladder calculus, which may be the complications of BPH. The technique is particularly suitable for prostate of varying volumes and sizes. Indeed, HoLEP also presents certain disadvantages, such as a long learning curve and costly equipment. Regardless, this method may be the "new standard" and the excellent method for the surgical treatment of BPH.

Surgical Treatment for Benign Prostatic Hyperplasia: Holmium Laser Enucleation of the Prostate HoLEP.

Here we present a safe and efficient protocol, holmium laser enucleation of the prostate, to treat benign prostatic hyperplasia.

양성 전립선 비 대 증에 대 한 수술 치료: Holmium 레이저 Enucleation (HoLEP) 전립선의.

Benign prostatic hyperplasia (BPH) commonly occurs among elderly males. The condition causes symptoms in the lower urinary tract, thereby reducing the ...

Enucleation of the Prostate for the Treatment of Benign Prostatic Hyperplasia Using a 980 nm Diode Laser

In the aging male population, the occurrence of lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) is a common problem. Here, we introduce a new technique called 980 nm diode laser enucleation (DiLEP) to treat BPH1. Diode lasers can absorb both water and hemoglobin at the same time, so they are good for cutting and hemostasis2. The diode laser was approved by the FDA in 2007, and has been used in the treatment of BPH because of its effective cutting and hemostasis effect3. DiLEP presents several advantages over other techniques, such as TURP, HoLEP, and PVP. During the procedure, we define the boundary of a high-volume prostate and separate it into three lobes with a diode laser by burning two rings and one groove (like a Cupid&#39;s arrow). Compared to other procedures, mDiLEP has fewer intraoperative complications, a shorter learning curve, and achieves more tissue resection.

Here, we present a protocol for modified 980 nm diode laser enucleation to treat large volume benign prostatic hyperplasia.

980nm 다이오드 레이저를 사용한 양성 전립선 비대증 치료를 위한 전립선 적출

In the aging male population, the occurrence of lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) is a common problem. ...

Endoscopy Guided Photoablation of Endometrial Cysts using a 980 nm Laser with a Contact Fiber in Mares

In mares, endometrial cysts are associated with endometriosis and can cause maternal recognition failure or compromise and delay pregnancy diagnoses. Historical treatments were invasive and had adverse effects on the endometrium. Hysteroscopically guided laser therapy is easy and effective for endometrial cysts resection, with no deleterious effects for the endometrium.
A 110 cm long and 1.0 cm wide endoscope is sterilely introduced in the uterus through the open cervix of an estrous mare after vulvar cleaning. The uterus is slowly infused with less than 1 L of physiologic solution and the laser fiber is inserted in the biopsy canal of the endoscope. Cysts are then cauterized with the 980 nm diode laser with a contact fiber set at 20&#8210;2 5W in continuous mode. Each cyst is punctured&#160;until complete voiding of the cyst and shrinking of the cyst wall around the fiber. Uterine lavages with sterile saline solution are performed directly after the surgery and for one or two days as non-inflammatory fluid can be observed.
This procedure is easy and quickly performed, with no obvious deleterious effects. Cysts resection makes ultrasound pregnancy diagnosis easier and, in some cases, could restore proper embryo migration in the uterine horns between day 6.5 and 17. However, this treatment does not improve the underlying histological lesions related to endometriosis. These considerations should be clearly expressed to the breeder before this procedure.

The aim of this report is to describe the photoablation of endometrial cysts in the mare using an endoscopic laser device, and to discuss the interest and limitations of this new approach to deal with low fertility issues.

내시경 검사 유도 자궁 내막 낭종의 980 nm 레이저를 사용 하 여 Mares에 접촉 섬유와

In mares, endometrial cysts are associated with endometriosis and can cause maternal recognition failure or compromise and delay pregnancy diagnoses. ...

Focal Laser Ablation of Prostate Cancer: An Office Procedure

In this article, we describe and illustrate an outpatient procedure for focal laser ablation (FLA) of prostate cancer (PCa). The procedure is conceptually similar to a fusion biopsy and is performed under local anesthesia in a clinic setting; treatment time is usually less than one hour. Laser insertion is guided by ultrasound; lesion targeting is via magnetic resonance imaging-ultrasound (MRI/US) fusion, as in targeted prostate biopsy. Real-time ablation monitoring is achieved utilizing a thermal probe adjacent to the laser fiber. The video demonstrates procedure planning, patient preparation, various steps during the procedure, and treatment monitoring. Safety, feasibility, and efficacy of this approach have been established during a previous trial. Outpatient FLA under local anesthesia is an option for management of intermediate risk prostate cancer.

