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  1. Article ; Online: Robotic-assisted Simple Prostatectomy: An Intrafascial Approach for a Prostate of 470 g.

    Poncel, Jaime / Celis, Valeria / Sayegh, Aref S / Eppler, Michael / Medina, Luis G / Sotelo, Rene

    Urology

    2023  Volume 176, Page(s) 246–247

    Abstract: Background: Simple prostatectomy has been established as a management option for lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) with glands larger than 80 cc.: Materials and methods: A 56-year-old with LUTS (IPSS: 34) ... ...

    Abstract Background: Simple prostatectomy has been established as a management option for lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) with glands larger than 80 cc.
    Materials and methods: A 56-year-old with LUTS (IPSS: 34) for over 6 years, complicated with multiple episodes of urinary retention. PSA: 20.6 ng/mL. MRI reported a 463 cc prostate volume without focal lesions. First, the retropubic space was developed. Cystotomy was performed at the anterior bladder neck. A plane between the prostatic capsule and the surrounding fascia was dissected while carefully preserving the neurovascular bundles. Due to its large size, the prostate was divided into segments to facilitate its extraction. Hemostatic control and vesicourethral anastomosis were performed.
    Results: Discharged on postoperative day 1 with a Jackson-Pratt drain and Foley catheter removed on days 6 and 9, respectively. Pathology was negative for malignancy. Patient-reported improvement of LUTS (IPSS: 3) and preservation of erectile function (SHIM: 23) at the 3-month follow-up.
    Conclusion: The intrafascial technique can be useful in cases where a large-sized prostate hinders a transvesical approach. Additionally, it allows for an easier piecemeal of the gland. A larger series is needed to determine its potential benefits.
    MeSH term(s) Male ; Humans ; Middle Aged ; Prostate/pathology ; Robotic Surgical Procedures/methods ; Prostatic Hyperplasia/complications ; Prostatic Hyperplasia/surgery ; Prostatic Hyperplasia/pathology ; Urinary Bladder/pathology ; Prostatectomy/methods ; Lower Urinary Tract Symptoms/surgery ; Lower Urinary Tract Symptoms/complications ; Treatment Outcome
    Language English
    Publishing date 2023-03-24
    Publishing country United States
    Document type Video-Audio Media
    ZDB-ID 192062-5
    ISSN 1527-9995 ; 0090-4295
    ISSN (online) 1527-9995
    ISSN 0090-4295
    DOI 10.1016/j.urology.2023.02.034
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    Zs.A 1142: Show issues Location:
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  2. Article ; Online: Robotic Management of Complex Vesicourethral Anastomosis Stenosis With Transperineal Urethral Advancement: A Step-by-Step Technique.

    Rodriguez, Veronica I / Celis, Valeria / Sayegh, Aref / Medina, Luis G / Sanchez, Desiree / Sotelo, Rene

    Urology

    2023  Volume 184, Page(s) e256–e257

    Abstract: Background: Vesicourethral anastomosis stenosis (VUAS) refers to the diameter narrowing of a vesicourethral anastomosis (VUA). It is a known complication after radical prostatectomy that nowadays presents in less than 1% of these cases. When the lumen ... ...

