Howard N. Winfield

Urology Associates

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Ralph V. Clayman

University of California, Irvine

James F. Donovan

University of Cincinnati Medical Center

David D. Thiel

Mayo Clinic in Florida

David S. Wang

Boston University

David A. Duchêne

University of Copenhagen

Vincent G. Bird

University of Florida

Inderbir S. Gill

University of Southern California

Greg O. Lund

University of Iowa

Thai T. Nguyen

Urology Associates

Paul Kozlowski

Stony Brook University

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University of Iowa

Cleveland Clinic

American Urological Association

University of Iowa Hospitals and Clinics

University of Michigan–Ann Arbor

Harvard University

Iowa City Public Library

Cornell University

Duke Medical Center

The University of Texas Southwestern Medical Center

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Laparoskopische partielle Nephrektomie

Elsevier eBooks (2017)

David D. Thiel Howard N. Winfield

10.1016/b978-3-437-21071-6.00162-6

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Citations (0)

Construction of the Intestinal Stoma with an Intraluminal Stapling Device

The Journal of Urology (1989)

James F. Donovan Howard N. Winfield Richard D. Williams

We have used the intraluminal circular stapler to facilitate construction of the intestinal conduit stoma. We have encountered no complications related to the stapled stoma construction technique in 8 patients. The stoma is circular, uniform in size and is fitted easily with an appliance. The circular staple line provides a watertight seal that prevents contamination of the subcutaneous tissues. The technique is rapid, reliable and reproducible.

Stoma (medicine)

Electrical conduit

10.1016/s0022-5347(17)39056-0

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Citations (3)

Transplantation of Embryonic Dopamine Neurons for Severe Parkinson's Disease

New England Journal of Medicine (2001)

Curt R. Freed Paul Greene Robert E. Breeze Wei‐Yann Tsai William DuMouchel

Transplantation of human embryonic dopamine neurons into the brains of patients with Parkinson's disease has proved beneficial in open clinical trials. However, whether this intervention would be more effective than sham surgery in a controlled trial is not known.

Putamen

10.1056/nejm200103083441002

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Citations (2,305)

Laparoscopy in Urology

The Journal of Urology (1996)

Howard N. Winfield

10.1097/00005392-199607000-00098

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Care of the patient undergoing robotic-assisted laparoscopic pyeloplasty.

Urologic Nursing (2006)

Paula Francis Howard N. Winfield

Laparoscopic pyeloplasty as a treatment for ureteropelvic junction obstruction has shown comparable success rates with open pyeloplasty techniques. The use of robotic technology to assist during laparoscopic pyeloplasty procedures has been encouraged by the steep learning curve for laparoscopic surgical skills, and the complexity of laparoscopic suturing. Robotic technology provides the surgeon with the ability to filter out any physiologic hand tremor, more degrees of freedom of movement than traditional laparoscopic instruments, the ability to scale movement to provide better control for microsurgery, better ergonomics during surgery, and three-dimensional vision. Details of the procedure and specific nursing care of the patient undergoing robotic-assisted laparoscopic pyeloplasty at the University of Iowa Hospital and Clinics are described.

Pyeloplasty

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Laparoscopic Surgical Training: Effectiveness and Impact on Urological Surgical Practice Patterns

The Journal of Urology (1993)

