Category Archives: Cirugia Ronotica

Today in Los Angeles interview…

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I share a free translation from the interview published by the newspaper Hoy Los Angeles in relation to the book ‘Don’t Fear the Finger’.

By Selena Rivera

For many men the idea of having a finger inside the rectum to palpate any lumps or abnormal growths on the prostate is a nightmare; for some, apart from how uncomfortable this might be, it also represents a “threat” to their virility.

However, early and regular check-ups could save their lives, according to the urologist René Sotelo from the health centers of the University of Southern California.

Prostate cancer is the second leading cause of death in males, behind lung cancer. According to the American Cancer Society about one man in 38 will die from this disease.

A glandular organ that lies below the bladder and in front of the rectum produces semen.

“Prostate cancer, as any other cancer, is the uncontrolled growth of the cells of the body” Dr. Sotelo states.

Symptoms include frequent urination, weak or interrupted urine flow or pain while urinating, painful ejaculation, blood in the urine or semen, or an uncomfortable pain in the back, hip or pelvis. Nonetheless, these symptoms may also be signs of other diseases.

In many cases there are no symptoms in the early stages of the cancer. Besides, this disease may develop slowly”, Dr. Sotelo affirms.
That is why, it is necessary that, starting at age 50, all men begin to have a digital rectal exam.

“This exam allows a doctor to detect lumps or abnormalities. Unfortunately, for many men in our society this is a taboo subject; while others do not go to the doctor for fear of the result. This causes that many patients go to the doctor when the disease is in its advanced stages”, Dr. Sotelo states.

Today, a patient can also have a blood test that measures the level of a protein produced by the prostate. Higher than expected levels of this protein may mean that a tumor is present; it can also be a sign of an infection or an enlargement of the glandular organ.

The exact causes of prostate cancer are not known. Risk factors include family history and diet in men who eat large amounts of animal fat, he says.

“Likewise, it has been reported that the incidence of cancer is higher in countries with hotter weather”, Dr. Sotelo explains.
Prostate cancer may be a serious disease; however the majority of men diagnosed with prostate cancer do not die from this disease if it is treated in time, according to the American Cancer Society (ACS).

Other good news is that nowadays there are several treatments that may help patients, depending on their age and the stage of their cancer. “The key is that you ‘Don’t Fear the Finger’ and visit your doctor”, Dr. Sotelo, who wrote a book with this title, stresses.
Other facts found by the ACS:

About 220,800 new cases of prostate cancer were diagnosed in the United States in 2015.

About 27,540 deaths from prostate cancer were reported during 2015.

About 1 man in 7 will be diagnosed with prostate cancer during his lifetime.

Prostate cancer develops mainly in older men. About 6 cases in 10 are diagnosed in men aged 65 or older, and it is rare before age 40.

Original article available at Hoy Los Angeles.

Today in Los Angeles interview…

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I am grateful for the attention given in Hoy Los Angeles. My training is 100% Venezuelan. I share a free translation from the published interview:

By Selena Rivera

During his teenage years, René Sotelo was laughed at by his classmates because he was always wearing his lab coat. Back then, young Sotelo felt the calling to medicine as he began to take an interest in the body’s functions and its healing.

Decades later, the native of Venezuela became a pioneer in the handling of the robot in prostate and other diseases surgeries, thus being the first urologist to use this technique in Venezuela. This process was already being practiced in Mexico; however, it ceased after some surgical interventions because of “administrative issues”, Dr. Sotelo explains.

Since then, Venezuela took the lead with Sotelo at the forefront who took the leading position as regards the number of robotic surgeries performed in Latin America.

Then, his skills and futuristic methods have brought him to the renowned Hospital of the University of Southern California (USC) thanks to a job offer, through which he also obtained an extraordinary ability visa and a five year visa.

“I’ve been working at the USC for six months. I think that I was chosen because of my curriculum and my experience”, Dr. Sotelo says.
Just a quick look at the doctor’s resume is enough to notice it. His expertise in advanced robotic and laparoscopic surgery surpasses 2,300 cases which makes him one of the world’s most experienced professionals in this field. In addition, Dr. Sotelo has published more than 50 scientific articles, three textbooks and 28 book chapters about urology.

In recognition of his work, Dr. Sotelo has been invited as a lecturer to more than 35 universities, and he has shared his techniques in 19 countries. So far, he has trained more than 64 colleagues from 14 countries in the art and science of minimally invasive urology and robotic surgery.

He points out that he never thought he would get that far, since he studied in Venezuela and because of his humble startup.

“Mi mother was a school teacher and my father, a Mexican national, was a lithographer… from an early age they taught me to work hard; I witnessed how my parents worked overtime and at nights to pay for my studies”, he reveals.

Some time after, Dr. Sotelo worked for a clinic where he was more than welcomed and where he developed his talent. In 1992, young Sotelo graduated from the Central University of Venezuela, Hospital General del Este.

“I had no choice. I couldn’t afford to buy my own clinic. Over the years, I saw how the parents of some of my colleagues bought them their own clinics even when they didn’t graduate. However, it wasn’t my case”, he adds.

Nevertheless, he refined his techniques exceeding the medical community’s expectations. For this reason, he started to teach his skills abroad.

Based on laparoscopic surgery, robotic or minimally invasive surgery broadens its reach trough a four-armed robot and its 3D vision system.
This robot allows, therefore, the doctor to do the surgery with more precise movements as well as the possibility of preserving and restoring the patient’s anatomy.

