Resumo Objetivo Identificar evidências de validade da versão brasileira da Post-Discharge Coping Difficulty Scale - Adult Form. Métodos Estudo metodológico desenvolvido por meio das etapas de tradução, retrotradução, avaliação por comitê de especialistas, pré-teste e validação. A validação de conteúdo foi realizada por comitê de seis especialistas, os quais avaliaram as equivalências semântica, idiomática, experimental e conceitual. Para verificar as evidências de validade, a escala foi aplicada a 100 pacientes adultos clínicos e cirúrgicos. Foi realizada a análise de componentes principais, com rotação varimax. A confiabilidade foi verificada por meio do Coeficiente Alfa de Cronbach, quanto à estabilidade, por meio do Teste-Reteste e quanto à equivalência por meio de Confiabilidade Interavaliadores. Verificou-se a validade preditiva da escala em relação à utilização de serviço de emergência e readmissão. Resultados Na avaliação do comitê de especialistas foram realizadas adequações e todos os itens apresentaram um Índice de Validade de Conteúdo superior a 0,80. Na etapa de validação, a análise de componentes principais revelou que a melhor solução seria unifatorial, conforme a escala original. A consistência interna da escala foi satisfatória. A confiabilidade teste-reteste e interavaliadores não mostraram diferença estatística (P > 0,05). Conclusão A versão brasileira da Escala de Dificuldade de Enfrentamento Pós-alta com 10 itens apresenta boas evidências de validade e confiabilidade. Mostrou ser de fácil compreensão pelos participantes e representa uma ferramenta útil para os profissionais e pesquisadores na prática do cuidado. PostDischarge Post Discharge Form tradução retrotradução préteste pré teste semântica idiomática conceitual cirúrgicos varimax Cronbach estabilidade TesteReteste Teste Reteste Interavaliadores Verificouse Verificou se readmissão 080 0 80 0,80 unifatorial original satisfatória testereteste reteste P 0,05. 005 0,05 . 05 0,05) Pósalta Pós alta 1 cuidado 08 8 0,8 00 0,0 0,

Abstract Objective To identify validity evidence of the Brazilian version of the Post-Discharge Coping Difficulty Scale - Adult Form. Methods This methodological study was carried out by means of the stages of translation, back-translation, evaluation by a committee of experts, pre-testing, and validation. Content validation was carried out by a committee of six experts, who evaluated semantic, idiomatic, experimental, and conceptual equivalence. To verify validity evidence, the scale was applied to 100 adult clinical and surgical patients. Principal component analysis was carried out with varimax rotation. Reliability was checked using Cronbach’s alpha, stability using test-retest, and equivalence using inter-rater reliability. The scale’s predictive validity was verified in relation to emergency service use and readmission. Results In the expert committee’s assessment, adjustments were made, and all the items obtained a Content Validity Index higher than 0.80. In the validation stage, the principal component analysis revealed that the best solution would be unifactorial, according to the original scale. The scale’s internal consistency was satisfactory. Test-retest and inter-rater reliability showed no statistical difference (P > 0.05). Conclusion The Brazilian version of the 10-item Post-Discharge Coping Difficulty Scale shows good evidence of validity and reliability. It proved to be easy to understand by the participants and represents a useful tool for professionals and researchers in the practice of care. PostDischarge Post Discharge Form translation backtranslation, backtranslation back back-translation experts pretesting, pretesting pre testing, testing pre-testing semantic idiomatic experimental 10 patients rotation Cronbachs Cronbach s alpha testretest, testretest test retest, retest test-retest interrater inter rater scales readmission committees assessment made 080 0 80 0.80 stage unifactorial satisfactory Testretest Test P 0.05. 005 0.05 . 05 0.05) 10item item care 1 08 8 0.8 00 0.0 0.