William A. See Ronald J. Fisher Howard N. Winfield James F. Donovan

No AccessJournal of Urology1 May 1993Laparoscopic Surgical Training: Effectiveness and Impact on Urological Surgical Practice Patterns William A. See, Ronald J. Fisher, Howard N. Winfield, and James F. Donovan William A. SeeWilliam A. See , Ronald J. FisherRonald J. Fisher , Howard N. WinfieldHoward N. Winfield , and James F. DonovanJames F. Donovan View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)36294-8AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Urological interest in laparoscopic surgical techniques has dramatically increased during the last several years. However, the extent to which these methods are being used and the impact of training courses on clinical use are unclear. We assessed urologist practice patterns subsequent to a formal training course in urological laparoscopic surgery. On 5 dates between January and October 1991, a total of 163 urologists participated in a 2-day, university sponsored, laparoscopic surgery training seminar. Instruction consisted of 8hours of didactic lectures including 2 live video cases, 4.5hours of simulation and 4.5hours in a live animal laboratory. Three months after the course the participants were mailed a questionnaire inquiring as to the interval laparoscopic surgery experience. Practice demographics, additional training, equipment availability, number of laparoscopic surgery candidates identified, percentage of overall surgical case load, patient inquiries, cases performed and complications were assessed by the questionnaire. Descriptive and correlative information was then derived from the data set. A total of 105 course participants (64%) responded to the questionnaire and 64 had engaged in some form of additional training following the course. During the 3 months since course completion respondents had identified an average of 4 candidates for laparoscopic surgery, which represented a mean of 2.5% of the total case load. Specific patient inquiries averaged less than 1 per physician within 3 months. During this same interval respondents had performed a total of 156 laparoscopic procedures (1.7 per urologist). Of the participants 45% had not performed their first case and 32% had performed more than 1 laparoscopic procedure. A total of 11 complications was reported (7.2%) and in 7 instances the surgeon was required to convert to an open approach. Veress needle placement was perceived as the most difficult aspect of the technique (22% of the respondents). Training subsequent to the course was the best predictor of clinical use. Of those who responded 88% believed that their future use of laparoscopy would increase. This survey suggests that subsequent to training, laparoscopic techniques are being rapidly and safely used by urologists. However, in the current state of development the impact of laparoscopic surgery on global urological practice patterns appears to be small. © 1993 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byCOLEGROVE P, WINFIELD H, DONOVAN J and SEE W (2018) LAPAROSCOPIC PRACTICE PATTERNS AMONG NORTH AMERICAN UROLOGISTS 5 YEARS AFTER FORMAL TRAININGJournal of Urology, VOL. 161, NO. 3, (881-886), Online publication date: 1-Mar-1999.FAHLENKAMP D, RASSWEILER J, FORNARA P, FREDE T and LOENING S (2018) COMPLICATIONS OF LAPAROSCOPIC PROCEDURES IN UROLOGY: EXPERIENCE WITH 2,407 PROCEDURES AT 4 GERMAN CENTERSJournal of Urology, VOL. 162, NO. 3 Part 1, (765-771), Online publication date: 1-Sep-1999.Clayman R (2018) Pediatric Laparoscopy: Quo Vadis? A View from the OutsideJournal of Urology, VOL. 152, NO. 2 Part 2, (730-733), Online publication date: 1-Aug-1994.See W, Cooper C and Fisher R (2018) Urological Laparoscopic Practice Patterns 1 Year After Formal TrainingJournal of Urology, VOL. 151, NO. 6, (1595-1598), Online publication date: 1-Jun-1994. Volume 149Issue 5 Part 1May 1993Page: 1054-1057 Advertisement Copyright & Permissions© 1993 by The American Urological Association Education and Research, Inc.KeywordsurologysurgeryeducationperitoneoscopyMetricsAuthor Information William A. See More articles by this author Ronald J. Fisher More articles by this author Howard N. Winfield More articles by this author James F. Donovan More articles by this author Expand All Advertisement PDF downloadLoading ...

10.1016/s0022-5347(17)36294-8

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Citations (42)

Editorial Comments

The Journal of Urology (1993)

Howard N. Winfield

10.1016/s0022-5347(17)42254-3

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Citations (1)

Laparoscopy in UrologyCoptcoatM.J. and JoyceA.D.: Laparoscopy in Urology. Boston: Blackwell Scientific Publications1994. 158 pages.

The Journal of Urology (1996)

Howard N. Winfield

No AccessJournal of UrologyBook Review1 Jul 1996Laparoscopy in Urology Howard N. WinfieldMD Howard N. WinfieldHoward N. Winfield More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)66020-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Laparoscopy in Urology." The Journal of Urology, 156(1), p. 330 Department of Urology, University of Iowa College of Medicine, Iowa City, Iowa.© 1996 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 156Issue 1July 1996Page: 330 Advertisement Copyright & Permissions© 1996 by American Urological Association, Inc.MetricsAuthor Information Howard N. Winfield More articles by this author Expand All Advertisement PDF downloadLoading ...

