CARLOS ALFREDO BATAGELLO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
6 resultados
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conferenceObject IN VITRO EVALUATION OF SINGLE-USE DIGITAL FLEXIBLE URETEROSCOPES: A PRACTICAL COMPARISON FOR A PATIENT-CENTERED APPROACH(2018) MARCHINI, Giovanni; BATAGELLO, Carlos; MONGA, Manoj; TORRICELLI, Fabio; VICENTINI, Fabio; DANILOVIC, Alexandre; SROUGI, Miguel; NAHAS, William; MAZZUCCHI, Eduardo- Current trends of percutaneous nephrolithotomy in a developing country(2018) BATAGELLO, Carlos A.; VICENTINI, Fabio Carvalho; MARCHINI, Giovanni Scala; TORRICELLI, Fabio Cesar Miranda; SROUGI, Miguel; NAHAS, Willian Carlos; MAZZUCCHI, EduardoIntroduction: To present the current practice patterns on percutaneous nephrolithotomy (PCNL) in a developing country. Materials and Methods: A survey was offered to Brazilian urologists during the II International Endourology Symposium held in Sao Paulo, in 2015. The first seven questions were related to demographic data while the 20 remaining were directed to urologists who performed PCNL. Results: From 250 participants, 100 replied to the survey, 81% performed PCNL and 60.4% of performers had been in practice for less than 15 years. Eighty-one percent were trained in the prone position and 64% in supine. PCNL was learned during the residency in 66.7% and 2.5% had fellowship training. Prone position was the preferred decubitus for simple or complex calculi, though for obese patients there was no difference. Younger surgeons prefer supine while older surgeons prefer prone. The access was obtained by the surgeon in all cases, 96.3% use fluoroscopy and 3.7% prefer ultrasonography. Forty-seven percent use ultrasonic lithotripters and 4.1% laser. For kidney drainage, 71.6% place a nephrostomy tube. Double J stent is left in 77%. The postoperative image method was CT for 50%. Colonic injury was reported by 25%, predominantly in the senior group without statistically difference between positions. Conclusions: From a selected group of urologists, we observe that Brazilian urologists usually gain their own access for PCNL guided by fluoroscopy. They predominantly prefer the prone position, use fascial dilators, ultrasonic lithotripters and place a nephrostomy tube when exiting the kidney. Fellowship programs, ultrasonography, flexible nephoscopy and tubeless procedures could be encouraged.
- In Vitro Evaluation of Single-Use Digital Flexible Ureteroscopes: A Practical Comparison for a Patient-Centered Approach(2018) MARCHINI, Giovanni Scala; BATAGELLO, Carlos A.; MONGA, Manoj; TORRICELLI, Fabio Cesar Miranda; VICENTINI, Fabio C.; DANILOVIC, Alexandre; SROUGI, Miguel; NAHAS, Willian C.; MAZZUCCHI, EduardoObjective: To compare the manufacturing and in vitro performance characteristics of two single-use flexible ureteroscopes with a permanent optical flexible ureteroscope. Materials and Methods: Two single-use flexible ureteroscopes, LithoVue (Boston Scientific) and Pusen (1rs. generation; Zhuhai Pusen Medical Technology Company Limited, China), were tested and compared with a permanent Flex-X-2 ureteroscope (Karl Storz, Germany) in terms of technical characteristics, optics, deflection mechanism, and additional parameters which could potentially affect surgical technique. Results: Pusen was the lightest ureteroscope while the LithoVue had the longest working length. LithoVue had a higher resolution power than the other two ureteroscopes at all distances tested (p<0.001). Pusen showed higher resolution than Flex-X-2 (p<0.01). Field of view was wider for LithoVue (87 degrees), followed by Flex-X-2 (85 degrees) and Pusen (75 degrees). Color representation was superior for Flex-X-2 than LithoVue and then Pusen. LithoVue outperformed Pusen and Flex-X-2 for all settings with instruments in terms of deflection loss (p<0.01). Pusen had the highest irrigation flow (52mL/min) with an empty working channel (p<0.01). LithoVue and Pusen showed similar flow rates with a 200m (21mL/min) and 365m laser fiber (7mL/min) and 1.3F basket (18mL/min), being superior to Flex-X-2 (p<0.01). With the 1.9F basket, LithoVue had superior flow rate (7mL/min) than Pusen (3.5mL/min) and Flex-X-2 (4mL/min; p=0.01). Conclusion: LithoVue outperformed the other ureteroscopes in terms of optical resolution, field of view, deflection capacity, and irrigation flow with larger instruments. Pusen is the lighter scope and showed better results in terms of irrigation when no instruments are in place. Flex-X-2 was superior in terms of color representation.
