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Dr. Paulos  Yohannes  Md image

Dr. Paulos Yohannes Md

2735 N Clarkson St
Fremont NE 68025
402 275-5000
Medical School: University Of Louisville School Of Medicine - 1994
Accepts Medicare: Yes
Participates In eRX: Yes
Participates In PQRS: Yes
Participates In EHR: Yes
License #: 21850
NPI: 1043299985
Taxonomy Codes:
208800000X

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Awards & Recognitions

About Us

Practice Philosophy

Conditions

Dr. Paulos Yohannes is associated with these group practices

Procedure Pricing

HCPCS Code Description Average Price Average Price
Allowed By Medicare
HCPCS Code:71260 Description:Ct thorax w/dye Average Price:$550.00 Average Price Allowed
By Medicare:
$111.67
HCPCS Code:52214 Description:Cystoscopy and treatment Average Price:$592.31 Average Price Allowed
By Medicare:
$190.08
HCPCS Code:52353 Description:Cystouretero w/lithotripsy Average Price:$763.64 Average Price Allowed
By Medicare:
$379.37
HCPCS Code:55866 Description:Laparo radical prostatectomy Average Price:$2,000.00 Average Price Allowed
By Medicare:
$1,622.42
HCPCS Code:52601 Description:Prostatectomy (TURP) Average Price:$1,156.25 Average Price Allowed
By Medicare:
$781.42
HCPCS Code:74176 Description:Ct abd & pelvis Average Price:$500.00 Average Price Allowed
By Medicare:
$147.37
HCPCS Code:55700 Description:Biopsy of prostate Average Price:$450.00 Average Price Allowed
By Medicare:
$127.64
HCPCS Code:74178 Description:Ct abd & pelv 1/> regns Average Price:$645.00 Average Price Allowed
By Medicare:
$324.36
HCPCS Code:71250 Description:Ct thorax w/o dye Average Price:$450.00 Average Price Allowed
By Medicare:
$172.13
HCPCS Code:51797 Description:Intraabdominal pressure test Average Price:$275.00 Average Price Allowed
By Medicare:
$38.24
HCPCS Code:52332 Description:Cystoscopy and treatment Average Price:$325.00 Average Price Allowed
By Medicare:
$119.32
HCPCS Code:76872 Description:Us transrectal Average Price:$297.50 Average Price Allowed
By Medicare:
$110.97
HCPCS Code:51728 Description:Cystometrogram w/vp Average Price:$463.64 Average Price Allowed
By Medicare:
$287.45
HCPCS Code:51784 Description:Anal/urinary muscle study Average Price:$209.23 Average Price Allowed
By Medicare:
$36.24
HCPCS Code:51797 Description:Intraabdominal pressure test Average Price:$275.00 Average Price Allowed
By Medicare:
$110.70
HCPCS Code:52310 Description:Cystoscopy and treatment Average Price:$294.44 Average Price Allowed
By Medicare:
$138.26
HCPCS Code:51729 Description:Cystometrogram w/vp&up Average Price:$452.50 Average Price Allowed
By Medicare:
$303.67
HCPCS Code:51600 Description:Injection for bladder x-ray Average Price:$261.54 Average Price Allowed
By Medicare:
$114.51
HCPCS Code:52005 Description:Cystoscopy & ureter catheter Average Price:$266.18 Average Price Allowed
By Medicare:
$120.87
HCPCS Code:51705 Description:Change of bladder tube Average Price:$216.72 Average Price Allowed
By Medicare:
$81.47
HCPCS Code:J9217 Description:Leuprolide acetate suspnsion Average Price:$350.00 Average Price Allowed
By Medicare:
$215.93
HCPCS Code:51784 Description:Anal/urinary muscle study Average Price:$196.82 Average Price Allowed
By Medicare:
$87.19
HCPCS Code:76872 Description:Us transrectal Average Price:$125.52 Average Price Allowed
By Medicare:
$32.23
HCPCS Code:74430 Description:Contrast x-ray bladder Average Price:$140.00 Average Price Allowed
By Medicare:
$47.11
HCPCS Code:76942 Description:Echo guide for biopsy Average Price:$110.00 Average Price Allowed
By Medicare:
$31.24
HCPCS Code:51701 Description:Insert bladder catheter Average Price:$125.00 Average Price Allowed
By Medicare:
$52.34
