BRUNO CAMARGO TISEO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina
6 resultados
Resultados de Busca
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- Comparison of the learning curves and frustration level in performing laparoscopic and robotic training skills by experts and novices(2015) PASSEROTTI, Carlo C.; FRANCO, Felipe; BISSOLI, Julio C. C.; TISEO, Bruno; OLIVEIRA, Caio M.; BUCHALLA, Carlos A. O.; INOUE, Gustavo N. C.; SENCAN, Arzu; SENCAN, Aydin; PARDO, Rogerio Ruscitto do; NGUYEN, Hiep T.Robotic assistance may provide for distinct technical advantages over conventional laparoscopic technique. The goals of this study were (1) to objectively evaluate the difference in the learning curves by novice and expert surgeons in performing fundamental laparoscopic skills using conventional laparoscopic surgery (CLS) and robotic-assisted laparoscopic surgery (RALS) and (2) to evaluate the surgeons' frustration level in performing these tasks. Twelve experienced and 31 novices in laparoscopy were prospectively evaluated in performing three standardized laparoscopic tasks in five consecutive, weekly training sessions. Analysis of the learning curves was based on the magnitude, rate, and quickness in performance improvement. The participant's frustration and mood were also evaluated during and after every session. For the novice participants, RALS allowed for shorter time to task completion and greater accuracy. However, significant and rapid improvement in performance as measured by magnitude, rate, and quickness at each session was also seen with CLS. For the experienced surgeons, RALS only provided a slight improvement in performance. For all participants, the use of RALS was associated with less number of sessions in which they felt frustrated, less number of frustration episodes during a session, lower frustration score during and after the session, and higher good mood score. The advantages of RALS may be of most benefit when doing more complex tasks and by less experienced surgeons. RALS should not be used as a replacement for CLS but rather in specific situations in which it has the greatest advantages.
conferenceObject A scoring system for testicular torsion: Decreasing costs and therapeutic delay(2012) BARBOSA, J. A. B. A.; OLIVEIRA, C. M.; TISEO, B. C.; PASSEROTTI, C. C.; SROUGI, M.; NGUYEN, H. T.; RETIK, A. B.NTRODUCTION & OBJECTIVES: Testicular torsion is a surgical emergency requiring prompt intervention to prevent testicular loss. Differential diagnosis is not easily done with clinical evaluation, and imaging studies are usually required, especially ultrasound, causing therapeutic delay. Our objective was to create a scoring system for clinical diagnosis of testicular torsion, thus eliminating the necessity of ultrasound (US). MATERIAL & METHODS: Patients presenting with acute scrotum at a tertiary care center were prospectively evaluated and physical examination was performed by the first urologist to see the patient. Scrotal ultrasound was performed in all patients after visit. Single variate analysis was performed and clinical variables associated with testicular torsion were identified. A scoring system was created based upon logistic regression with relevant variables from univariate analysis. Retrospective validation of the scoring system was performed including all patients seen with suspicion for testicular torsion at this institution up to 2 years prior to the beginning of the prospective evaluation. RESULTS: Two hundred and thirty one patients were enrolled in the first phase of the study. Mean age of patients was 12.1 years and mean duration of symptoms was 40.2 hours. Thirty-three patients had a final diagnosis of torsion. Clinical variables associated with torsion were scrotal swelling, nausea and vomiting from history and testicular swelling, high-riding test icle, horizontal lie of the testicle, increased consistency of the testicle to palpation, presence of a thickened spermatic cord, negative Prehn's sign, absent cremasteric reflex and fixed scrotal skin to testis on physical examination (p<0.05). A scoring system was created with 5 variables, and patients were stratified in low, intermediate and high risk for torsion. Twenty-two patients were at high risk for testicular torsion, all of which had a final diagnosis of torsion, and 170 patients were at low risk for torsion, none of which had a diagnosis for this condition. Low and high risk groups comprised 82% of all patients seen. Retrospective validation was performed for 116 patients and 83% of cases fell within low or high risk categories; all patients in the high risk category had a final diagnosis of torsion and none in the low risk group. CONCLUSIONS: The present scoring system is a valuable tool for diagnosis of testicular torsion, eliminating the necessity of ultrasound in 80% of cases. Prospective validation of this score is necessary.