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Citations (3)

LAPAROSCOPIC PRACTICE PATTERNS AMONG NORTH AMERICAN UROLOGISTS 5 YEARS AFTER FORMAL TRAINING

The Journal of Urology (1999)

Peter M. Colegrove Howard N. Winfield James F. Donovan William A. See

No AccessJournal of UrologyClinical Urology: Original Article1 Mar 1999LAPAROSCOPIC PRACTICE PATTERNS AMONG NORTH AMERICAN UROLOGISTS 5 YEARS AFTER FORMAL TRAINING PETER M. COLEGROVE, HOWARD N. WINFIELD, JAMES F. DONOVAN, and WILLIAM A. SEE PETER M. COLEGROVEPETER M. COLEGROVE , HOWARD N. WINFIELDHOWARD N. WINFIELD , JAMES F. DONOVANJAMES F. DONOVAN , and WILLIAM A. SEEWILLIAM A. SEE View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)61796-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We assessed urologist laparoscopy practice patterns 5 years after a postgraduate training course in urological laparoscopic surgery. Results were compared to findings from similar studies performed on the same cohort at 3 and 12 months after training. Materials and Methods: Between January 1991 and November 1992, 11, 2-day university sponsored, postgraduate laparoscopic surgery training programs were held. A survey was mailed to the 322 North American participants in the summer of 1997 to determine current laparoscopic use and experience. Results: Of the 166 respondents (51% response rate) 53.6% (89) had performed 1 or more laparoscopic procedures in the previous year, compared to 84% 1 year following course completion. Of the respondents 37% believed their laparoscopic experience was sufficient to maintain skills compared to 66% at 1 year. Of the respondents 6% had performed more laparoscopic procedures while 82% had performed fewer than anticipated. Reasons cited for decreased use included decreasing and/or lack of indications, increased cost, decreased patient interest, higher complication rates, decreased institutional support and increased operative time. Respondents practicing in academic or residency affiliated centers, or those who had completed residency after 1980 were more likely to have performed more procedures than anticipated (p = 0.044) compared to community based colleagues. Conclusions: Laparoscopic use by urologists trained in the postgraduate setting is decreasing. Few respondents are maintaining the skills acquired during the original training course. Decreased use appears to be multifactorial. References 1 : Laparoscopic surgical training: effectiveness and impact on urological surgical practice patterns. J. Urol.1993; 149: 1054. Link, Google Scholar 2 : Urological laparoscopic practice patterns 1 year after formal training. J. Urol.1994; 151: 1598. Google Scholar 3 : Predictors of laparoscopic complications after formal training in laparoscopic surgery. J.A.M.A.1993; 270: 2689. Google Scholar 4 : Urological laparoscopic surgery. J. Urol.1991; 146: 941. Link, Google Scholar 5 : Advances in urological laparoscopy. J. Urol.1995; 154: 1275. Link, Google Scholar 6 : The use of prostate specific antigen, clinical stage and Gleason score to predict pathological stage in men with localized prostate cancer. J. Urol.1993; 150: 110. Abstract, Google Scholar 7 : Laparoscopic versus subinguinal varicocelectomy: a comparative study. Fertil. Steril.1994; 61: 1092. Google Scholar 8 : Comparative financial analysis of laparoscopic versus open pelvic lymph node dissection for men with cancer of the prostate. J. Urol.1994; 151: 675. Link, Google Scholar 9 : Laparoscopic nephrectomy: initial experience and cost complications. Brit. J. Urol.1995; 75: 276. Google Scholar 10 : Staging pelvic lymphadenectomy for prostate cancer: a comparison of laparoscopic and open techniques. J. Urol.1993; 150: 396. Link, Google Scholar 11 : Comparative financial analysis of laparoscopic pelvic lymph node dissection (LPLND) performed in 1990–91 versus 1993–94. J. Urol.1995; 153: 357A. abstract 516. Google Scholar From the Department of Urology, University of Iowa, Iowa City, Iowa© 1999 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byAnderson C, Atoria C, Touijer K, Ehdaie B and Elkin E (2018) Surgeon Adoption of Minimally Invasive Radical ProstatectomyUrology Practice, VOL. 3, NO. 6, (505-510), Online publication date: 