Resumen Objetivo Identificar las evidencias de validez de la versión brasileña de la Post-Discharge Coping Difficulty Scale - Adult Form. Métodos Estudio metodológico llevado a cabo mediante las etapas de traducción, retrotraducción, revisión por comité de especialistas, prueba piloto y validación. La validación de contenido se realizó por un comité de seis especialistas, que evaluaron las equivalencias semánticas, idiomáticas, experimentales y conceptuales. Se aplicó la escala a 100 pacientes adultos clínicos y quirúrgicos para verificar las evidencias de validez. Se realizó el análisis de los componentes principales con rotación varimax. La fiabilidad se verificó mediante el coeficiente Alfa de Cronbach, la estabilidad con el test-retest y la equivalencia mediante la fiabilidad entre evaluadores. Se verificó la validez predictiva de la escala con relación a la utilización del servicio de emergencia y readmisión. Resultados Se realizaron adaptaciones en la etapa de revisión del comité de especialistas, y todos los ítems presentaron un índice de validez de contenido superior a 0,80. En la etapa de validación, el análisis de los componentes principales reveló que la mejor solución era unifactorial, según la escala original. La consistencia interna de la escala fue satisfactoria. La fiabilidad test-retest y entre evaluadores no mostraron diferencia estadística (P > 0,05). Conclusión La versión brasileña de la Escala de Dificultad de Enfrentamiento Posalta, que tiene 10 ítems, presenta buenas evidencias de validez y fiabilidad. Demostró ser de fácil comprensión por parte de los participantes y representa una herramienta útil para los profesionales e investigadores de la práctica del cuidado. PostDischarge Post Discharge Form traducción retrotraducción especialistas semánticas idiomáticas conceptuales varimax Cronbach testretest test retest readmisión 080 0 80 0,80 unifactorial original satisfactoria P 0,05. 005 0,05 . 05 0,05) Posalta 1 cuidado 08 8 0,8 00 0,0 0,

ABSTRACT Purpose: Keratoconus presents certain peculiarities in pediatric patients when compared with adults. The greatest challenge in children is that the disease is more severe and faster in progression. In this retrospective study, we aimed to compare the accelerated and Dresden protocols for corneal crosslinking in patients aged <18 years who were followed-up for at least 12 months. Methods: A total of 36 eyes from 27 patients were included in the study. The best corrected and uncorrected visual acuity, maximal keratometry, corneal thickness, foveal thickness, and endothelial microscopy findings were evaluated at baseline and during the postoperative period at one, three, and six months. Thereafter, the patients were evaluated at one, three, six and twelve months postoperative. Corneal crosslinking was performed in all patients via the Dresden protocol (n=21 eyes) or the accelerated protocol (n=15 eyes). Data between the two groups were compared and XY statistical analysis was used. Results: Both protocols were effective in halting keratoconus progression. No patient had progression at the 12-month follow-up. A significant reduction in Kmax and improvement in the corrected distance visual acuity were observed only in the Dresden protocol group. Although the Dresden protocol was superior to the accelerated protocol in reducing Kmax (p=0.002), there was no significant difference in corrected distance visual acuity between the two groups. Conclusion: The accelerated protocol is as efficient as the Dresden protocol in stabilizing keratoconus progression. Although the Dresden protocol was superior to the accelerated protocol in reducing the Kmax, it did not produce better clinical results. Thus, the accelerated protocol is an efficient option. Furthermore, considering the advantages of reduced surgical time, the accelerated protocol is effective in halting keratoconus progression in the pediatric age group. Purpose adults study 18 <1 followedup followed up 1 Methods 3 2 keratometry thickness one three Thereafter n=21 n21 n 21 (n=2 n=15 n15 15 (n=1 eyes. . used Results 12month month followup. followup follow up. follow-up group p=0.002, p0002 p p=0.002 , 0 002 (p=0.002) Conclusion results Thus option Furthermore time < n=2 n2 (n= n=1 n1 p000 p=0.00 00 (p=0.002 n= (n p00 p=0.0 (p=0.00 p0 p=0. (p=0.0 p=0 (p=0. p= (p=0 (p= (p