    Abstract Background: Vesicourethral anastomosis stenosis (VUAS) refers to the diameter narrowing of a vesicourethral anastomosis (VUA). It is a known complication after radical prostatectomy that nowadays presents in less than 1% of these cases. When the lumen narrows sufficiently to impede urine flow, obstructive symptoms arise. While the incidence of VUAS used to be notably higher prior to the widespread use of the robotic approach, traditional procedures still fail in up to 42% of cases. Initial management typically involves endoscopic procedures, such as dilation, incision, or resection. If these approaches prove ineffective, VUA reconstruction is warranted. Following the resection of the unhealthy urethra, a potential drawback is the insufficient length of the healthy proximal urethral to reach the bladder without tension. In such cases, urinary diversion with an ileal conduit is an option. However, when the patient prefers to maintain an orthotopic urinary tract configuration, there is limited guidance in the literature regarding surgical techniques.
    Objective: To outline the indications, describe the step-by-step technique, and evaluate the outcomes of transperineal urethral advancement to facilitate a tension-free VUA.
    Materials: We first discuss the indications to identify which patients are candidates for this procedure. Then, a step-by-step description of the robotic VUA revision assisted by transperineal urethral mobilization is presented. Detailed steps and helpful hints are included. Finally, we outline the postoperative pathway and expected outcomes.
    Results: This technique allows patients with VUAS to preserve the orthotopic configuration of the urinary tract when a tension-free anastomosis proves challenging. Although urinary incontinence is expected, an artificial urinary sphincter could be placed in the following months.
    Conclusion: The robotic management of complex vesicourethral anastomosis stenosis with transperineal urethral advancement is a feasible and safe procedure that requires the interdisciplinary management of robotic and reconstructive urologists.
    MeSH term(s) Male ; Humans ; Urethra/surgery ; Constriction, Pathologic/etiology ; Constriction, Pathologic/surgery ; Robotic Surgical Procedures ; Urogenital Surgical Procedures ; Anastomosis, Surgical
    Language English
    Publishing date 2023-11-29
    Publishing country United States
    Document type Video-Audio Media
    ZDB-ID 192062-5
    ISSN 1527-9995 ; 0090-4295
    ISSN (online) 1527-9995
    ISSN 0090-4295
    DOI 10.1016/j.urology.2023.10.035
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  3. Article ; Online: AUTHOR REPLY.

    Medina, Luis G / Sayegh, Aref S / Polotti, Charles F / Cacciamani, Giovanni E / Sotelo, Rene

    Urology

    2022  Volume 169, Page(s) 109

    Language English
    Publishing date 2022-11-09
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 192062-5
    ISSN 1527-9995 ; 0090-4295
    ISSN (online) 1527-9995
    ISSN 0090-4295
    DOI 10.1016/j.urology.2022.05.062
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  4. Article ; Online: Assessment and Reporting of Perioperative Adverse Events and Complications in Patients Undergoing Inguinal Lymphadenectomy for Melanoma, Vulvar Cancer, and Penile Cancer: A Systematic Review and Meta-analysis.

    Cacciamani, Giovanni E / Medina, Luis G / Sayegh, Aref S / La Riva, Anibal / Perez, Laura C / Eppler, Michael B / Gill, Inderbir / Sotelo, Rene

    World journal of surgery

    2023  Volume 47, Issue 4, Page(s) 962–974

    Abstract: Background: Inguinal lymph node dissection (ILND) plays a crucial role in the oncological management of patients with melanoma, penile, and vulvar cancer. This study aims to systematically evaluate perioperative adverse events (AEs) in patients ... ...

    Abstract Background: Inguinal lymph node dissection (ILND) plays a crucial role in the oncological management of patients with melanoma, penile, and vulvar cancer. This study aims to systematically evaluate perioperative adverse events (AEs) in patients undergoing ILND and its reporting.
    Methods: A systematic review was conducted according to PRISMA. PubMed, MEDLINE, Scopus, and Embase were queried to identify studies discussing perioperative AEs in patients with melanoma, penile, and vulvar cancer following ILND.
    Results: Our search generated 3.469 publications, with 296 studies meeting the inclusion criteria. Details of 14.421 patients were analyzed. Of these studies, 58 (19.5%) described intraoperative AEs (iAEs) as an outcome of interest. Overall, 68 (2.9%) patients reported at least one iAE. Postoperative AEs were reported in 278 studies, combining data on 10.898 patients. Overall, 5.748 (52.7%) patients documented ≥1 postoperative AEs. The most reported ILND-related AEs were lymphatic AEs, with a total of 4.055 (38.8%) events. The pooled meta-analysis confirmed that high BMI (RR 1.09; p = 0.006), ≥1 comorbidities (RR 1.79; p = 0.01), and diabetes (RR 1.81; p =  < 0.00001) are independent predictors for any AEs after ILND. When assessing the quality of the AEs reporting, we found 25% of studies reported at least 50% of the required criteria.
    Conclusion: ILND performed in melanoma, penile, and vulvar cancer patients is a morbid procedure. The quality of the AEs reporting is suboptimal. A more standardized AEs reporting system is needed to produce comparable data across studies for furthering the development of strategies to decrease AEs.
    MeSH term(s) Male ; Female ; Humans ; Penile Neoplasms/surgery ; Penile Neoplasms/pathology ; Vulvar Neoplasms/surgery ; Vulvar Neoplasms/etiology ; Lymph Node Excision/adverse effects ; Lymph Node Excision/methods ; Melanoma/surgery ; Lymphatic Vessels/pathology
    Language English
    Publishing date 2023-01-28
    Publishing country United States
    Document type Meta-Analysis ; Systematic Review ; Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 224043-9
    ISSN 1432-2323 ; 0364-2313
    ISSN (online) 1432-2323
    ISSN 0364-2313
    DOI 10.1007/s00268-022-06882-6
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    Zs.A 1336: Show issues Location:
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  5. Article ; Online: Urine leak after robotic radical prostatectomy: not all urine leaks come from the anastomosis.