HCPCS Code:51702 Description:Insert temp bladder cath Average Price:$140.00 Average Price Allowed
By Medicare:
$67.41
HCPCS Code:99202 Description:Office/outpatient visit new Average Price:$120.00 Average Price Allowed
By Medicare:
$67.19
HCPCS Code:84403 Description:Assay of total testosterone Average Price:$85.00 Average Price Allowed
By Medicare:
$36.57
HCPCS Code:96402 Description:Chemo hormon antineopl sq/im Average Price:$78.49 Average Price Allowed
By Medicare:
$30.89
HCPCS Code:52000 Description:Cystoscopy Average Price:$138.24 Average Price Allowed
By Medicare:
$91.01
HCPCS Code:88305 Description:Tissue exam by pathologist Average Price:$101.66 Average Price Allowed
By Medicare:
$62.88
HCPCS Code:99231 Description:Subsequent hospital care Average Price:$72.68 Average Price Allowed
By Medicare:
$35.96
HCPCS Code:99232 Description:Subsequent hospital care Average Price:$101.05 Average Price Allowed
By Medicare:
$66.04
HCPCS Code:84154 Description:Assay of psa free Average Price:$60.96 Average Price Allowed
By Medicare:
$26.06
HCPCS Code:99203 Description:Office/outpatient visit new Average Price:$131.36 Average Price Allowed
By Medicare:
$96.95
HCPCS Code:84153 Description:Assay of psa total Average Price:$60.00 Average Price Allowed
By Medicare:
$26.06
HCPCS Code:74420 Description:Contrst x-ray urinary tract Average Price:$50.00 Average Price Allowed
By Medicare:
$16.89
HCPCS Code:51741 Description:Electro-uroflowmetry first Average Price:$54.23 Average Price Allowed
By Medicare:
$21.50
HCPCS Code:84270 Description:Assay of sex hormone globul Average Price:$63.43 Average Price Allowed
By Medicare:
$30.78
HCPCS Code:74000 Description:X-ray exam of abdomen Average Price:$52.00 Average Price Allowed
By Medicare:
$22.67
HCPCS Code:84402 Description:Assay of testosterone Average Price:$63.59 Average Price Allowed
By Medicare:
$36.07
HCPCS Code:86386 Description:Nuclear matrix protein 22 Average Price:$50.00 Average Price Allowed
By Medicare:
$22.53
HCPCS Code:96372 Description:Ther/proph/diag inj sc/im Average Price:$45.00 Average Price Allowed
By Medicare:
$22.20
HCPCS Code:51798 Description:Us urine capacity measure Average Price:$40.00 Average Price Allowed
By Medicare:
$17.34
HCPCS Code:99211 Description:Office/outpatient visit est Average Price:$33.75 Average Price Allowed
By Medicare:
$18.24
HCPCS Code:80053 Description:Comprehen metabolic panel Average Price:$29.66 Average Price Allowed
By Medicare:
$14.90
HCPCS Code:80048 Description:Metabolic panel total ca Average Price:$25.00 Average Price Allowed
By Medicare:
$11.98
HCPCS Code:99212 Description:Office/outpatient visit est Average Price:$51.61 Average Price Allowed
By Medicare:
$39.24
HCPCS Code:82565 Description:Assay of creatinine Average Price:$18.00 Average Price Allowed
By Medicare:
$7.12
HCPCS Code:85025 Description:Complete cbc w/auto diff wbc Average Price:$17.00 Average Price Allowed
By Medicare:
$6.58
HCPCS Code:99214 Description:Office/outpatient visit est Average Price:$102.88 Average Price Allowed
By Medicare:
$97.08
HCPCS Code:99213 Description:Office/outpatient visit est Average Price:$70.96 Average Price Allowed
By Medicare:
$65.48
HCPCS Code:36415 Description:Routine venipuncture Average Price:$8.00 Average Price Allowed
By Medicare:
$3.00
HCPCS Code:81003 Description:Urinalysis auto w/o scope Average Price:$8.00 Average Price Allowed
By Medicare:
$3.18
HCPCS Code:J1070 Description:Testosterone cypionat 100 MG Average Price:$8.00 Average Price Allowed
By Medicare:
$4.12
HCPCS Code:J9155 Description:Degarelix injection Average Price:$5.00 Average Price Allowed
By Medicare:
$2.96
HCPCS Code:Q9967 Description:LOCM 300-399mg/ml iodine,1ml Average Price:$0.60 Average Price Allowed
By Medicare:
$0.14