ABSTRACT Purpose: To evaluate the predictive value of initial intraocular pressure difference of the detached and fellow eyes of patients with complex rhegmatogenous retinal detachment on postoperative persistent ocular hypotony. Methods: This retrospective observational study included 538 eyes of 538 unilateral complex rhegmatogenous retinal detachment patients with a proliferative vitreoretinopathy grade of C-1 or higher, treated with silicone oil endotamponade following pars plana vitrectomy. The patients were divided into Group A (patients having silicone oil removal without ocular hypotony; n=504) and Group B (patients with persistent ocular hypotony following silicone oil removal [n=8, 23.5%] and with retained silicone oil [n=26, 76.5%] due to the risk of persistent ocular hypotony; total n=34). Ocular hypotony was defined as an intraocular pressure of <6 mmHg on two or more occasions. Patients’ demographics, including age, sex, and follow-up time, and ocular characteristics, including ocular surgical and trauma history, initial and final best-corrected visual acuity, intraocular pressure and initial intraocular pressure difference of the detached and fellow eyes, and anatomical success rates and postoperative complications, were retrospectively collected from the electronic patient files. Results: The initial intraocular pressure was significantly lower in the detached eyes of Group B than in Group A (8.3 ± 3.5 vs. 12.9 ± 3.3, p<0.001). Also, the initial intraocular pressure difference was significantly higher in Group B than in Group A (8.9 ± 3.2 vs. 2.2 ± 2.7mmHg, p<0.001). The receiver operating characteristic curve analysis showed that the cutoff value of the initial intraocular pressure difference was 7.5mmHg for the risk of persistent ocular hypotony. The most influential factors on postoperative persistent ocular hypotony in the binary logistic regression analysis were the initial intraocular pressure difference and the need for a retinectomy. Conclusion: In eyes with complex rhegmatogenous retinal detachment treated with pars plana vitrectomy and silicone oil tamponade, the initial intraocular pressure difference could be of value in predicting postoperative persistent ocular hypotony and could guide surgeons on the decision of silicone oil removal. Purpose Methods 53 C1 C 1 C- n=504 n504 n 504 n=8, n8 8 [n=8 23.5% 235 23 5 n=26, n26 26 [n=26 76.5% 765 76 n=34. n34 n=34 . 34 n=34) 6 < occasions Patients demographics age sex followup follow up time characteristics history bestcorrected best corrected acuity complications files Results 8.3 83 3 (8. 35 3. vs 129 12 9 12. 33 3.3 p<0.001. p0001 p p<0.001 0 001 p<0.001) Also 8.9 89 32 2 22 2. 27mmHg 7mmHg 2.7mmHg 75mmHg 7 5mmHg retinectomy Conclusion tamponade n=50 n50 50 n=8 [n= 23.5 n=26 n2 [n=2 76.5 n3 n=3 8. (8 p000 p<0.00 00 n=5 n5 n= [n 23. n=2 76. ( p00 p<0.0 p0 p<0. p<0 p<

RESUMO Objetivo: Relatar dois casos de pneumotórax bilateral espontâneo múltiplo sucessivo em crianças com envolvimento pulmonar maciço por histiocitose de células de Langerhans (HCL), alertando para a possibilidade desse diagnóstico diferencial para o pediatra geral. Ademais, casos publicados que descrevem pacientes pediátricos com manifestações pulmonares de HCL foram revisados na literatura. Descrição do caso: Caso 1: Paciente masculino, três anos, com episódio súbito pneumotórax espontâneo à direita, drenado cirurgicamente. Após dois meses, apresentou dois novos episódios de pneumotórax contralateral. Biópsia linfonodal pulmonar revelou diagnóstico de HCL. Foi submetido a cirurgia torácica assistida por vídeo (VATS) bilateral e minitoracotomia com pleurodese mecânica, além de tratamento quimioterápico, necessitando de internação prolongada. Caso 2: Menino, quatro anos, apresentando dispneia progressiva e sibilância por cinco meses. Biópsia pulmonar revelou HCL. Evoluiu com importante desconforto respiratório e pneumotórax direito, necessitando drenagem. Foi realizada pleurodese com nitrato de prata e diferentes esquemas de quimioterapia. Ambos os pacientes evoluíram bem após tratamentos quimioterápicos múltiplos, cirurgias e suporte intensivo. Comentários: A HCL é uma doença desafiadora. Sua manifestação clínica é variável, e o envolvimento pulmonar ocorre em cerca de 10–15% dos casos. Consideram-se o manejo cirúrgico especializado e o suporte multidisciplinar essenciais para o tratamento de pacientes com HCL pulmonar maciça. Ainda que raro, o envolvimento pulmonar maciço por HCL deve ser considerado em quadros de pneumotórax recorrentes em crianças. Objetivo HCL, , (HCL) geral Ademais literatura caso 1 masculino anos direita cirurgicamente meses contralateral VATS (VATS mecânica quimioterápico prolongada 2 Menino direito drenagem quimioterapia múltiplos intensivo Comentários desafiadora variável 1015 10 15 10–15 Consideramse Consideram se maciça raro (HCL 101 10–1 10–

