Robotics in Urology

Question 1

What is one of the major benefits of robotic surgery vs. laparoscopy?

Answer 1

• better at putting things back together and preserving non-target tissues.
• better reproducibility
• problem is expense

Question 2

** Where do the nerves for erections run in relation to the prostate? (TEST QUESTION)

Answer 2

• POSTERIOR and LATERAL to the prostate.

* must be mindful of these when doing a prostatectomy.

Question 3

** How is a SIMPLE prostatectomy performed? (TEST QUESTION)

Answer 3

• via OPEN ENUCLEATION= removal of only the inside obstructing adenoma of the prostate.

Question 4

** What is often seen with open enucleation of a simple prostatectomy?

Answer 4

• stones and adenoma.

Question 5

** What do BLADDER STONES imply? (TEST QUESTION)

Answer 5

• BPH and OBSTRUCTION

Question 6

** Where do the adrenal glands sit in relation to the kidneys? (TEST QUESTION)?

Answer 6

• cephalad to the kidneys.

* It has 60 vessels surrounding it!

Question 7

** What are the layers of the adrenal CORTEX and what do they produce? (TEST QUESTION)

Answer 7

• Zona Glomerulosa= aldosterone
• Zona Fasiculata= cortisol
• Zona Reticulata= androgens

Question 8

** What does the adrenal MEDULLA produce? (TEST QUESTION)

Answer 8

• epinephrine (80%)
• norepinephrine (19%)
• dopamine (1%)

Question 9

** What is Conn’s syndrome? (TEST QUESTION)?

Answer 9

• an adenoma of the Zona Glomerulosa (outermost layer of the cortex)= ALDOSTERONOMA causing hypokalemic metabolic alkalosis and HTN.
• AM serum aldosterone (aldosterone: renin ration greater than 30).

Question 10

** What is Pheochromocytoma? (TEST QUESTION)

Answer 10

• an adenoma of the MEDULLA (inner adrenal) secreting metanephrines, epinephrine, and norepinephrine.

Question 11

** What is important to know about the LEFT renal VEIN? (TEST QUESTION)?

Answer 11

• it is LONGER than the right vein and passes OVER the AORTA and UNDER the SMA.
• almost always sits over (anterior to) the renal artery.

Question 12

** What is important to know about the RIGHT renal ARTERY? (TEST QUESTION)

Answer 12

• it is LONGER than the left artery and passes BEHIND the VENA CAVA.

Question 13

** How does the kidney develop? (TEST QUESTION)

Answer 13

• it rises out of the pelvis in the fetus and comes to rest under the adrenal gland.

Question 14

What are the easiest kidney tumors to remove?

Answer 14

• left lower pole

Question 15

What are the hardiest kidney tumors to remove?

Answer 15

• right central

Question 16

** What is a pT2 tumor and how is it treated?

Answer 16

• muscle invasion and treated with cystectomy

Question 17

** What is pTA tumor and how is it treated?

Answer 17

• superficial disease, TURBT

Question 18

** What is the main blood supply to the bladder?

Answer 18

• the bilateral internal and external iliac arteries; the inferior and superior vesical arteries from the aorta.

Question 19

** What happens to the ileal conduit in radical cystectomy?

Answer 19

• it is positioned in the right lower quadrant; the left ureter must be passed under the sigmoid.