HCPCS Code Definitions

51600
Injection procedure for cystography or voiding urethrocystography
51701
Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine)
51702
Insertion of temporary indwelling bladder catheter; simple (eg, Foley)
51705
Change of cystostomy tube; simple
51728
Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique
51729
Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure profile studies (ie, urethral closure pressure profile), any technique
51741
Complex uroflowmetry (eg, calibrated electronic equipment)
51784
Electromyography studies (EMG) of anal or urethral sphincter, other than needle, any technique
51784
Electromyography studies (EMG) of anal or urethral sphincter, other than needle, any technique
51797
Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (List separately in addition to code for primary procedure)
51797
Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (List separately in addition to code for primary procedure)
51798
Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging
52000
Cystourethroscopy (separate procedure)
52005
Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service
52214
Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands
52310
Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple
52332
Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type)
52353
Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)
52601
Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included)
55700
Biopsy, prostate; needle or punch, single or multiple, any approach
55866
Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed
71250
Computed tomography, thorax; without contrast material
71260
Computed tomography, thorax; with contrast material(s)
74000
Radiologic examination, abdomen; single anteroposterior view
74176
Computed tomography, abdomen and pelvis; without contrast material
74178
Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions
74420
Urography, retrograde, with or without KUB
74430
Cystography, minimum of 3 views, radiological supervision and interpretation
76872
Ultrasound, transrectal
76872
Ultrasound, transrectal
76942
Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation
88305
Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, biopsy, not requiring microscopic evaluation of surgical margins Breast, reduction mammoplasty Bronchus, biopsy Cell block, any source Cervix, biopsy Colon, biopsy Duodenum, biopsy Endocervix, curettings/biopsy Endometrium, curettings/biopsy Esophagus, biopsy Extremity, amputation, traumatic Fallopian tube, biopsy Fallopian tube, ectopic pregnancy Femoral head, fracture Fingers/toes, amputation, non-traumatic Gingiva/oral mucosa, biopsy Heart valve Joint, resection Kidney, biopsy Larynx, biopsy Leiomyoma(s), uterine myomectomy - without uterus Lip, biopsy/wedge resection Lung, transbronchial biopsy Lymph node, biopsy Muscle, biopsy Nasal mucosa, biopsy Nasopharynx/oropharynx, biopsy Nerve, biopsy Odontogenic/dental cyst Omentum, biopsy Ovary with or without tube, non-neoplastic Ovary, biopsy/wedge resection Parathyroid gland Peritoneum, biopsy Pituitary tumor Placenta, other than third trimester Pleura/pericardium - biopsy/tissue Polyp, cervical/endometrial Polyp, colorectal Polyp, stomach/small intestine Prostate, needle biopsy Prostate, TUR Salivary gland, biopsy Sinus, paranasal biopsy Skin, other than cyst/tag/debridement/plastic repair Small intestine, biopsy Soft tissue, other than tumor/mass/lipoma/debridement Spleen Stomach, biopsy Synovium Testis, other than tumor/biopsy/castration Thyroglossal duct/brachial cleft cyst Tongue, biopsy Tonsil, biopsy Trachea, biopsy Ureter, biopsy Urethra, biopsy Urinary bladder, biopsy Uterus, with or without tubes and ovaries, for prolapse Vagina, biopsy Vulva/labia, biopsy
96372
Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular
96402
Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic
99202
Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 20 minutes are spent face-to-face with the patient and/or family.
99203
Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family.
99211
Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician or other qualified health care professional. Usually, the presenting problem(s) are minimal. Typically, 5 minutes are spent performing or supervising these services.
99212
Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.
99213
Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 15 minutes are spent face-to-face with the patient and/or family.
99214
Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
99231
Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A problem focused interval history; A problem focused examination; Medical decision making that is straightforward or of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is stable, recovering or improving. Typically, 15 minutes are spent at the bedside and on the patient's hospital floor or unit.
99232
Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is responding inadequately to therapy or has developed a minor complication. Typically, 25 minutes are spent at the bedside and on the patient's hospital floor or unit.
J1070
Injection, testosterone cypionate, up to 100 mg
J9155
Injection, degarelix, 1 mg
J9217
Leuprolide acetate (for depot suspension), 7.5 mg
Q9967
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml

