Taşçi Ai

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Tuğcu

Bakırköy Dr.Sadi Konuk Eğitim ve Araştırma Hastanesi

Erkan Sönmezay

Bakırköy Dr.Sadi Konuk Eğitim ve Araştırma Hastanesi

Bircan Mutlu

Bakırköy Dr.Sadi Konuk Eğitim ve Araştırma Hastanesi

A Bitkin

Alper Bitkin

Bakırköy Dr.Sadi Konuk Eğitim ve Araştırma Hastanesi

Ali Gedikbaşı

Turkish Society of Hematology

Adem Fazlıoğlu

Gaziosmanpaşa Taksim Eğitim ve Araştırma Hastanesi

Sinem Taş

Yıldız Technical University

AŞ

Abdülmuttalip Şimşek

İstanbul Başakşehir Çam ve Sakura Şehir Hastanesi

Mehmet Uhri

Sağlık Bilimleri Üniversitesi

Cooperative Institutions

Bakırköy Dr.Sadi Konuk Eğitim ve Araştırma Hastanesi

Sağlık Bilimleri Üniversitesi

University of Health Science

University of Health Sciences

Istanbul University-Cerrahpaşa

Ministry of Health

Istanbul University

Bezmialem Foundation University Medical Faculty Hospital

Eskişehir City Hospital

Haseki Eğitim ve Araştırma Hastanesi

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Fascia-sparing intrafascial nerve-sparing robot-assisted radical prostatectomy and anatomic vesicourethral anastomosis: point of technique.

PubMed (2014)

Taşçi Ai Abdülmuttalip Şimşek Torer Bd Doğukan Sökmen Süleyman Şahin

Nerve-sparing radical prostatectomies provide excellent control of cancer, but the recovery of continence and sexual function are uncertain. We report the operative details and surgical techniques of a robot-assisted radical prostatectomy (RARP) experiences for organ confined prostate cancer.Between the years of 2009 and 2012, 68 patients with clinically localized prostate cancer underwent fascia-sparing intrafascial nerve-sparing robot-assisted radical prostatectomy and anatomic vesicourethral anastomosis. None of the patients were incontinent. 48 of them had an IIEF-5 potency score equal or greater than 22, without receiving phosphodiesterase-5 inhibitors. Our techniques included preservation of the bladder neck, preservation of the endopelvic fascia and puboprostatic ligaments, a nerve-sparing intrafascial approach, selective suturing of the dorsal venous complex, and anterior and posterior reconstruction. We evaluated the patients at the 1st, 3rd, 6th, and 12th postoperative months to determine if these techniques are correlated with early recovery of urinary continence and potency.The mean operation time was 258.2±78.5 minutes, and the mean estimated blood loss was 111.2±22.9 cc during the operation. A nerve-sparing procedure was performed bilaterally in 62 (91.2 %) cases and unilaterally in 6 (8.8%) cases. The mean drain extraction time was 2.3±0.9 days, and the mean hospital stay was 3.4±1.1 days. The catheter was removed on postoperative day 9.9±0.9. The surgical margin was positive in 10 (14.7%) patients. The continence rates at 1, 3, 6, and 12 months were 74.2%, 76.9%, 80.6%, and 95.6%, respectively. During the same period, among the patients without ED, the potency rates were 29.4%, 38.2%, 54.1%, and 75%, respectively All operations were completed successfully, and there were no major complications.A more comprehensive approach for reporting prostate cancer surgery outcomes is needed. Our study findings suggest that fascia-sparing techniques positively influence the early recovery of urinary continence. However, randomized controlled trials with large samples are needed.

Urinary continence

Nerve sparing

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Transperitoneal versus retroperitoneal laparoscopic partial nephrectomy: initial experience.

