To evaluate the feasibility and effectiveness of aspirator blowing in laparoscopic partial nephrectomy.

The data of forty-two cases of laparoscopic partial nephrectomy of the Sixth Affiliated Hospital of Sun Yat-sen University from July 2018 to June 2021 were analyzed retrospectively, the renal thermal ischemia time, operation time, intraoperative blood loss and intraoperative and postoperative complications were recorded.

All the 42 patients underwent laparoscopic partial nephrectomy successfully, and no one needed conversion to open procedures, the success rate was 100%. There were no serious complications such as renal failure, postoperative bleeding, urinary fistula, and positive postoperative pathological margin.

The application of aspirator blowing method in laparoscopic partial nephrectomy has the advantages of providing a clear field of vision, no effect on pneumoperitoneum pressure, vision stable and so on, and the operation is simple, which is worthy of clinical promotion.

To report the treatment of a peculiar morphology of prostatic hyperplasia nodule-the extra-vesicle median lobe during robot-assisted radical prostatectomy.

Among the 339 cases of RARP performed by a single operator between July 2022 and June 2023, 238 cases with preserved surgical videos were reviewed, focusing on the bladder neck dissection and its subsequent dorsal prostate detachment procedures, and a total of 8 patients with typical extravesical median lobes were screened out for reviewing in combination with the patient's preoperative multiparametric magnetic resonance imaging data. In this article, we would focus on the analysis of one of the cases.

The extra-vesicle median lobe was usually located behind the urethra, and its anatomical location and texture were close to the contralateral vas deferens and seminal vesicles. During robot-assisted radical prostatectomy (RARP), it potentially misled the surgeon into the wrong anatomical plane. Due to the modification of the surgical plane, the operation time would probably be prolonged, which might impact the surgical determination of the surgeon.

How to predict the existence of "the extra-vesicle median lobe" before and during operation and make timely adjustment of surgical strategies is a problem worth exploring by surgeons.

To investigate the feasibility and safety of a novel single-port robotic surgical system in radical prostatectomy.

From October 2021 to April 2022, 17 cases of radical prostatectomy were carried out in the First Affiliated Hospital of Naval Military Medical University, the Second Affiliated Hospital of Nanjing Medical University and the First Affiliated Hospital of Zhejiang University with a novel single-port robotic surgical system. The perioperative information was recorded, such as oncological profiles, surgical approach, operating time, console time, estimated blood loss, number of auxiliary ports, perioperative complications, pathological results, PSA and continence 1 month after operation.

The average age of the patients was (70±7) years old, the average BMI was (24.8±2.7) kg/m², the average PSA before operation was 11.9(6.6) ng/ml, and the Gleason score was 6 in 7 cases and 7 in 10 cases. All operations were successfully completed, including 10 transperitoneal cases and 7 extraperitoneal cases. Five cases were received pure single-port operation, and in 12 cases, a 12 mm auxiliary port was added. The average operation time was (210±63) minutes, the console time was (172±52) minutes, and estimated blood loss was (115±92) ml. There were no complications observed, such as blood transfusion, colon injury, urinary leakage, fever, poor wound healing and so on. Postoperative pathology showed that Gleason score was 6 in 4 cases, 7 in 12 cases, and 9 in 1 case. Fourteen cases were in T₂ stage and 3 cases were T₃. There were 4 cases (23.5%) with positive margin. One month after operation, the average PSA was 0.01(0.074) ng/ml, and continence was achieved in 12 cases (71%).

The novel single-port robotic surgical system can be safely and effectively applied in transperitoneal and extraperitoneal radical prostatectomy.

To explore the clinical effect of self-made "forceps lifting" auxiliary device for transurethral bladder tumor en-bloc resection in the treatment of non-muscle invasive bladder cancer.

The clinical data of 64 cases of non-muscle invasive bladder cancer in Shanghai University of Medicine&Health Sciences Affiliated Zhoupu Hospital from March 2021 to January 2023 were retrospectively analyzed. They were divided into general group and improved group, 32 cases in each group. For enucleation, the improved group used a self-made "forceps lifting" auxiliary device for transurethral en-bloc enucleation of bladder tumors with holmium laser, the general group underwent traditional transurethral holmium laser en-bloc enucleation of bladder tumors. The operation time, intraoperative hemoglobin decrease, surgical complications and tumor recurrence were compared between the two groups.

The operations of all patients went smoothly. The hemoglobin in the improved group decreased by (5±3) g/L, the probability of bladder perforation was 0%(0/32), the tumor recurrence rate in situ was 3.13%(1/32), and the hemoglobin in the general group decreased (6±3) g/L, the probability of bladder perforation was 9.38%(3/32), and the tumor recurrence rate in situ was 12.5%(4/32), there was no significant difference between the two groups (P>0.05). The operation time of the improved group was (19±7) min, shorter than the general group [(25±8) min](P=0.004); the number of people with muscular layer tissue in the tumor base of the improved group accounted for 93.75%, which was significantly more than that of the general group, which was 40.63% (P<0.001).

The holmium laser enuclear enucleation of transurethral bladder tumors treated with self-made "forceps lifting" auxiliary device has the same fewer surgical complications as general en bloc holmium laser enucleation of transurethral bladder tumors, and is safe. Because it can clearly and stably expose the tumor base, the operation time is shorter, and more muscle tissue at the base of the tumor can be obtained, which is conducive to tumor pathological detection. The technology is self-made with existing equipment, easy to operate, and worthy of clinical promotion.

To investigate the efficacy and safety of needle- perc nephroscope for treatment of renal calculi in pediatric patients.

From September 2019 to June 2020, 20 children with renal calculi were treated with needle-perc nephroscope and holmium laser lithotripsy under general anesthesia in our hospital. The operation time, postoperative hemoglobin decline, postoperative pain score, hospitalization time and complications were observed.

Twenty two sides of 20 cases of renal calculi were successfully punctured, including 16 cases of single puncture, 4 cases of 2 times of puncture, and 2 sides of 3 times of puncture. The average operation time was (45±12) min, the average decrease of hemoglobin was (5.5±0.8) g/L, the average postoperative pain score was (3.5±0.5) points, and the average day of postoperative hospitalization was (3.7±0.9) d. There were 3 cases of Clavien grade I complications with renal colic and 2 cases of Clavien grade II complications with body temperature ≥38.0℃ after operation. No blood transfusion cases and no Clavien III complications occurred. The stone-free rate at one month was 86.36% (19/22).

Percutaneous nephrolithotomy with needle-perc nephroscope for the treatment of small renal calculi in pediatric patients is safe and effective, with high stone-free rate, low complications and short hospitalization time.