ABSTRACT Objective: The objective of this study was to report two cases of successive multiple spontaneous bilateral pneumothorax in children with massive lung involvement due to Langerhans cell histiocytosis (LCH), emphasizing the possibility of this differential diagnosis for the general pediatrician. Additionally, published cases describing pediatric patients with pulmonary manifestations of LCH were reviewed in the literature. Case description: Case #1: A 3-year-old male patient with a sudden episode of spontaneous right-sided pneumothorax, surgically drained. After 2 months, he experienced two new episodes of contralateral pneumothorax. A pulmonary lymph node biopsy revealed the diagnosis of LCH. He underwent bilateral video-assisted thoracic surgery and mini-thoracotomy with mechanical pleurodesis, in addition to chemotherapy, requiring prolonged hospitalization. Case #2: A 4-year-old boy with progressive dyspnea and wheezing for 5 months. A pulmonary biopsy revealed LCH. He developed significant respiratory distress and right pneumothorax, requiring drainage. Silver nitrate pleurodesis and different chemotherapy regimens were performed. Both patients responded well to multiple chemotherapy treatments, surgeries, and intensive care support. Comments: LCH is a challenging disease. Its clinical manifestation is variable, and pulmonary involvement occurs in about 10–15% of cases. We consider specialized surgical management and multidisciplinary support essential for the treatment of patients with massive pulmonary LCH. Although rare, massive pulmonary involvement by LCH should be considered in cases of recurrent pneumothorax in children. Objective LCH, , (LCH) pediatrician Additionally literature description #1 1 3yearold yearold 3 year old rightsided sided drained months videoassisted video assisted minithoracotomy mini thoracotomy hospitalization #2 4yearold 4 drainage performed treatments surgeries Comments disease variable 1015 10 15 10–15 rare (LCH # 101 10–1 10–

Resumen Antecedentes: la histerectomía en bloque es un procedimiento controvertido y con poca literatura actualizada. Se define como la extirpación del útero grávido con su contenido gestacional in situ, las indicaciones para la realización de esta cirugía son los procesos neoplásicos (como la causa más frecuente( procesos sépticos, enfermedad trofoblástica y hemorragia secundaria a inserción placentaria anómala. Caso clínico: paciente de 45 años con embarazo de 8 semanas y 5 días, según la fecha de última regla, con miomatosis uterina gigante asociada con tromboembolismo pulmonar, quien decide la interrupción voluntaria del embarazo y realizarse la histerectomía en bloque. Conclusiones: la histerectomía en bloque es una cirugía poco realizada en la actualidad, sin embargo, este abordaje quirúrgico es una opción segura y efectiva para la interrupción voluntaria del embarazo, y no se debe descartar entre las alternativas de tratamiento quirúrgico, siempre individualizando cada paciente.

ABSTRACT BACKGROUND: En bloc hysterectomy is defined as the removal of the pregnant uterus with its gestational content in situ. The indications for performing this en bloc surgery are neoplastic processes, as the most frequent cause; septic processes, trophoblastic disease and hemorrhage secondary to abnormal placental insertion, however, it is a controversial procedure, and with little updated literature. CLINICAL CASE: 45-year-old patient with a pregnancy of 8 weeks and 5 days, with giant uterine myomatosis associated with pulmonary thromboembolism who decided to voluntarily terminate the pregnancy, and it was decided to perform en bloc hysterectomy. CONCLUSIONS: En bloc hysterectomy is a surgery rarely performed at present, however, this surgical approach is a safe and effective option for the voluntary termination of pregnancy, and it should not be ruled out among the surgical treatment alternatives, always individualizing each patient.

Resumen Descripción del caso: Paciente de 23 años con hemorragia abdominal de origen no claro, que posteriormente presenta inestabilidad hemodinámica, requiriendo manejo quirúrgico en tres ocasiones con evolución satisfactoria. Hallazgos clínicos: Presentó sangrado cuantificado de 5500 cc en cavidad abdominal (grado IV - clasificación ATLS) con lesiones hepáticas en los segmentos I, IV y VIII, sin hallazgos sugestivos de trauma al examen físico, ni otros hallazgos traumáticos internos. Tratamiento y resultados: Se llevó a cabo una intervención quirúrgica precoz mediante laparotomía exploratoria con hallazgos ya descritos, además de dos tiempos quirúrgicos adicionales que llevaron al control del sangrado, con evolución satisfactoria. Relevancia clínica: El sangrado abdominal y laceración de víscera sólida secundario a trauma cerrado de abdomen es una etiología común en pacientes jóvenes masculinos, siendo contrario a esta afirmación el sangrado de origen hepático sin trauma es una etiología poco común. El presente caso resulta ser una dificultad diagnóstica en cuanto a la etiología, ya que lo evidenciado en la exploración quirúrgica no concuerda con el examen físico externo, sin una historia clínica clara al ingreso se deja la interrogante de la causa.

