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  1. Article: Dual balloon adjustable continence therapy for urinary incontinence.

    Feloney, Michael P / Klock, Julie A / Zhang, Yuanyuan

    American journal of clinical and experimental urology

    2023  Volume 11, Issue 4, Page(s) 334–338

    Abstract: Dual balloon adjustable continence therapy (DBACT) has emerged as a promising option for treating stress urinary incontinence. DBACT is a minimally invasive and easily reversible procedure in which two periurethral balloons are placed just distal to the ... ...

    Abstract Dual balloon adjustable continence therapy (DBACT) has emerged as a promising option for treating stress urinary incontinence. DBACT is a minimally invasive and easily reversible procedure in which two periurethral balloons are placed just distal to the bladder neck to increase bladder outflow resistance. The device is connected to a small titanium port placed under the scrotal or labial skin. The port is used for adjustment to balloon volume in the clinic setting, allowing for refinement and optimization of urinary continence. DBACT placement is typically performed under general anesthesia and is considered an outpatient procedure. Several studies have evaluated the effectiveness of DBACT in treating urinary incontinence, and the results are promising. DBACT was effective in 91% of patients who underwent the procedure, 80% reported a significant improvement in their symptoms, and 70% reported being completely dry after the procedure. DBACT is a safe procedure with few reported complications. The most common complication is mild pain or discomfort at the site of device placement, which usually resolves within a few days. Overall, DBACT is minimally invasive, adjustable, and highly successful in restoring urinary continence.
    Language English
    Publishing date 2023-08-15
    Publishing country United States
    Document type Journal Article
    ISSN 2330-1910
    ISSN 2330-1910
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  2. Article ; Online: Robotic Hiatal Hernia Repair Associated with Higher Morbidity and Readmission Rates Compared to Laparoscopic Repair: 10-Year Analysis from the National Readmissions Database (NRD).

    Klock, Julie A / Walters, Ryan W / Nandipati, Kalyana C

    Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

    2022  Volume 27, Issue 3, Page(s) 489–497

    Abstract: Background: Laparoscopic techniques have been used for hiatal hernia repair. Robotic-assisted repairs have been increasingly used with unproven benefits. The aim of this study was to compare outcomes between laparoscopic and robotic-assisted hiatal ... ...

    Abstract Background: Laparoscopic techniques have been used for hiatal hernia repair. Robotic-assisted repairs have been increasingly used with unproven benefits. The aim of this study was to compare outcomes between laparoscopic and robotic-assisted hiatal hernia repair.
    Methods: The Nationwide Readmissions Database (NRD) was used to identify hospitalizations for laparoscopic or robotic hiatal hernia repair from 2010 to 2019. Primary outcomes included post-operative complications and 30- and 90-day readmission rates. Secondary outcomes included in-hospital death, length of stay, and inflation-adjusted hospital cost. Multivariable models were estimated for overall complication and readmission rates.
    Results: Approximately 517,864 hospitalizations met inclusion criteria with 11.3% including robotic repairs. Robotic repair was associated with a higher overall complication rate (9.2% vs. 6.8%, odds ratio [OR]: 1.4, 95% CI: 1.3-1.5, p < .001); however, the trend showed more similar complication rates across years. The higher overall complication rate remained after adjusting for patient and facility characteristics (adjusted OR [aOR]: 1.3, 95% CI: 1.2-1.4, p < .001). Robotic repairs were associated with higher 30-day (6.1% vs. 7.4%, aOR: 1.2, 95% CI: 1.2-1.3, p < .001) and 90-day readmission rates (9.4% vs. 11.2%, aOR: 1.2, 95% CI: 1.2-1.3, p < .001). In-hospital mortality and length of stay were similar, although, higher hospital costs were associated with robotic repairs. Both complications and readmission rates were lower as annual procedural volume increased.
    Conclusion: Robotic repairs had higher unadjusted and adjusted complication and readmission rates. The overall complication rate has shown a trend towards improvement which may be a result of increasing experience with robotic surgery.
    MeSH term(s) Humans ; Robotic Surgical Procedures/adverse effects ; Patient Readmission ; Herniorrhaphy/adverse effects ; Herniorrhaphy/methods ; Hospital Mortality ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Morbidity ; Laparoscopy/adverse effects ; Laparoscopy/methods ; Hernia, Hiatal/surgery ; Hernia, Hiatal/complications ; Retrospective Studies
    Language English
    Publishing date 2022-12-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2012365-6
    ISSN 1873-4626 ; 1934-3213 ; 1091-255X
    ISSN (online) 1873-4626 ; 1934-3213
    ISSN 1091-255X
    DOI 10.1007/s11605-022-05548-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5207: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 354: Show issues

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  3. Article ; Online: Robotic-Assisted Bariatric Surgery Is Associated with Increased Postoperative Complications Compared to Laparoscopic: a Nationwide Readmissions Database Study.