Five years ago, it was imperative to remove the kidney affected by cancer. Nowadays, with this intervention only the tumor is removed, preserving the organ.

Dr. Sotelo adds that “these kinds of interventions are applied in the field of Urology, especially with regard to prostate, bladder and gynecological issues; it is also employed in cardiovascular, thoracic and valve replacement surgeries, and in general in surgeries requiring tissue reconstruction.”

For the young immigrant, living in a country that is new for him and his family is a challenge. Nevertheless, Dr. Sotelo is glad to represent the Latinos, to have the opportunity to use the advanced technology that is available in the United Stated, and to show the new generation of postgraduate medical students that with dedication and tenacity everything is possible.

Original article available here.

AUA2016: Course Complications of Robotic Urological Surgery

The American Urological Association’s (AUA) Annual Meeting, May 6 – 10, 2016, is the place to learn about groundbreaking sciences and the latest advances in urologic products and technology.

You shouldn’t miss this postgraduate course: Complications of Robotic Urological Surgery, prevention, recognition and management.

Join us in San Diego. Register today at WWW.AUA2016.ORG

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Complications in Surgery: Interview at EAU 2015

What are the complications in surgery? Which are the most frequent complications? Are complications under estimated? What is the best way to grade complications?

This doubts are answered in this interview. Thanks to UroOnco for share it:

 

Safer Surgery by Learning from Complications

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The uptake of robotic surgery has led to changes in potential operative complications, as many surgeons learn minimally invasive surgery, and has allowed the documentation of such complications through the routine collection of intraoperative video.

For more information, Safer Surgery by Learning from Complications: A Focus on Robotic Prostate Surgery realesed in European Urology Magazine released in European Urology Magazine.

Minimally invasive oncologic surgery: The best is yet to come

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Dr. Inderbir Gill, director of the USC Institute of Urology, was the cover story feature on the August 2015 issue of the Urology Times (vol 43). The topic is “Surgical advances, minimally invasive oncologic surgery – the best is yet to come.”. This article is available at urologytimes.modernmedicine.com:

The use of minimally invasive surgery in urology has evolved and expanded since its inception. Inderbir S. Gill, MD, MCh, who is widely considered the international leader in minimally invasive urologic oncologic surgery, says the best is yet to come. In this interview, Dr. Gill discusses what he calls the three most significant advances in minimally invasive oncologic surgery, how the current model for education can be improved, and the next frontier in minimally invasive surgery. Dr. Gill is chairman and professor of the Catherine and Joseph Aresty Department of Urology at the University of Southern California (USC), founding executive director of the USC Institute of Urology, and associate dean of clinical innovation at the Keck School of Medicine of USC. He served as a consultant for Mimic Technologies, which has developed a surgical simulator in conjunction with USC.Dr. Gill was interviewed by Urology Times Editorial Consultant Stephen Y. Nakada, MD, The Uehling Professor and founding chairman of the department of urology at the University of Wisconsin, Madison.

What would you say are the three greatest advances in minimally invasive surgery in the last quarter century?

The biggest advance has been the substantially increased application of minimally invasive urologic/oncologic surgery. In 2015, we are now able to bring a confident, even an increasingly dominant presence in this arena. This has taken a quarter of a century to come to fruition.

Second are the advances in robotic technology that have further improved our ability to do minimally invasive surgery. I personally used to be a laparoscopic aficionado. Now, for a host of very good reasons, I have become a convert to robotic surgery.

Third is the increasing push toward obtaining level one evidence—randomized, controlled trials. Gone are the days of do one, see one, teach one. Now, appropriately, far more robust and dependable level one data are required.

Source: Urology Times

Robotic Surgery for Vena Cava Tumor Thrombectomy

The robotic surgery is an innovate technology with numerous applications in the field of urology and general surgery. For this reason, I found really interesting this article called Robotic Surgery Possible for Inferior Vena Cava Tumor Thrombectomy, available on  renalandurologynews.com:

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(HealthDay News) — Completely intracorporeal robotic level III inferior vena cava tumor thrombectomy is feasible, according to a report published recently inThe Journal of Urology.

Inderbir S. Gill, M.D., M.Ch., from the University of California Institute of Urology in Los Angeles, and colleagues present the initial series of completely intracorporeal robotic level III inferior vena cava tumor thrombectomy cases. Nine and seven patients underwent robotic level III inferior vena cava thrombectomy and level II thrombectomy, respectively. The entire operation was performed robotically. An “inferior vena cava-first, kidney-last” robotic technique was developed to minimize the chances of intraoperative inferior vena cava thrombus embolization.

The researchers found that all 16 robotic procedures were successful, with no incidence of open conversion or mortality. The median primary kidney cancer size was 8.5 cm for level III cases, and inferior vena cava thrombus length was 5.7 cm. The median operative time was 4.9 hours, blood loss was estimated at 375 cc, and hospital stay was 4.5 days. Surgical margins were negative in all cases. No intraoperative complications and one postoperative complication occurred. All patients were alive at a median of seven months of follow-up. The level III cohort trended toward greater inferior vena cava length, operative time, and blood loss, compared with the level II cohort.

“Larger experience, longer follow-up, and comparison with open surgery are needed to confirm these initial outcomes,” the authors write.

Several authors disclosed financial ties to the medical device industry.

Source

  1. Gill, IS; Metcalfe, C; Abreu, A; et al. The Journal off Urology; doi: 10.1016/j.juro.2015.03.119.
This article originally appeared here.