Medical Malpractice Cases

None Found

Medical Board Sanctions

None Found

Referrals

NPI
Doctor Name
Specialty
Count
1427023993
Internal Medicine
3,487
1326048927
Medical Oncology
2,549
1154411395
Internal Medicine
1,887
1326092453
Infectious Disease
1,672
1679587778
Family Practice
1,605
1740238559
Family Practice
1,393
1659305506
Family Practice
1,267
1538154141
Family Practice
1,104
1942314604
Psychiatry
842
1972564961
Cardiovascular Disease (Cardiology)
814
*These referrals represent the top 10 that Dr. Yohannes has made to other doctors

Publications

Influence of a genomic classifier on post-operative treatment decisions in high-risk prostate cancer patients: results from the PRO-ACT study. - Current medical research and opinion
To assess the effect of an individualized genomic classifier (GC) test, for predicting metastasis following radical prostatectomy (RP), on urologists' adjuvant treatment decisions when caring for high-risk patients.Data were submitted by US board-certified urologists in community practices (n = 15), who ordered the GC test for 146 prostate cancer patients with adverse pathologic features following RP (i.e., pathologic stage pT3 or positive surgical margins). Treatment recommendations were reported using an electronic data collection instrument, before and after reviewing the GC test report. Physicians also completed a Decision Conflict Scale (DCS), a decisional conflict measure, to assess their confidence with their treatment recommendations.Over 60% of high-risk patients were re-classified as low risk after review of the GC test results. Overall, adjuvant treatment recommendations were modified for 30.8% (95% CI = 23-39%) of patients. With GC test results, 42.5% of patients who were initially recommended adjuvant therapy were subsequently recommended observation. Although the number of patients recommended adjuvant therapy remained the same before and after review of the GC test results, it did influence patient treatment strategies. Multivariable analysis confirmed GC risk was the only significant predictor of treatment recommendations (OR = 4.04; 95% CI = 2.36, 6.92; p < 0.0001). Decisional conflict with regard to adjuvant treatment decisions was significantly less with the use of the GC test (p < 0.0001).Information on individualized metastasis risk based on a patient's tumor biology, with use of the GC test, significantly changed urologists' adjuvant treatment recommendations for post-operative patients with prostate cancer, who were at high risk of metastasis. Namely, the results of this study provide evidence for the utility of the GC test, and show it may guide use of adjuvant radiation.
Expression of leukemia/lymphoma related factor (LRF/Pokemon) in human benign prostate hyperplasia and prostate cancer. - Experimental and molecular pathology
Leukemia/lymphoma related factor (LRF), also known as Pokemon, is a protein that belongs to the POK family of transcriptional repressors. It has an oncogenic role in many different solid tumors. In this study, the expression of LRF was evaluated in benign prostate hyperplastic (BPH) and prostate cancer (PC) tissues. The functional expression of LRF was studied using multiple cellular and molecular methods including RT-PCR, western blotting, immunohistochemistry, and immunofluorescence. Paraffin-embedded human tissues of BPH and PC were used to examine LRF expression. Histological staining of the BPH and PC tissue sections revealed nuclear expression of LRF with minimal expression in the surrounding stroma. The semi-quantitative RT-PCR and western immunoblot analyses demonstrated significantly higher mRNA transcripts and protein expression in PC than BPH. High expression of LRF suggests that it may have a potential role in the pathogenesis of both BPH and prostate cancer. Further studies will help elucidate the mechanisms and signaling pathways that LRF may follow in the pathogenesis of prostate carcinoma.Copyright © 2011 Elsevier Inc. All rights reserved.
Application of TZERO calibrated modulated temperature differential scanning calorimetry to characterize model protein formulations. - International journal of pharmaceutics
