Laparoendoscopic Single-Site Pyelolithotomy With Use of a Carter-Thomason Needle Grasper

서일영,임정식 대한비뇨의학회 2013 Investigative and Clinical Urology Vol.54 No.3

Purpose: To study the feasibility and safety of the procedure, we present our early experience with laparoendoscopic single-site (LESS) pyelolithotomy performed by use of a Carter-Thomason needle grasper. Materials and Methods: Four patients underwent LESS pyelolithotomy for the removal of renal pelvic stones. The patients’ mean age was 57.8 years, and their mean body mass index was 23.01. We used a homemade single-port device made with a surgical glove that was inserted into a 2.5-cm periumbilical incision. The operation was performed transperitoneally by using a Carter-Thomason grasper. After removal of the stone, a double-J stent was placed in situ, and laparoscopic intracorporeal suturing was performed. No additional ports were used. Results: All surgeries were completed successfully without conversion to conventional laparoscopy or open surgery. The mean operative time was 124.5 minutes, and the mean estimated blood loss was 255.2 mL. There were no significant complications, except in one patient who required a blood transfusion. The mean duration of hospital stay was 8.3 days. The mean stone size was 3.9 cm. Chemical analysis of the stones showed that three patients had calcium-containing stones and one patient had a uric acid stone. Postoperative radiologic study showed a stone clearance rate of 100%. Conclusions: Our results, albeit limited, showed that LESS pyelolithotomy is a feasible and safe procedure. Especially with the use of a Carter-Thomason needle grasper, this operation can be performed without an additional port.

복강경 신우성형술로 치료한 신우요관이행부 폐색

서일영,박승철,오상진 대한비뇨의학회 2005 Investigative and Clinical Urology Vol.46 No.4

Urologic robotic surgery in Korea: Past and present

서일영 대한비뇨의학회 2015 Investigative and Clinical Urology Vol.56 No.8

Since 2005 when the da Vinci surgical system was approved as a medical device by the Korean Ministry of Health and Welfare, 51systems have been installed in 40 institutions as of May 2015. Although robotic surgery is not covered by the national health insuranceservice in Korea, it has been used in several urologic fields as a less invasive surgery. Since the first robotic-assisted laparoscopicradical prostatectomy in 2005, partial nephrectomy, radical cystectomy, pyeloplasty, and other urologic surgeries have beenperformed. The following should be considered to extend the indications for robotic surgery: training systems including accreditation,operative outcomes from follow-up results, and cost-effectiveness. In this review, the history and current status of roboticsurgeries in Korea are presented.

Long-Term Follow-up Results of Laparoscopic Pyeloplasty

서일영,오태훈,이재환 대한비뇨의학회 2014 Investigative and Clinical Urology Vol.55 No.10

Purpose: To assess the long-term follow-up results of laparoscopic pyeloplasty for ureteropelvicjunction obstruction. Materials and Methods: Sixty-five patients (mean age, 43.8 years) who underwentstandard laparoscopic pyeloplasty by transperitoneal approaches were enrolled in thisstudy. The chief complaint was flank pain (n=57 patients); the remaining cases weredetected incidentally. Twenty-three patients had undergone previous abdominal surgeries,including open pyeloplasty and endopyelotomy. Mean stricture length was 1.06cm. Grade 3/4 and 4/4 hydronephrosis was detected in 36 and 14 patients, respectively. An obstructive pattern was present on the renal scan in 53 patients (81.5%). Results: Fifty-seven patients were treated with dismembered Anderson-Hynes pyeloplastyand eight patients with Fenger pyeloplasty. During the operation, crossing vesselswere found in 27 patients (41.5%). Mean operating time was 159.42 minutes. Although there were no cases of open conversion, two patients with colon and spleeninjuries were detected postoperatively. The mean starting time of postoperative ambulationand diet was 1.54 days and 1.86 days, respectively. Mean hospital stay was 8.09days. Mean follow-up period was 36.5 months. Follow-up intravenous pyelography andrenal scan showed improvements in 59 patients, and the radiologic success rate was90.8%. Eight patients showed failure on radiologic or symptomatic evaluation, and theoverall success rate was 87.7%. In the comparative analysis between the success andfailure groups, drained amount was the only risk factor related to failure (554.41 mL. vs. 947.70 mL, p=0.024). Conclusions: Long-term follow-up results support laparoscopic pyeloplasty as thestandard treatment for ureteropelvic junction obstruction. Drained amount is a riskfactor for failure of the operation.