PubMed (2011)

Tuğcu A Bitkin Erkan Sönmezay Hakan Polat Ilbey Yo

We present the transperitoneal and retroperitoneal approaches to laparoscopic partial nephrectomy and compare the outcomes of each technique.Between December 2006 and March 2010, retroperitoneal laparoscopic partial nephrectomy (RLPN) was performed in 23 patients and transperitoneal laparoscopic partial nephrectomy (TLPN) in 26 patients. They were compared regarding surgical technique, operative parameters, postoperative recovery and follow-up data. The 2 approaches used similar operative techniques to control parenchymal bleeding.The patient demographics were similar in both groups. The mean tumour size was 3.1 cm in the retroperitoneal group and 3.4 cm in the transperitoneal group. The difference was not statistically significant (p: 0.095). The mean operative time was significantly longer in the transperitoneal group (215 vs 185 minutes, p: 0.031). The mean warm ischemia time difference was not statistically significant (25 vs 28 minutes, p: 0.102). The mean estimated blood loss (EBL) was greater in the transperitoneal group (254 vs 204 cc, p: 0.003). Moreover, the mean hospital stay was 4.1 days in the RLPN and 4.3 days in the TLPN group (p: 0.303) The difference was not statistically significant. The median follow-up was 11 months (range: 2 to 35) in the retroperitoneal group and 13 months (range 1 to 36) in the transperitoneal group.Our experience has shown that laparoscopic partial nephrectomy is a safe, feasible technique for patients with small exophytic renal tumours. We believe that the decision regarding the approach should be based on the tumor location on the kidney surface.

Demographics

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Increased testicular 8-hydroxy-2'-deoxyguanosine (8-OHdG) and inducible nitric oxide synthetase (iNOS) and nuclear factor κB (NF-κB) expressions in experimental rat varicocele.

PubMed (2010)

Tuğcu Ali Gedikbaşı Birsen Mutlu Ertugrul Güner Mehmet Uhri

To assess nuclear factor-kappaB (NF-kappaB), inducible NO synthase (iNOS) immunohistochemically, and 8-hydroxy-2'-deoxyguanosine (8-OHdG) biochemically, which are sensitive biological markers of oxidative damage and stress, in testes with experimental varicocele.Adult rats were randomly divided into three groups. Control group (n: 10), sham group (n: 10), varicocele group (n: 10). Of 14 rats undergoing partial ligation of the left renal vein, 10 rats had developed dilation of the left spermatic vein when evaluated 3 months after varicocele-inducing surgery. The rats were sacrificed after 3 months of the varicocele-inducing surgery. Ipsilateral and contralateral testes were examined for 8-hydroxy-2'-deoxyguanosine (8-OHdG) biochemically, inducible NO synthase (iNOS) and nuclear factor-kappaB (NF-kappaB) expression immunohistochemically.Inducible NO synthase (iNOS), nuclear factor-kappaB (NF-kappaB) expressions and 8-hydroxy-2'-deoxyguanosine (8-OHdG) levels in both testes of varicocele group were markedly higher compared with control and sham groups (p < 0.01). There was no difference between control and sham groups (p > 0.05).Regarding to our results, we suggest that varicocele may produce oxidative stress in both of testes, and we believe that this stress may play a role in male fertility.

Deoxyguanosine

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Laparoscopic-endoscopic single-site surgery retroperitoneal ureterolithotomy: technique and initial experience.

PubMed (2012)

Tuğcu Bircan Mutlu Yollu Mehmet Yücel Taşçi Ai

Laparoscopic-endoscopic single-site surgery (LESS) is a nearly scarless surgical technique. The aim was to assess the results of our initial LESS retroperitoneal ureterolithotomy (LESS-RU) experience and our technique.Primary indication for LESS-RU procedure in this study was obstructive or impacted ureteral stone(s) larger than 15 mm and located in the middle or upper part of the ureter in those patients in whom prior interventions have failed. Eighteen patients underwent LESS-RU for upper or middle ureteric stone by one experienced laparoscopist, between December 2008 and December 2009. Patient characteristics, operative details, complications, use of analgesic medication and time to return to work were recorded.Eighteen cases were successfully accomplished. The mean patient age was 40.1 yr (19-60 yr), and median BMI was 27.7 kg/m2 (21-32). The mean operative time was 69.9 min (50-150 min), and the mean blood loss was 31.9 mi (20-70 mi). Mean stone size was 18.1 mm (range: 16-22). No patient required morphine for pain relief and the main use of oral analgesics was for two days. In postoperative follow-up there was a minimally scar and good cosmetic results were detected.LESS-RU proved to be safe and feasible. We think that LESS-RU will take place of laparoscopic ureterolithotomy in the near future with better cosmetic results. Further clinical investigation in comparison to the established techniques should take place to evaluate the outcome of LESS-RU.