Summary: Case description: 23-year-old patient with abdominal hemorrhage of unclear origin, who subsequently presented hemodynamic instability, requiring surgical management on three occasions with satisfactory evolution. Clinical findings: she presented quantified bleeding of 5500 cc in the abdominal cavity (grade IV-ATLS classification) with liver lesions in segments I, IV and VIII, without findings suggestive of trauma on physical examination, or other internal traumatic findings. Treatment and results: An early surgical intervention was carried out through exploratory laparotomy with findings already described, in addition to two additional surgical procedures that led to control of bleeding, with satisfactory evolution. Clinical relevance: Abdominal bleeding and solid viscus laceration secondary to blunt abdominal trauma is a common etiology in young male patients, contrary to this statement, bleeding of hepatic origin without trauma is a rare etiology. The present case turns out to be a diagnostic difficulty in terms of etiology, since what was evidenced in the surgical exploration does not agree with the external physical examination, without a clear clinical history at admission, the question of the cause is left.

ABSTRACT Introduction: We aim to compare the safety and effectiveness of the KangDuo (KD)-Surgical Robot-01 (KD-SR-01) system and the da Vinci (DV) system for robot-assisted radical nephroureterectomy (RARNU). Materials and Methods: This multicenter prospective randomized controlled trial was conducted between March 2022 and September 2023. Group 1 included 29 patients undergoing KD-RARNU. Group 2 included 29 patients undergoing DV-RARNU. Patient demographic and clinical characteristics, perioperative data, and follow-up outcomes were collected prospectively and compared between the two groups. Results: There were no significant differences in patient baseline demographic and preoperative characteristics between the two groups. The success rates in both groups were 100% without conversion to open or laparoscopic surgery or positive surgical margins. No significant difference was observed in docking time [242 (120-951) s vs 253 (62-498) s, P = 0.780], console time [137 (55-290) min vs 105 (62-220) min, P = 0.114], operative time [207 (121-460) min vs 185 (96-305) min, P = 0.091], EBL [50 (10-600) mL vs 50 (10-700) mL, P = 0.507], National Aeronautics and Space Administration Task Load Index scores, and postoperative serum creatinine levels between the two groups. None of the patients showed evidence of distant metastasis, local recurrence, or equipment-related adverse events during the four-week follow-up. One (3.4%) patient in Group 2 experienced postoperative enterovaginal and enterovesical fistulas (Clavien-Dindo grade III). Conclusions: The KD-SR-01 system is safe and effective for RARNU compared to the DV Si or Xi system. Further randomized controlled studies with larger sample sizes and longer durations are required. Introduction KDSurgical KD Surgical Robot01 Robot 01 Robot-0 KDSR01 KDSR SR (KD-SR-01 (DV robotassisted robot assisted RARNU. . (RARNU) Methods 202 2023 KDRARNU. KDRARNU KD-RARNU DVRARNU. DVRARNU DV-RARNU data followup follow up Results 100 margins 242 [24 120951 120 951 (120-951 25 62498 62 498 (62-498 0.780, 0780 0.780 , 0 780 0.780] 137 [13 55290 55 290 (55-290 10 62220 220 (62-220 0.114, 0114 0.114 114 0.114] 207 [20 121460 121 460 (121-460 18 96305 96 305 (96-305 0.091, 0091 0.091 091 0.091] [5 10600 600 (10-600 5 10700 700 (10-700 0.507, 0507 0.507 507 0.507] scores metastasis recurrence equipmentrelated equipment related fourweek four week followup. up. 3.4% 34 3 4 (3.4% ClavienDindo Clavien Dindo III. III III) Conclusions KD-SR-0 required Robot0 Robot- KDSR0 (KD-SR-0 (RARNU 20 24 [2 12095 12 95 (120-95 6249 6 49 (62-49 078 0.78 78 13 [1 5529 (55-29 6222 22 (62-22 011 0.11 11 12146 46 (121-46 9630 9 30 (96-30 009 0.09 09 [ 1060 60 (10-60 1070 70 (10-70 050 0.50 3.4 (3.4 KD-SR- (KD-SR- 1209 (120-9 624 (62-4 07 0.7 7 552 (55-2 622 (62-2 0.1 1214 (121-4 963 (96-3 00 0.0 106 (10-6 107 (10-7 05 0.5 3. (3. KD-SR (KD-SR (120- (62- 0. (55- (121- (96- (10- (3 (120 (62 (55 (121 (96 (10 ( (12 (6 (5 (9 (1