This article presents and describes an outpatient treatment for prostate cancer using focal laser ablation. Laser catheter placement is guided by MRI-ultrasound fusion imaging in a fashion similar to prostate needle biopsy. Treatment is monitored in real-time with a thermal probe, placed adjacent to the laser fiber.

전립선암의 초점 레이저 절제: 사무실 절차

In this article, we describe and illustrate an outpatient procedure for focal laser ablation (FLA) of prostate cancer (PCa). The procedure is conceptually ...

사정관 막힘을 치료하기 위한 정액 방광경 레이저 보조 수술

Treatment of Ejaculatory Duct Obstruction by Seminal Vesiculoscopy Assisted Flow Modification

Transurethral resection of ejaculatory duct (TURED) is a primary surgical approach to treat ejaculatory duct obstruction (EDO) caused by the ejaculatory duct cyst. Intraoperative excision of the verumontanum is usually required to expose the ejaculatory ducts. However, preserving the verumontanum structure allows for a better simulation of normal physiological anatomy. Maintaining the verumontanum may increase the risk of postoperative distal ejaculatory duct scarring, leading to recurrent obstruction or reduced semen volume. Therefore, we attempted a novel technique that preserves the verumontanum, which is relatively easier and safer compared to TURED. The following were the procedural steps: 1. A 6F seminal vesiculoscope was introduced through the external urethral orifice to the vicinity of the verumontanum, locating the opening of the affected-side ejaculatory duct and introducing a guidewire into the cyst. This successful step preserved the verumontanum, maximizing the retention of the anti-reflux mechanism in the distal ejaculatory duct. 2. The holmium laser enlarged the affected-side ejaculatory duct opening to 5 mm, decreasing the likelihood of postoperative closure of the ejaculatory duct opening and simplifying the procedure. 3. A window was created within the cyst to access the contralateral seminal vesicle, and then a holmium laser was used to burn and dilate the opening to 5 mm, redirecting the contralateral ejaculatory duct into the cystic cavity. This modification preserved the opening of the healthy-side ejaculatory duct and provided a new outflow passage for semen, reducing the risk of decreased semen volume postoperatively. The patients experienced no complications postoperatively, had shorter hospital stays, and showed improvement in semen volume. Hence, this surgical approach is simple yet effective.

저자 스포트라이트: 내시경 매개 정액 채널 환류를 사용하는 정액관 막힘의 고급 치료 

This protocol introduces the clinical application of seminal vesicle endoscopy combined with holmium laser in the treatment of ejaculatory duct obstruction caused by ejaculatory duct cyst.

정액 방맥경 보조 흐름 수정에 의한 사정관 폐쇄 치료

Transurethral resection of ejaculatory duct (TURED) is a primary surgical approach to treat ejaculatory duct obstruction (EDO) caused by the ejaculatory ...

최종 발사 리튬 Triborate 크리스탈 레이저를 통해 전립선의 Photoselective Vaporesection

요약

더 많은 비디오 탐색

이 비디오의 챕터

Intravital 이미징을 사용하여 실시간으로 종양의 Nanoparticle의 이해 평가

요로의 프로브 기반 공 촛점 레이저 Endomicroscopy : 기술

마우스의 기관 내 삽관

양성 전립선 비 대 증에 대 한 수술 치료: Holmium 레이저 Enucleation (HoLEP) 전립선의.

980nm 다이오드 레이저를 사용한 양성 전립선 비대증 치료를 위한 전립선 적출

내시경 검사 유도 자궁 내막 낭종의 980 nm 레이저를 사용 하 여 Mares에 접촉 섬유와

전립선암의 초점 레이저 절제: 사무실 절차

정액 방맥경 보조 흐름 수정에 의한 사정관 폐쇄 치료

정액 방맥경 보조 흐름 수정에 의한 사정관 폐쇄 치료

정액 방맥경 보조 흐름 수정에 의한 사정관 폐쇄 치료