1-Nov-2016.Patel S, Hedican S, Bishoff J, Shichman S, Link R, Wolf J and Nakada S (2018) Skill Based Mentored Laparoscopy Course Participation Leads to Laparoscopic Practice Expansion and Assists in Transition to Robotic SurgeryJournal of Urology, VOL. 186, NO. 5, (1997-2000), Online publication date: 1-Nov-2011.Kolla S, Gamboa A, Li R, Santos R, Gan J, Shell C, Andrade L, Louie M, Clayman R and McDougall E (2018) Impact of a Laparoscopic Renal Surgery Mini-Fellowship Program on Postgraduate Urologist Practice Patterns at 3-Year FollowupJournal of Urology, VOL. 184, NO. 5, (2089-2093), Online publication date: 1-Nov-2010.Gamboa A, Santos R, Sargent E, Louie M, Box G, Sohn K, Truong H, Lin R, Khosravi A, Santos R, Ornstein D, Ahlering T, Tyson D, Clayman R and McDougall E (2018) Long-Term Impact of a Robot Assisted Laparoscopic Prostatectomy Mini Fellowship Training Program on Postgraduate Urological Practice PatternsJournal of Urology, VOL. 181, NO. 2, (778-782), Online publication date: 1-Feb-2009.Hruby G, Sprenkle P, Abdelshehid C, Clayman R, McDougall E and Landman J (2018) The EZ Trainer: Validation of a Portable and Inexpensive Simulator for Training Basic Laparoscopic SkillsJournal of Urology, VOL. 179, NO. 2, (662-666), Online publication date: 1-Feb-2008.Yucel S, Brown B, Bush N, Ahmad N and Baker L (2018) What to Anticipate With Experience in Pediatric Laparoscopic Ablative Renal SurgeryJournal of Urology, VOL. 179, NO. 2, (697-702), Online publication date: 1-Feb-2008.Duchene D, Moinzadeh A, Gill I, Clayman R and Winfield H (2018) Survey of Residency Training in Laparoscopic and Robotic SurgeryJournal of Urology, VOL. 176, NO. 5, (2158-2167), Online publication date: 1-Nov-2006.HUYNH P and HOLLANDER J (2018) TRENDS TOWARD LAPAROSCOPIC NEPHRECTOMY AT A COMMUNITY HOSPITALJournal of Urology, VOL. 173, NO. 2, (547-551), Online publication date: 1-Feb-2005.FREDE T, ERDOGRU T, ZUKOSKY D, GULKESEN H, TEBER D and RASSWEILER J (2018) COMPARISON OF TRAINING MODALITIES FOR PERFORMING LAPAROSCOPIC RADICAL PROSTATECTOMY: EXPERIENCE WITH 1,000 PATIENTSJournal of Urology, VOL. 174, NO. 2, (673-678), Online publication date: 1-Aug-2005.LEE C, ANDERSON J and MONGA M (2018) Residency Training in Percutaneous Renal Access: Does It Affect Urological Practice?Journal of Urology, VOL. 171, NO. 2, (592-595), Online publication date: 1-Feb-2004.MARGUET C, YOUNG M, L’ESPERANCE J, TAN Y, EKERUO W, PREMINGER G and ALBALA D (2018) HAND ASSISTED LAPAROSCOPIC TRAINING FOR POSTGRADUATE UROLOGISTS: THE ROLE OF MENTORINGJournal of Urology, VOL. 172, NO. 1, (286-289), Online publication date: 1-Jul-2004.WANG D and WINFIELD H (2018) SURVEY OF UROLOGICAL LAPAROSCOPIC PRACTICE PATTERNS IN THE MIDWESTJournal of Urology, VOL. 172, NO. 6 Part 1, (2282-2286), Online publication date: 1-Dec-2004.FABRIZIO M, TÜERK I and SCHELLHAMMER P (2018) Laparoscopic Radical Prostatectomy: Decreasing the Learning Curve Using A Mentor Initiated ApproachJournal of Urology, VOL. 169, NO. 6, (2063-2065), Online publication date: 1-Jun-2003.KAYNAN A, LEE K and WINFIELD H (2018) Survey of Urological Laparoscopic Practices in the State of CaliforniaJournal of Urology, VOL. 167, NO. 6, (2380-2386), Online publication date: 1-Jun-2002.SHALHAV A, DABAGIA M, WAGNER T, KOCH M and LINGEMAN J (2018) Training Postgraduate Urologists in Laparoscopic Surgery: The Current ChallengeJournal of Urology, VOL. 167, NO. 5, (2135-2137), Online publication date: 1-May-2002. Volume 161Issue 3March 1999Page: 881-886 Advertisement Copyright & Permissions© 1999 by American Urological Association, Inc.MetricsAuthor Information PETER M. COLEGROVE More articles by this author HOWARD N. WINFIELD More articles by this author JAMES F. DONOVAN More articles by this author WILLIAM A. SEE More articles by this author Expand All Advertisement PDF downloadLoading ...

10.1016/s0022-5347(01)61796-8

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Citations (80)

Retroperitoneal and pelvic extraperitoneal laparoscopy: an international perspective

Urology (1998)

Inderbir S. Gill Ralph V. Clayman David Albala Yoshio Aso Allen W. Chiu

Retroperitoneal space

10.1016/s0090-4295(98)00314-8

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Citations (166)