    Shah, Mihir / Medina, Luis G / Azhar, Raed A / La Riva, Anibal / Ortega, David / Sotelo, Rene

    Journal of robotic surgery

    2021  Volume 16, Issue 2, Page(s) 247–255

    Abstract: Radical prostatectomy is the gold standard in patients that are surgical candidates with localized prostate cancer. While most postoperative urine leaks are from vesico-urethral anastomosis, urologists must be aware that a small percentage of patients ... ...

    Abstract Radical prostatectomy is the gold standard in patients that are surgical candidates with localized prostate cancer. While most postoperative urine leaks are from vesico-urethral anastomosis, urologists must be aware that a small percentage of patients may have a urine leak from other sites that may have been inadvertently injured during the procedure. We propose a systematic workup to evaluate the source of the urinary leak as well as appropriate management of such injuries. The mid-ureter can be injured during lymph node dissection. The distal ureter is at risk of injury when performing the Montsouris approach. The posterior bladder neck dissection can at times be challenging. If not careful, one can easily cause an injury to the trigone and/or ureteral orifices. The most common site of leak is at the vesico-urethral anastomosis due to a non-watertight closure. The management of intraoperatively detected ureteral injuries require placement of a ureteral stent. The location, severity and type of injury determine the reconstruction required to fix it. Postoperatively urine leak can be frequently detected when assessing the pelvic drain, and imaging such as CT Urogram with a cystogram phase may be helpful in the diagnosis. Urine leak after robotic-assisted laparoscopic radical prostatectomy remains a rare complication, sometimes the diagnosis can be challenging, and management varies depending on the site and severity of injury.
    MeSH term(s) Anastomosis, Surgical/adverse effects ; Anastomosis, Surgical/methods ; Humans ; Male ; Prostatectomy/adverse effects ; Prostatectomy/methods ; Prostatic Neoplasms/pathology ; Robotic Surgical Procedures/methods ; Robotics ; Urinary Incontinence/etiology
    Language English
    Publishing date 2021-04-24
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2268283-1
    ISSN 1863-2491 ; 1863-2483
    ISSN (online) 1863-2491
    ISSN 1863-2483
    DOI 10.1007/s11701-021-01242-3
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  6. Article ; Online: Distal ureter and bladder cuff excision using the "Keyhole Technique" during Robotic Radical Nephroureterectomy.

    Medina, Luis G / Alsyouf, Muhannad / Ghoreifi, Alireza / Sayegh, Aref S / Koh, Kailyn / Yu, Wenhao / Sobhani, Sina / Douglawi, Antoin / Djaladat, Hooman

    International braz j urol : official journal of the Brazilian Society of Urology

    2022  Volume 48, Issue 5, Page(s) 876–877

    Abstract: Introduction: Upper tract urothelial carcinoma (UTUC) accounts for 5-10% of all urothelial tumors (1). Radical nephroureterectomy (RNU) remains the standard treatment for high, and low-grade UTUC (2). Although the open approach has been considered the ... ...