- Complete supine percutaneous nephrolithotomy with GoPro (R). Ten steps for success(2018) VICENTINI, Fabio Carvalho; SANTOS, Hugo Daniel Barone dos; BATAGELLO, Carlos Alfredo; AMUNDSON, Julia Rothe; OLIVEIRA NETO, Evaristo Peixoto; MARCHINI, Giovanni Scala; SROUGI, Miguel; NAHAS, Willian Carlos; MAZZUCCHI, EduardoObjective: To show a video of a complete supine Percutaneous Nephrolithotomy (csPCNL) performed for the treatment of a staghorn calculus, from the surgeon's point of view. The procedure was recorded with a GoPro (R) camera, demonstrating the ten essential steps for a successful procedure. Materials and methods: The patient was a 38 years-old woman with 2.4cm of left kidney lower pole stone burden who presented with 3 months of lumbar pain and recurrent urinary tract infections. She had a previous diagnosis of polycystic kidney disease and chronic renal failure stage 2. CT scan showed two 1.2cm stones in the lower pole (Guy's Stone Score 2). She had a previous ipsilateral double J insertion due to an obstructive pyelonephritis. The csPCNL was uneventful with a single access in the lower pole. The surgeon had a Full HD GoPro Hero 4 Session (R) camera mounted on his head, controlled by the surgical team with a remote control. All of the mains steps were recorded. Informed consent was obtained prior to the procedure. Results: The surgical time was 90 minutes. Hemoglobin drop was 0.5g/dL. A post-operative CT scan was stone-free. The patient was discharged 36 hours after surgery. The camera worked properly and didn't cause pain or muscle discomfort to the surgeon. The quality of the recorded movie was excellent. Conclusion: GoPro (R) camera proved to be a very interesting tool to document surgeries without interfering with the procedure and with great educational potential. More studies should be conducted to evaluate the role of this equipment.
conferenceObject IMPACT OF CAMERA DEVIATION ON CURVATURE ASSESSMENTS USING GONIOMETER AND 2D PHOTOGRAPHIES(2018) NASCIMENTO, Bruno; CERQUEIRA, Ivan; MIRANDA, Eduardo P.; BESSA JR., Jose; FIDELIS, Renato; GUGLIELMETTI, Giuliano; BATAGELO, Carlos; SILVA, Gabriel C.; NAHAS, William; SROUGI, Miguel; CHIESA, Giorgio; CURY, Jose- Recurrent Penile Fracture-Case Report and Alternative Surgical Approach(2018) NASCIMENTO, Bruno; GUGLIELMETTI, Giuliano B.; MIRANDA, Eduardo P.; IVANOVIC, Renato F.; BATAGELLO, Carlos A.; NAHAS, William C.; SROUGI, Miguel; CURY, JoseIntroduction: Penile refracture is an exceedingly rare event, with very few published studies. To the best of our knowledge, this is the first documented case in the literature of penile fracture with 3 same-site recurrences. Aims: To describe the case of a 25-year-old Caucasian man with recurrent penile fracture ultimately treated with resuture and patch reinforcement. Methods: Patient history (clinical and surgical) and literature review. Results: After the 3rd same-site recurrence, patch reinforcement over the sutured area was performed. The patient had an uneventful recovery and no recurrences to date. Conclusion: There is no evidence indicating the superiority of non-absorbable sutures. Bovine pericardium reinforcement over the sutured area was used to minimize the chance of another recurrence. More studies are necessary to investigate its safety and efficacy in this scenario.