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Robotic malfunction during live robotic urologic surgery: live surprise in a robotic surgery congress.

PubMed (2012)

Tuğcu Bircan Mutlu Abdullah Erdem Canda Erkan Sönmezay Taşçi Ai

Robotic-assisted laparoscopic radical prostatectomy (RARP) has increasingly become a preferred treatment of choice. Since it is a device dependant surgery, robotic surgery may be a challenging procedure due to failure.We report how we managed to complete successfully a case of RARP with laparoscopic approach in spite of right robotic arm failure during live surgery.A 56-year-old male patient diagnosed with localized prostate cancer (PCa) (Gleason score 3 + 3 = 6) with a serum prostate specific antigen (PSA) level of 7.6 ng/mL was elected for a live RARP case during the 1st Turkish National Robotic Surgery Congress in 2011. Following 120 minutes from starting the RARP procedure, the right robotic arm failed surprisingly with a "recoverable fault" message appeared on the screen. Pressing "recover fault" button did not work and the right arm operated for few seconds more but the fault repeated again. We replaced the robotic instruments, shut down and restarted the system again that were all useless. Finally, all of the arms were out of order and we were not able to use the robot anymore. Therefore, we laparoscopically completed the procedure successfully without converting to open surgery.Although da Vinci surgical system failure rarely occurs, surgical team should be prepared to convert to open or complete the procedure laparoscopically. Having previous laparoscopic experience seems to be an advantage in order to complete the procedure without converting to open. Patients should be informed about the possibility of robotic failure and about its consequences before the surgery.

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Incidence of ureteral stricture after ureterorenoscopic pneumatic lithotripsy for distal ureteral calculi.

PubMed (2011)

Sinem Taş Tuğcu Burcu Mutlu Serdar Karadağ Alper Bitkin

We investigated the incidence of ureteral stricture in patients treated with ureterorenoscopic pneumatic lithotripsy for distal ureteral calculi.Between April 2006 and January 2009, 154 patients requiring ureterorenoscopic pneumatic lithotripsy for distal ureteral calculi were enrolled into the study. We evaluated the stone size, impaction of a stone, the need for ureteral orifice dilatation and the need for application of double-J stent.A total of 154 patients underwent URS-PL for ureteral calculi. Mean calculi diameter was 12.17 +/- 2.54 (range: 5-20 mm). Stone free rates after the first URS-PL operation were 97.4% of patients. In 2 patients (1.29%), ureteral perforation occurred as an early complication. We observed deep mucosal injury in 9 patients (5.84%). Partial stricture (partial obstruction) was observed in 9 patients (5.84%). Of 9 patients who had an ureteral stricture postoperatively, 7 patients had ureteral calculi > or = 10 mm, 2 patients had calculi < 10 mm. We observed ureteral stricture in 2 (8.69%) out of 23 patients who had calculi < 10 mm, and in 7 (5.34%) out of 131 patients who had calculi > or = 10 mm (p > 0.05). Ureteral stricture was observed in 2 (13.33%) out of 15 patients who had impacted calculi, and in 7 (5.03%) out of 139 patients who did not have impacted calculi (p < 0.05). We observed ureteral stricture in 3 (6.25%) out of 48 patients who required ureteral dilatation, and in 6 (5.66%) out of 106 patients who did not require ureteral dilatation (p > 0.05). Ureteral stricture was observed in 6 (15%) out of 40 patients who required ureteral double-J catheter placement, and in 3 (2.63%) out of 114 patients who did not require ureteral double-J catheter placement (p < 0.05).The results of our study have demonstrated that the success rate was not related to the stone dimension, but the time of operation was found to be increased with larger stones. Main risk factors for formation of ureteral stricture were impacted ureteral calculi and reasons which merits double-J catheter placement like mucosal damage, perforation, impacted calculi and high stone burden.

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Ureteroscopy

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Citations (17)

[Rehabilitation of patients after cystectomy and construction of a continent intestinal reservoir].

PubMed (1992)

Güven Sevın M. Çek Taşçi Ai Adem Fazlıoğlu Gokhan Gz

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