    Abstract Introduction: Upper tract urothelial carcinoma (UTUC) accounts for 5-10% of all urothelial tumors (1). Radical nephroureterectomy (RNU) remains the standard treatment for high, and low-grade UTUC (2). Although the open approach has been considered the gold standard, robotic techniques have shown comparable oncological outcomes with potential advantages in terms of peri-operative morbidity (3).
    Materials and methods: We present a novel "Keyhole" technique for management of distal ureter and bladder cuff during robotic RNU. This technique allows the surgeon to directly visualize the ureteric orifices, delineate resection borders, and maintain oncologic principles of en-bloc excision without necessitating secondary cystotomy incision or concomitant endoscopic procedure. Descriptive demographic characteristics, surgical, pathological, and oncological outcomes were analyzed. Complications were reported using the Clavien-Dindo classification system.
    Results: Between 2015 and 2020, ten patients underwent robotic RNU with bladder cuff excision using the Keyhole technique (single-dock, single-position). Median age was 75 years. Eight patients underwent surgery for right-sided tumors. Median operative time, estimated blood loss, and length of hospital stay were 287 min, 100 mL, and 3 days, respectively. No intraoperative complications occurred, and one grade II complication occurred during the 90-day postoperative period. All patients had high-grade UTUC, being 90% pure urothelial. Bladder recurrences occurred in 30% of patients with an overall median follow-up of 11.2 months.
    Conclusions: Keyhole technique for the management of distal ureter and bladder cuff during RNU represents a feasible approach with minimal 90-day complications and low bladder recurrence rate at centers of experience.
    MeSH term(s) Aged ; Carcinoma, Transitional Cell/pathology ; Carcinoma, Transitional Cell/surgery ; Humans ; Nephrectomy/methods ; Nephroureterectomy/methods ; Retrospective Studies ; Robotic Surgical Procedures/methods ; Ureter/pathology ; Ureter/surgery ; Ureteral Neoplasms/pathology ; Ureteral Neoplasms/surgery ; Urinary Bladder/pathology ; Urinary Bladder/surgery ; Urinary Bladder Neoplasms/surgery
    Language English
    Publishing date 2022-03-23
    Publishing country Brazil
    Document type Video-Audio Media
    ZDB-ID 2206649-4
    ISSN 1677-6119 ; 1677-5538
    ISSN (online) 1677-6119
    ISSN 1677-5538
    DOI 10.1590/S1677-5538.IBJU.2022.0147
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  7. Article ; Online: Robotic-assisted vesicovaginal fistula repair using a vaginal cuff flap.

    Sayegh, Aref S / La Riva, Anibal / Perez, Laura C / Rangel, Enanyeli / Medina, Luis G / Adamic, Brittany / Sotelo, Rene

    International urogynecology journal

    2022  Volume 33, Issue 9, Page(s) 2581–2585

    Abstract: Introduction and hypothesis: Vesicovaginal fistula (VVF) is an abnormal communication between the bladder and the vagina. Complex fistulae include those after failed repair attempts, radiotherapy, measuring ≥ 2 cm, located in the trigone, or with ... ...

    Abstract Introduction and hypothesis: Vesicovaginal fistula (VVF) is an abnormal communication between the bladder and the vagina. Complex fistulae include those after failed repair attempts, radiotherapy, measuring ≥ 2 cm, located in the trigone, or with concomitant ureteric strictures or fistulae. We aimed to describe a technique for the robotic repair of a complex VVF using a vaginal cuff flap.
    Methods: A 56-year-old woman with a history of ovarian debulking surgery and radiotherapy underwent repair for VVF and rectovaginal fistula. In lithotomy, cystoscopy was performed for fistulous tract cannulation. Port placement, extensive adhesiolysis, and robot docking followed. The vaginal apex was dissected, the VVF excised, and the bladder closed. The rectum was separated from the posterior vaginal wall, the rectovaginal fistula excised, and the rectum closed. A vaginal cuff flap was harvested and interposed between the bladder and the vagina.
    Results: Operative time was 9 h, estimated blood loss was 300 cc, and no intraoperative complications occurred. The patient was discharged on postoperative day 8. Further management included 37 sessions in a hyperbaric chamber and a transvesical endoluminal bladder closure 10 months after the initial surgery. Follow-up at 30 months shows no fistula recurrence.
    Conclusions: Vaginal cuff flaps represent a feasible interposition tissue in patients with hysterectomy for managing complex VVF in the case of omentum unavailability.
    MeSH term(s) Female ; Humans ; Middle Aged ; Rectovaginal Fistula ; Robotic Surgical Procedures/methods ; Surgical Flaps ; Urologic Surgical Procedures/methods ; Vesicovaginal Fistula/etiology ; Vesicovaginal Fistula/surgery
    Language English
    Publishing date 2022-03-12
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 1050631-7
    ISSN 1433-3023 ; 0937-3462
    ISSN (online) 1433-3023
    ISSN 0937-3462
    DOI 10.1007/s00192-022-05144-2
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    Zs.A 3070: Show issues Location:
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  8. Article: Superior Mesenteric Artery Injury during Robotic Radical Nephrectomy: Scenarios and Management Strategies.