The objective of this study was to evaluate the feasibility of using T(ZERO) modulated temperature differential scanning calorimetry (MDSC) as a novel technique to characterize protein solutions using lysozyme as a model protein and IgG as a model monoclonal antibody. MDSC involves the application of modulated heating program, along with the standard heating program that enables the separation of overlapping thermal transitions. Although characterization of unfolding transitions for protein solutions requires the application of high sensitive DSC, separation of overlapping transitions like aggregation and other exothermic events may be possible only by use of MDSC. A newer T(ZERO) calibrated MDSC model from TA instruments that has improved sensitivity than previous models was used. MDSC analysis showed total, reversing and non-reversing heat flow signals. Total heat flow signals showed a combination of melting endotherms and overlapping exothermic events. Under the operating conditions used, the melting endotherms were seen in reversing heat flow signal while the exothermic events were seen in non-reversing heat flow signal. This enabled the separation of overlapping thermal transitions, improved data analysis and decreased baseline noise. MDSC was used here for characterization of lysozyme solutions, but its feasibility for characterizing therapeutic protein solutions needs further assessment.
Minimally invasive procedures for urethral incontinence: is there a role for laparoscopy? - International braz j urol : official journal of the Brazilian Society of Urology
This article focuses on the minimally invasive surgical approaches for the treatment of stress urinary incontinence (SUI). The role of laparoscopic suspension is reviewed and compared with other minimally invasive techniques, such as the pubovaginal sling procedure and injection of the urethral bulking agents. The role of laparoscopic Burch colposuspension remains ill defined in 2002. Once this minimally invasive technique is shown to duplicate the success rate of the open Burch procedure, it could be offered as a first-line therapy to patients with SUI. At this time, the pubovaginal sling (PVS) offers the best long-term results with acceptable low complication rates of urinary retention, urgency, and sling erosion or infection. These complications are rarely seen with the laparoscopic repair but the incidence of bladder injuries is higher. The PVS operation can be performed as a salvage procedure, in obese patients, and concomitant with cystocele and rectocele repair whereas data for laparoscopy in these conditions are lacking. Until the long-term efficacy of the laparoscopic repair is clearly defined, offering it to patients as a minimally invasive therapy denies them of procedures with superior efficacy.
Robot-assisted Bricker ileoureteral anastomosis during intracorporeal laparoscopic ileal conduit urinary diversion for prostatocutaneous fistula: case report. - Journal of endourology / Endourological Society
The da Vinci robot is useful during minimally invasive surgery in performing intracorporeal suturing. We report one case of its application during laparoscopic ileal conduit urinary diversion for prostatocutaneous fistula.A 58-year-old paraplegic man with a neurogenic bladder and bowel and a long history of urinary incontinence developed a prostatocutaneous fistula after numerous procedures to correct the incontinence. He underwent laparoscopic ileal conduit urinary diversion to improve his quality of life. The da Vinci robot was used to perform the ileoureteral anastomosis.The operative time was 10 hours. The estimated blood loss was <100 mL. There were no intraoperative complications. The patient was started on a clear liquid diet on postoperative day 3. There was no narcotic use because of the patient's neurologic status. The patient was discharged home on day 6.Laparoscopic urinary diversion remains a technically challenging procedure. The da Vinci robot is useful during laparoscopic ileal conduit construction.
Retroperitoneoscopic nephrectomy v classic lumbotomy for pyonephrosis. - Journal of endourology / Endourological Society
To describe our experience and operative technique for retroperitoneoscopic nephrectomy for pyonephrosis and to compare the results with those of open surgery.Since October 1998, 23 successful retroperitoneoscopic nephrectomies for pyonephrosis were performed in our institution (Group A). These patients were compared with 23 patients, matched by age, sex, and body weight, who underwent classic lumbotomy for pyonephrosis (Group B). The two groups were compared in terms of operative time, blood loss, hospital stay, wound complications, and time of return to previous occupation.All the features studied except operative time were significantly different in favor of laparoscopy.Although technically difficult, retroperitoneoscopic nephrectomy for pyonephrosis is feasible. The extraperitoneal approach allows direct access to the renal hilum and helps avoid spillage of pus into the peritoneum.
