Gary W Chien

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PURPOSE Rapid intracorporeal suturing represents a challenge when performing laparoscopic partial nephrectomy (LPN). During warm ischemia time (WIT) knot tying is a major time-consuming step. We present our technique of eliminating knot tying during LPN and the outcomes of our initial series. MATERIALS AND METHODS Between October 2002 and October 2003, 32(More)
INTRODUCTION We present our technique for clipless antegrade neurovascular bundle preservation during robotic laparoscopic radical prostatectomy, along with short-term follow-up of our patients' sexual function. TECHNICAL CONSIDERATIONS Using the da Vinci three-arm robotic system, we performed robotic laparoscopic radical prostatectomy using a(More)
PURPOSE We propose an algorithm to help guide surgeons' decisions between laparoscopic partial nephrectomy (LPN) and renal laparoscopic cryoablation (LCA) based on preoperative parameters and outcomes defined in the literature. PATIENTS AND METHODS From July 2004 to December of 2007, we performed 51 LPNs and 22 LCAs. We formulated an algorithm between LPN(More)
OBJECTIVES To prospectively compare outcomes during robotic prostatectomy between surgeons with formal training in either robotic prostatectomy (RALP) or laparoscopic prostatectomy (LRP). METHODS A total of 286 robotic prostatectomies were performed by 12 urologists between August 2008 and March 2009 as part of a new robotic surgery program at one of the(More)
OBJECTIVES To present our technique, modifications, and experience of laparoscopic partial nephrectomy (LPN). Nephron-sparing surgery is an increasingly accepted treatment for selected T1a kidney tumors. Because of the more complex surgical technique involved, LPN is evolving more slowly than laparoscopic radical nephrectomy. METHODS The data of 41(More)
BACKGROUND AND OBJECTIVES The classic belief is that right-sided laparoscopic adrenalectomy is technically more difficult to perform than left-sided. The purpose of this study was to determine whether objective outcomes are different for the right- versus left- sided operation. METHODS A retrospective review of 163 laparoscopic adrenalectomies was(More)
PURPOSE We present the rapid implementation of a robot-assisted surgery program by one of the largest health maintenance organizations (HMOs) in the United States. MATERIALS AND METHODS A core group of 10 urologists were offered access to a new da Vinci S surgical system. A core group of five ancillary staff was assembled and trained at an Intuitive(More)
Riedel's lobe of the liver is an anatomic variant, described as a caudal extension of the right lobe of the liver, that presents a challenge in laparoscopic right renal surgery. A 52-year-old woman with a Riedel's lobe of the liver and a large right renal mass underwent laparoscopic right radical nephrectomy. Transperitoneal access with the Veress needle(More)
Efficient motion intent communication is necessary for safe and collaborative work environments with collocated humans and robots. Humans efficiently communicate their motion intent to other humans through gestures, gaze, and social cues. However, robots often have difficulty efficiently communicating their motion intent to humans via these methods. Many(More)
Laparoscopic partial nephrectomy is an alternative to the open approach. For centrally located tumors, open extracorporeal partial nephrectomy has been used. We report 2 cases of laparoscopic nephrectomy for the purpose of extracorporeal partial nephrectomy and autotransplantation for renal cell cancer.