    Sayegh, Aref S / Medina, Luis G / La Riva, Anibal / Perez, Laura C / Poncel, Jaime / Forsyth, Edward / Cacciamani, Giovanni E / Challacombe, Ben / Stifelman, Michael / Gill, Inderbir / Sotelo, Rene

    Journal of clinical medicine

    2023  Volume 12, Issue 2

    Abstract: Injury to the superior mesenteric artery (SMA) is a rare, underreported, and potentially devastating complication. This study aims to propose a systematic workup to describe how to prevent and manage SMA injury in a standardized stepwise manner. Three ... ...

    Abstract Injury to the superior mesenteric artery (SMA) is a rare, underreported, and potentially devastating complication. This study aims to propose a systematic workup to describe how to prevent and manage SMA injury in a standardized stepwise manner. Three different instances of intraoperative injury to the SMA are described in an accompanying video. All three occurred when the SMA was misidentified as the left renal artery during left robotic radical nephrectomy. In the first case, the SMA was mistakenly identified as the renal artery, but after further dissection, the real renal artery was identified and SMA injury was prevented. In the second case, the SMA was clipped and the real left renal artery was subsequently identified, requiring clip removal. In the third case, the SMA was clipped and completely transected, requiring prompt repair by vascular surgery with a successful outcome. This study aims to propose a systematic workup to describe how to prevent and manage SMA injury in a standardized stepwise manner. The proper anatomic recognition of the SMA may prevent its injury. Intraoperative SMA injury should be promptly identified and repaired to avoid its devastating consequences.
    Language English
    Publishing date 2023-01-05
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12020427
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  9. Article ; Online: Development of a Classification System for Live Surgical Feedback.

    Wong, Elyssa Y / Chu, Timothy N / Ma, Runzhuo / Dalieh, Istabraq S / Yang, Cherine H / Ramaswamy, Ashwin / Medina, Luis G / Kocielnik, Rafal / Ladi-Seyedian, Seyedeh-Sanam / Shtulman, Andrew / Cen, Steven Y / Goldenberg, Mitchell G / Hung, Andrew J

    JAMA network open

    2023  Volume 6, Issue 6, Page(s) e2320702

    Abstract: Importance: Live feedback in the operating room is essential in surgical training. Despite the role this feedback plays in developing surgical skills, an accepted methodology to characterize the salient features of feedback has not been defined.: ... ...

    Abstract Importance: Live feedback in the operating room is essential in surgical training. Despite the role this feedback plays in developing surgical skills, an accepted methodology to characterize the salient features of feedback has not been defined.
    Objective: To quantify the intraoperative feedback provided to trainees during live surgical cases and propose a standardized deconstruction for feedback.
    Design, setting, and participants: In this qualitative study using a mixed methods analysis, surgeons at a single academic tertiary care hospital were audio and video recorded in the operating room from April to October 2022. Urological residents, fellows, and faculty attending surgeons involved in robotic teaching cases during which trainees had active control of the robotic console for at least some portion of a surgery were eligible to voluntarily participate. Feedback was time stamped and transcribed verbatim. An iterative coding process was performed using recordings and transcript data until recurring themes emerged.
    Exposure: Feedback in audiovisual recorded surgery.
    Main outcomes and measures: The primary outcomes were the reliability and generalizability of a feedback classification system in characterizing surgical feedback. Secondary outcomes included assessing the utility of our system.
    Results: In 29 surgical procedures that were recorded and analyzed, 4 attending surgeons, 6 minimally invasive surgery fellows, and 5 residents (postgraduate years, 3-5) were involved. For the reliability of the system, 3 trained raters achieved moderate to substantial interrater reliability in coding cases using 5 types of triggers, 6 types of feedback, and 9 types of responses (prevalence-adjusted and bias-adjusted κ range: a 0.56 [95% CI, 0.45-0.68] minimum for triggers to a 0.99 [95% CI, 0.97-1.00] maximum for feedback and responses). For the generalizability of the system, 6 types of surgical procedures and 3711 instances of feedback were analyzed and coded with types of triggers, feedback, and responses. Significant differences in triggers, feedback, and responses reflected surgeon experience level and surgical task being performed. For example, as a response, attending surgeons took over for safety concerns more often for fellows than residents (prevalence rate ratio [RR], 3.97 [95% CI, 3.12-4.82]; P = .002), and suturing involved more errors that triggered feedback than dissection (RR, 1.65 [95% CI, 1.03-3.33]; P = .007). For the utility of the system, different combinations of trainer feedback had associations with rates of different trainee responses. For example, technical feedback with a visual component was associated with an increased rate of trainee behavioral change or verbal acknowledgment responses (RR, 1.11 [95% CI, 1.03-1.20]; P = .02).
    Conclusions and relevance: These findings suggest that identifying different types of triggers, feedback, and responses may be a feasible and reliable method for classifying surgical feedback across several robotic procedures. Outcomes suggest that a system that can be generalized across surgical specialties and for trainees of different experience levels may help galvanize novel surgical education strategies.
    MeSH term(s) Humans ; Feedback ; Reproducibility of Results ; Neoplasm Recurrence, Local ; Surgeons/education ; Specialties, Surgical
    Language English
    Publishing date 2023-06-01
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2023.20702
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  10. Article ; Online: Obturator Nerve Injury in Robotic Pelvic Surgery: Scenarios and Management Strategies.