ABSTRACT Purpose: Ureteroplasty using buccal or lingual mucosa graft Is feasible for complex proximal ureteral stricture (1, 2). Ileal ureter replacement is considered as the last resort for ureteral reconstruction. Totally intracorporeal robot-assisted ileal ureter replacement can be performed safely and effectively (3). In China, the KangDuo Surgical Robot 2000 Plus (KD-SR-2000 Plus) has been developed featuring two surgeon consoles and five robotic arms. This study aims to share our experience with totally intracorporeal robot-assisted bilateral ileal ureter replacement using KD-SR-2000 Plus. Materials and Methods: A 59-year-old female patient underwent a complete intracorporeal robot-assisted bilateral ileal ureter replacement for the treatment of ureteral strictures using KD-SR-2000 Plus. The surgical procedure involved dissecting the proximal ends of the bilateral ureteral strictures, harvesting the ileal ureter, restoring intestinal continuity, and performing an anastomosis between the ileum and the ureteral end as well as the bladder. The data were prospectively collected and analyzed. Results: The surgery was successfully completed with single docking without open conversion. The length of the harvested ileal ureter was 25 cm. The docking time, operation time and console time were 3.4 min., 271 min and 231 min respectively. The estimated blood loss was 50 mL. The postoperative hospitalization was 6 days. No perioperative complications occurred. Conclusions: It is technically feasible to perform totally intracorporeal robot-assisted bilateral ileal ureter replacement for the treatment of ureteral strictures using KD-SR-2000 Plus. A longer follow-up and a larger sample size are required to evaluate its safety and effectiveness. Purpose 1, 1 (1 2. 2 . 2) reconstruction robotassisted robot assisted 3. 3 (3) China 200 KDSR2000 KDSR KD SR (KD-SR-200 arms KD-SR-200 Methods 59yearold yearold 59 year old continuity bladder analyzed Results conversion cm 34 4 min. 27 23 respectively 5 mL days occurred Conclusions followup follow up effectiveness ( (3 20 KDSR200 (KD-SR-20 KD-SR-20 KDSR20 (KD-SR-2 KD-SR-2 KDSR2 (KD-SR- KD-SR- (KD-SR KD-SR

ABSTRACT Purpose: Minimally invasive radical nephrectomy is often preferred for larger renal tumours not suitable for partial nephrectomy (1). When performed with a multiport robot, the procedure is routinely performed with a transperitoneal approach, with recent studies highlighting important factors for surgical outcomes, including predictive factors (2), segmental artery unclamping techniques (3), and comparisons of robotic techniques (4). This video shows that SP Robot-Assisted Radical Nephrectomy (RARN) via a lower anterior approach is valuable in challenging cases. Materials and Methods: We performed SP-RARN on two complex patients using a retroperitoneal lower anterior approach. The first patient, a 54-year-old female with a BMI of 36.8 kg/m2, had a ventral hernia and bowel obstruction history, with a 9 cm right middle kidney mass. The second patient, a 58-year-old male with a BMI of 31.19 kg/m2, had ESRD and was on peritoneal dialysis for 8 years, with a 3.4x3.7 cm mass in the right superior pole, suspected to be RCC. The surgical technique is detailed in the video. Results: Both procedures were successful, with operative times of 173 and 203 minutes and blood loss of 150 mL. No complications occurred. Patients were discharged after 31 and 38 hours, respectively. Histopathology confirmed RCC. At the 3-month follow-up, no complications or readmissions were reported. Second patient continued peritoneal dialysis without issues. Conclusion: Retroperitoneal SP-RARN via the lower anterior approach avoids the peritoneal cavity, making it suitable for certain patients. In these patients, more so than in others, this procedure is feasible, safe, and less morbid than the standard multiport approach. Purpose 1. 1 . (1) robot outcomes 2, 2 , (2) 3, 3 (3) 4. 4 (4) RobotAssisted Robot Assisted RARN (RARN cases Methods SPRARN 54yearold yearold 54 year old 368 36 36. kgm2 kgm kg m2 m kg/m2 history 58yearold 58 3119 19 31.1 years 34x37 x 4x3 7 3.4x3. pole RCC Results successful 17 20 15 mL occurred hours respectively 3month month followup, followup follow up, up follow-up reported issues Conclusion cavity others feasible safe (1 (2 (3 (4 5 kg/m 311 31. 34x3 4x 3.4x3 ( 34x 3.4x