Primary adenocarcinoma of cutaneous vesicostomy 40 years later: a rare case. - Archives of pathology & laboratory medicine
We present a case of adenocarcinoma developing at the vesicocutaneous edge of a vesicostomy, 40 years after it was created, in a patient who underwent cadaveric kidney transplant. Although transitional and squamous cell carcinoma of a vesicostomy have been reported, to our knowledge, the presence of adenocarcinoma at the vesicostomy edge has not been reported previously.
Laparoscopic nephron-sparing surgery in a Jehovah's Witness patient. - Journal of endourology / Endourological Society
An obese 76-year-old woman with type II diabetes, hypertension, coronary artery disease, and gastroesophageal reflux was found to have a 6-cm lower-pole mass in a solitary functional right kidney. Because her religious beliefs prohibited blood transfusion, minimally invasive surgery--a laparoscopic partial nephrectomy--was performed, with a good result. Minimally invasive surgery, perhaps with administration of erythropoietin, iron-dextran, or both, is often a good option for severely anemic patients or those whose religious beliefs are opposed to transfusion. Methods of minimizing blood loss intraoperatively are reviewed.
Feasibility of robot-assisted totally intracorporeal laparoscopic ileal conduit urinary diversion: initial results of a single institutional pilot study. - Urology
To explore the use of the da Vinci Surgical Robotic System (DSRS) to assist in the completion of totally intracorporeal laparoscopic ileal conduit urinary diversion (TLIC).Two patients with radiation cystitis underwent TLIC procedures and another patient with bladder cancer underwent TLIC along with laparoscopic radical cystoprostatectomy at our institution. The ileal conduit urinary diversion was done totally intracorporeally using conventional laparoscopic techniques, and the DSRS was used to assist in the Bricker-type ureteroileal anastomosis.The 3 patients in the study included 2 men and 1 woman (mean age 73 years, range 64 to 84). The TLIC was completed intracorporeally in all 3 patients without the need for open conversion. The operative time, estimated blood loss, intraoperative decrease in hemoglobin, and time to hospital discharge for the 2 patients undergoing TLIC and the patient undergoing TLIC along with radical cystoprostatectomy was 628, 616, and 828 minutes, 50, 200, and 500 mL, 1.7, 2.8, and 5.3 g, and 5, 7, and 10 days, respectively. The median follow-up was 4.5 months (range 3.5 to 5.5). Postoperative satisfactory drainage of both kidneys was confirmed in all 3 patients at 8 weeks or later by intravenous urography or renal nuclear imaging. The serum creatinine remained stable in all 3 patients after surgery at hospital discharge. The only complication noted was postoperative ileus in the patient undergoing radical cystoprostatectomy that resolved with conservative management.TLIC is technically feasible and safe and can be done intracorporeally without complications. The DSRS can be successfully used to assist in the completion of TLIC. However, that each case lasted for more than 600 minutes highlights the need for further refinement in the technique. The practical application of TLIC requires improved long-term outcomes compared with open surgery, as well as a reduction in the operative time to justify the costs of robotic surgery.
Rapid communication: pure robot-assisted laparoscopic ureteral reimplantation for ureteral stricture disease: case report. - Journal of endourology / Endourological Society
The role of the da Vinci robot is slowly being defined in minimally invasive urologic surgery. We report its use in the management of ureteral stricture disease.A 42-year-old man with recurrent kidney stone disease was found to have a left distal-ureteral stricture. After failure of endoscopic treatment, a robot-assisted laparoscopic ureteral reimplantation was performed. The total operative time was 210 minutes. The estimated blood loss was <50 mL. There were no intraoperative or postoperative complications. Total analgesic use was 30 mg of morphine. The hospital stay was 5 days.Pure robot-assisted laparoscopic ureteral reimplantation is a safe and feasible approach to the management of ureteral stricture disease.

Map & Directions

2735 N Clarkson St Fremont, NE 68025
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