    La Riva, Anibal / Sayegh, Aref S / Perez, Laura C / Poncel, Jaime / Medina, Luis G / Adamic, Brittany / Powers, Ryan / Cacciamani, Giovanni E / Aron, Monish / Gill, Inderbir / Sotelo, Rene

    European urology

    2023  Volume 83, Issue 4, Page(s) 361–368

    Abstract: Background: Obturator nerve injury (ONI) is an uncommon complication of pelvic surgery, usually reported in 0.2-5.7% of cases undergoing surgical treatment of urological and gynecological malignancies involving pelvic lymph node dissection (PLND).: ... ...

    Abstract Background: Obturator nerve injury (ONI) is an uncommon complication of pelvic surgery, usually reported in 0.2-5.7% of cases undergoing surgical treatment of urological and gynecological malignancies involving pelvic lymph node dissection (PLND).
    Objective: To describe how an ONI may occur during robotic pelvic surgery and the corresponding management strategies.
    Design, setting, and participants: We retrospectively analyzed video content on intraoperative ONI provided by robotic surgeons from high-volume centers.
    Surgical procedure: ONI was identified during PLND and managed according to the type of nerve injury.
    Results and limitations: The management approach varies with the type of injury. Crush injury frequently occurs at an advanced stage of PLND. For a crush injury to the obturator nerve caused by a clip, management only requires its safe removal. Three situations can occur if the nerve is transected: (1) transection with feasible approximation and tension-free nerve anastomosis; (2) transection with challenging approximation requiring certain strategies for proper nerve anastomosis; and (3) transection with a hidden proximal nerve ending that may initially appear intact, but is clearly injured when revealed by further dissection. Each case has different management strategies with a common aim of prompt repair of the anatomic disruption to restore proper nerve conduction.
    Conclusions: ONI is a preventable complication that requires proper identification of the anatomy and high-risk areas when performing pelvic lymph node dissection. Prompt intraoperative recognition and repair using the management strategies described offer patients the best chance of recovery without sequelae.
    Patient summary: We describe the different ways in which the obturator nerve in the pelvic area can be damaged during urological or gynecological surgeries. This is a preventable complication and we describe how it can be avoided and different management options, depending on the type of nerve injury.
    MeSH term(s) Humans ; Robotic Surgical Procedures/adverse effects ; Obturator Nerve/injuries ; Obturator Nerve/surgery ; Retrospective Studies ; Lymph Node Excision/methods ; Peripheral Nerve Injuries/etiology ; Crush Injuries/complications ; Crush Injuries/surgery ; Laparoscopy/adverse effects
    Language English
    Publishing date 2023-01-14
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 193790-x
    ISSN 1873-7560 ; 1421-993X ; 0302-2838
    ISSN (online) 1873-7560 ; 1421-993X
    ISSN 0302-2838
    DOI 10.1016/j.eururo.2022.12.034
    Database MEDical Literature Analysis and Retrieval System OnLINE

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