Laparoscopic Excision of a Urachal Cyst Containing Large Stones in an Adult

서일영,한동엽,오상진,임정식 연세대학교의과대학 2008 Yonsei medical journal Vol.49 No.5

Stone-containing urachal cysts are extremely rare in adults. Here, we report the case of a 58-year-old man with a urachal cyst who had lower abdominal pain and urinary frequency. Abdominal ultrasonography and computed tomography showed hyperdense stones in the urachus. He was treated with a laparoscopic excision using a transperitoneal approach. The pathological diagnosis was an inflammed urachal cyst. This rare case illustrates an inflammed urachal cyst containing stones treated with laparoscopy.

Long-Term Outcome of Primary Endoscopic Realignment for Bulbous Urethral Injuries: Risk Factors of Urethral Stricture

서일영,임정식,이재환,박승철 대한배뇨장애요실금학회 2012 International Neurourology Journal Vol.16 No.4

Purpose: Although endoscopic realignment has been accepted as a standard treatment for urethral injuries, the long-term follow-up data on this procedure are not sufficient. We report the long-term outcome of primary endoscopic realignment in bulbous urethral injuries. Methods: Patients with bulbous urethral injuries were treated by primary endoscopic realignment between 1991 and 2005. The operative procedure included suprapubic cystostomy and transurethral catheterization using a guide wire, within 72 hours of injury. The study population included 51 patients with a minimum follow-up duration of 5 years. Results: The most common causes of the injuries were straddle injury from falling down (74.5%), and pelvic bone fracture (7.8%). Gross hematuria was the most common complaint (92.2%). Twenty-three patients (45.1%) had complete urethral injuries. The mean time to operation after the injury was 38.8±43.2 hours. The mean operation time and mean indwelling time of a urethral Foley catheter were 55.5±37.6 minutes and 22.0±11.9 days, respectively. Twenty out of 51 patients (39.2%) were diagnosed with urethral stricture in 89.1±36.6 months after surgery. A multivariate analysis revealed that young age and operation time were independent risk factors for strictures as a complication of urethral realignment (hazard ratio [HR], 6.554, P=0.032; HR, 6.206, P=0.035). Conclusions: Urethral stricture commonly developed as a postoperative complication of primary endoscopic urethral realignment for bulbous urethral injury, especially in young age and long operation time.

Fibronectin이 MBT-2 세포주에 대한 유도 대식세포의 항종양효과에 미치는 영향

서일영,임정식,정헌택 大韓泌尿器科學會 1996 Korean Journal of Urology Vol.37 No.1

재발성 후복막강 지방육종 1례

서일영,원호석,김종성,김호성,임정식 大韓泌尿器科學會 1994 Korean Journal of Urology Vol.35 No.12

시멘트 클린커 생성과정에 미치는 Potassium의 영향 I. 불안정 상태의 알칼리

서일영,최상홀 한국세라믹학회 1985 한국세라믹학회지 Vol.22 No.1

The states of alkali occuring in Portland cement clinker were studied. Potassium was added to raw mixture by there kinds ; $K_2SO_4$, $K_2CO_3$ and KOH. In case of $K_2CO_3$ and KOH addition the new state of unstable alkali was found when alkakli content is high and $SO_3$ content is low in the clinker. Unstable state of highly basic free 4K_2O$ causes lowering burnability much more than alkali sulfate especially at the early stage of burning. Lowered burnability by 4K_2O$ became more serious with higher LSF. Unstable free-4K_2O$ which is readily soluble with water reacts with gypsum to form <TES>$Ca(OH)_2$ and syngenite as soon as water is added. As a results the liberation rate of heat of hydration at the early hydration process(1st peak) was increased.

시멘트 클린커 생성과정에 미치는 Potassium의 영향 II. 불안정 알칼리 생성 인자

서일영,최상홀 한국세라믹학회 1985 한국세라믹학회지 Vol.22 No.2

Effect of alkali $SO_3$ and $C_2S$ content and cooling condition of clinker on the formation of unstable alkali and cooling condition of clinker on the formation of unstable alkali was investigated. As a result alkali and $SO_3$ content of clinker were the main factors of unstable alkali formation and equation (7) in which the two factors were the variables showed a good agreement with the observed results. Water soluble alkali content of sulphate was decreased with increase of $C_2S$ content of clinker resulted by the increase of solid solution rate of alkali to clinker minerals. But change of unsatble alkali content accordint to the increase of $C_2S$ content was slight. A increasing tendency of ignition loss of clinker with increase of unstable alkali content was found.