Diapositiva 1 - Istituto Auxologico Italiano
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Diapositiva 1 - Istituto Auxologico Italiano
Department of Urology Advanced Urotechnology Center Istituto Auxologico Italiano PD. Dr. Med. Andrea Cestari Prof. Dr. Med. Patrizio Rigatti Head of Department Scientific Director Department of Urology Presidio Ospedaliero Capitanio Via Mercalli 30, 20122 Milano Outpatient Clinics Centro Diagnostico S. Carlo Via Pier Lombardo, 22 Milano Centro di Ricerche e Tecnologie Biomediche Via Zucchi, 18 Cusano Milanino Centro di Ricerca e Cura dell’invecchiamento Via Mosè Bianchi, 90 Milano Istituto Scientifico Ospedale S Luca Piazzale Brescia 20 Milano Istituto Scientifico S. Michele Via Ariosto 13, Milano Centro Diagnostico Via S. Francesco, 16 Pioltello (Milano) Istituto Scientifico Ospedale S Giuseppe Via Cadorna, 90 Piancavallo Centro Diagnostico Meda Corso della Resistenza, 23 Meda Istituto Scientifico Villa Caramona Corso Mameli, 199 Verbania Advanced Urotechnology Center / 1 • Our Institute is at the forefront of the international scene for the technological level (first position in Europe) • Experienced urologists trained all over the World • High scientific activity • International Referral Center for: Intuitive (Robotic Surgery) Karl Storz (Laparoscopy and Endourology) Galil (Renal cryoablation) Dr. A. Cestari is Directive Board Member of: IEA ESUT EuRECA Advanced Urotechnology Center / 2 • Advanced diagnosis for urological and andrological pathology • Minimally-Invasive surgery for urological and andrological pathology • Multidisciplinary treatment of oncological metastatic diseases • Diagnosis, therapy, rehabilitation and follow up customized for each patient Minimally Invasive Oncological Surgery Radical Prostatectomy Radical cystectomy with orthotopic neobladder Partial nephrectomy Radical nephrectomy Minimally Invasive Reconstructive Surgery Pielo-ureteral joint syndrome Ureteral lesions (acquired) Megaureter Inguinal hernioplasty Colpopexy DaVinci Surgical System Robot-assisted Radical Prostatectomy (RARP) • Detailed anatomical vision • Delicate handling of anatomical structures significant reduction of a potential traumatic impact Erectile Function Recovery After RARP The rate of erectile function recovery at 12 and 24 months ranged from 54% to 90% and from 63% to 94%, respectively. Ficarra et al. 2012 In our series 87% at 12 months Urinary Continence Recovery After RARP At 12 months, the rates of postoperative urinary incontinence (continence defined as no pad use) ranged from 4% to 31% (mean 16%); when continence is defined as no pad or safety pad use, from 8% to 11% (mean 9%). Ficarra et al. 2012 In our series continence rate at 12-month 94% Innovative Techniques for Minimally Invasive Surgery 3D – HD Laparoscopy “Single-Site” Robotic surgery Cestari A et al. Eur Urol 2012;62:175-9 Minimally Invasive Oncological Surgery Cryoablation for Renal Cancer Crioablazione Holmium Laser Lithotripsy of bladder stones, ureteral and renal Retrograde Ureterotomy Retrograde endopyelotomy Uretrotomy Conservative treatment of urothelial tumors of the upper urinary tract Holmium Laser Enucleation of the Prostate (HoLEP) Instruments • 550 μm, end-firing, quartz fibre and • 80 W Ho:YAG laser 532 nm ‘Greenlight’ laser vaporisation of prostate • Vaporisation of prostatic tissue by a sudden increase in tissue temperature from 50°C to 100°C. • Green light emitted (λ=532 nm) • Laser vaporisation using 80 W Bipolar Transurethral Resection of the Prostate Olympus Plasma Vaporisation System Photodynamic diagnosis (PDD) with 5aminolevulinic acid (5-ALA) or hexyl aminolevulinate (HAL) Diagnosis and Follow-up of Patients with Non-Muscle-Invasive Bladder Cancer SPIES (STORZ Professional Image Enhancement System) • based on a computed virtual chromoendoscopy processing the color components by means of three specific filters • improves the contrast between abnormal and normal bladder mucosa Urinary Incontinence Botulin Toxin A for refractory Overactive Bladder Sacral nerve stimulation A form of electrical stimulation therapy. A wire with a small electrode tip is implanted inside the body so the tip is near the sacral nerve in the lower spine. Small electrical impulses activate the sacral nerve, which controls bladder function Stress urinary incontinence in women Laparoscopic colposuspension Mid-urethral slings for women with SUI Tension-free Vaginal Tape (TVT) 1.Skin-to-vagina (top-down) retropubic direction 2.Transobturator insertion (TVT-O) Surgery for stress urinary incontinence in men Fixed male sling - Continence restoration by: 1.urethral compression (InVance®,Istop TOMS, Argus®) 2.repositioning the bulb of urethra (AdVance) Surgery for stress urinary incontinence in men Non-circumferential compression device (ProAct®) Surgery for stress urinary incontinence in men Artificial urinary sphincter AMS 800TM Urinary Control System Erectile Dysfunction Penile prosthesis 1.low morbidity rate 2.highly effective ED treatment with higher treatment satisfaction 3.excellent long-term mechanical reliability 3-Pieces Penile Implant - best penile rigidity - natural flaccidity - mechanical reliability AMS 700 [email protected]