    Klock, Julie A / Bremer, Kristin / Niu, Fang / Walters, Ryan W / Nandipati, Kalyana C

    Obesity surgery

    2023  Volume 33, Issue 7, Page(s) 2186–2193

    Abstract: Purpose: Robotic-assisted (RA) bariatric surgery has been increasingly used without consistent benefit over a laparoscopic approach (LA). We compared intra- and post-operative complications and 30- and 90-day all-cause readmissions between RA and LA ... ...

    Abstract Purpose: Robotic-assisted (RA) bariatric surgery has been increasingly used without consistent benefit over a laparoscopic approach (LA). We compared intra- and post-operative complications and 30- and 90-day all-cause readmissions between RA and LA using the Nationwide Readmissions Database (NRD).
    Materials and methods: We identified hospitalizations with adult patients who underwent RA or LA bariatric surgery from 2010 to 2019. Primary outcomes included intra- and post-operative complications and 30- and 90-day all-cause readmissions. Secondary outcomes included in-hospital death, length of stay (LOS), cost, and cause-specific readmissions. Multivariable regression models were estimated; analyses accounted for the NRD sampling design.
    Results: A total of 1,371,778 hospitalizations met inclusion criteria with 7.1% using RA. Patient demographic and clinical characteristics were mostly similar between groups. Adjusted odds of complication were 13% higher for RA (adjusted odds ratio [aOR]: 1.13, 95% CI: 1.03-1.23 p = .008); aORs differed across bariatric procedures. The most common complications included nausea/vomiting, acute blood loss anemia, incisional hernia, and transfusion. Adjusted odds of 30- and 90-day readmission were 10% higher for RA (aOR: 1.10, 95% CI: 1.04-1.17, p = .001 and aOR: 1.10, 95% CI: 1.04-1.16, p <.001, respectively). LOS was similar (1.6 vs. 1.6 days, p = .253); although, hospital costs were 31.1% higher for RA ($15,806 vs. $12,056, p < .001).
    Conclusion: RA bariatric surgery is associated with 13% higher odds of complication, 10% higher odds of readmission, and 31% hospital costs. Subsequent studies are required using databases that can include additional patient-, facility-, surgery-, and surgeon-specific characteristics.
    MeSH term(s) Adult ; Humans ; Patient Readmission ; Robotic Surgical Procedures/adverse effects ; Hospital Mortality ; Obesity, Morbid/surgery ; Bariatric Surgery/adverse effects ; Length of Stay ; Postoperative Complications/etiology ; Laparoscopy/methods ; Retrospective Studies
    Language English
    Publishing date 2023-05-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1070827-3
    ISSN 1708-0428 ; 0960-8923
    ISSN (online) 1708-0428
    ISSN 0960-8923
    DOI 10.1007/s11695-023-06657-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3381: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  4. Article ; Online: Reply to Letter to the Editor Following "Robotic-Assisted Bariatric Surgery Is Associated with Increased Postoperative Complications Compared to Laparoscopic: a Nationwide Readmissions Database Study" by Klock et al.

    Klock, Julie A / Bremer, Kristin / Niu, Fang / Walters, Ryan W / Nandipati, Kalyana C

    Obesity surgery

    2023  Volume 33, Issue 10, Page(s) 3305–3306

    MeSH term(s) Humans ; Robotic Surgical Procedures/adverse effects ; Patient Readmission ; Obesity, Morbid/surgery ; Postoperative Complications/etiology ; Bariatric Surgery/adverse effects ; Laparoscopy/adverse effects
    Language English
    Publishing date 2023-08-14
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 1070827-3
    ISSN 1708-0428 ; 0960-8923
    ISSN (online) 1708-0428
    ISSN 0960-8923
    DOI 10.1007/s11695-023-06773-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

    Full text online

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3381: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

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