- Development and Initial Validation of a Scoring System to Diagnose Testicular Torsion in Children(2013) BARBOSA, Joao A.; TISEO, Bruno Camargo; BARAYAN, Ghassan A.; ROSMAN, Brian M.; TORRICELLI, Fabio Cesar Miranda; PASSEROTTI, Carlo C.; SROUGI, Miguel; RETIK, Alan B.; NGUYEN, Hiep T.Purpose: Testicular torsion is a surgical emergency requiring prompt intervention. Although clinical diagnosis is recommended, scrotal ultrasound is frequently ordered, delaying treatment. We created a scoring system to diagnose testicular torsion, decreasing the indication for ultrasound. Materials and Methods: We prospectively evaluated 338 patients with acute scrotum, of whom 51 had testicular torsion. Physical examination was performed by a urologist, and all patients underwent scrotal ultrasound. Univariate analysis and logistic regression were performed, and a scoring system for risk stratification of torsion was created. Retrospective validation was performed with 2 independent data sets. Results: The scoring system consisted of testicular swelling (2 points), hard testicle (2), absent cremasteric reflex (1), nausea/vomiting (1) and high riding testis (1). Cutoffs for low and high risk were 2 and 5 points, respectively. Ultrasound would be indicated only for the intermediate risk group. In the prospective data set 69% of patients had low, 19% intermediate and 11.5% high risk. Negative and positive predictive values were 100% for cutoffs of 2 and 5, respectively (specificity 81%, sensitivity 76%). Retrospective validation in 1 data set showed 66% of patients at low, 16% intermediate and 17% high risk. Negative and positive predictive values for cutoffs of 2 and 5 were 100% (specificity 97%, sensitivity 54%). The second retrospective data set included only torsion cases, none of which was misdiagnosed by the scoring system. Conclusions: This scoring system can potentially diagnose or rule out testicular torsion in 80% of cases, with high positive and negative predictive values for selected cutoffs. Ultrasound orders would be decreased to 20% of acute scrotum cases. Prospective validation of this scoring system is necessary.
- Surgical management of nonobstructive azoospermia(2015) TISEO, Bruno Camargo; HAYDEN, Russell Paul; TANRIKUT, CigdemNonobstructive azoospermia (NOA) is characterized by the complete absence of sperm in the ejaculate due to testicular failure. The evaluation and management of patients with NOA offer a challenge to the reproductive urologist. In the era of in vitro fertilization with intracytoplasmic sperm injection, surgical sperm extraction techniques can afford men with NOA biologic paternity. To provide a comprehensive review of surgical sperm retrieval approaches in the patient with NOA emphasizing complications, success rates and outcome optimization, a Medline search was conducted querying surgical approaches used to manage NOA. Four sperm extraction techniques are described including: testicular sperm aspiration, testicular sperm extraction, fine needle aspiration mapping and microdissection testicular sperm extraction. In addition, the roles for pre-extraction varicocelectomy and sperm cryopreservation are discussed. The management of NOA continues to evolve as newer tools become available. Several modalities of sperm acquisition exist. An understanding of their complications and success rates is fundamental to the treatment of NOA. (C) 2015 Editorial Office of Asian Journal of Urology. Production and hosting by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license
conferenceObject RELATION BETWEEN DIETARY IRON INTAKE AND TESTICULAR FUNCTION IN YOUNG MEN(2015) TISEO, B. C.; GABRIELSEN, J.; GASKINS, A. J.; SWAN, S. H.; MENDIOLA, J.; JOERGENSEN, N.; CHAVARRO, J. E.; TANRIKUT, C.conferenceObject DIETARY COENZYME Q10 INTAKE AND SEMEN PARAMETERS IN A SUBFERTILE POPULATION(2015) TISEO, B. C.; GASKINS, A. J.; CHAVARRO, J. E.; HAUSER, R.; TANRIKUT, C.