ABSTRACT Introduction: Robotic Radical Prostatectomy using the Da-Vinci Single-Port (SP) robot can provide comparable functional and oncological outcomes with potential advantages pertaining to peri-operative morbidity, especially in patients with an extensive history of prior abdominal surgeries (1, 2). Materials and Methods: Our case is a 74-year-old male with a history of diabetes, cardiac bypass, hypertension, and hyperlipidemia, presenting with a PSA of 7.2. His MRI showed a PIRADS-5 lesion in the left apex and mid-gland peripheral zone, and he was diagnosed with unfavorable intermediate-risk prostate cancer after MRI guided fusion biopsy. His BMI was 31, and past surgical history was pertinent for two exploratory laparotomies due to gunshot wounds and a colostomy creation followed by reversal. The standardized steps of robotic radical prostatectomy were carried out using SP robotic platform performed by author SH (3, 4). Results: Total operative time and estimated blood loss were 210 minutes and 150mL respectively. The patient was discharged on postoperative day one and final pathology showed adenocarcinoma of the prostate Gleason score 4+3=7, pT2NxR0 and negative surgical margins. The patient was continent four weeks after surgery and the PSA continues to be undetectable after three months. Conclusion: Transvesical Radical prostatectomy using the single port platform provides acceptable oncological and functional outcomes and quicker recovery given decreased risk of ileus and peritoneal irritation. Given that the abdominal cavity is not violated, the risk of bowel or vascular injury is mitigated, especially in patients with a hostile abdomen. Introduction DaVinci Da Vinci SinglePort Single Port (SP perioperative peri morbidity 1, 1 (1 2. 2 . 2) Methods 74yearold yearold 74 year old diabetes bypass hypertension hyperlipidemia 72 7 7.2 PIRADS5 PIRADS 5 PIRADS- midgland mid gland zone intermediaterisk intermediate biopsy 31 reversal 3, 3 (3 4. 4 4) Results 21 mL respectively 437 4+3=7 pTNxR pT NxR pT2NxR margins months Conclusion irritation violated mitigated abdomen ( 7. 43 4+3= 4+3 4+

ABSTRACT Introduction: Endoscopic Combined Intrarenal Surgery (ECIRS) has emerged as a promising technique for the management of large and complex kidney stones, potentially offering advantages over traditional Percutaneous Nephrolithotomy (PCNL). This study aims to evaluate best practices, outcomes, and future perspectives associated with ECIRS. Materials and Methods: A comprehensive PubMed search was conducted from 2008 to 2024, using MESH terms and the following key words: "ECIRS" and "Endoscopic Combined Intrarenal Surgery" The search yielded 157 articles, including retrospective cohort studies, two randomized controlled trials (RCTs), and four meta-analyses comparing ECIRS with PCNL. Most important findings were summarized regarding indications, patient positioning, kidney access, tract size, surgical outcomes, and complications. Results: ECIRS demonstrated higher stone-free rate, lower complication rate, and a reduced need for multiple procedures compared to traditional PCNL. Additionally, ECIRS has the potential to integrate new technologies to further enhance outcomes. Conclusion: ECIRS demonstrates significant advantages in the management of large kidney stones. Future research should focus on well-designed RCTs to provide robust evidence of its efficacy, safety, and cost-effectiveness, potentially establishing ECIRS as the first option treatment for complex kidney stones. Introduction (ECIRS stones PCNL . (PCNL) practices outcomes Methods 200 2024 words "ECIRS 15 articles studies RCTs, , (RCTs) metaanalyses meta analyses indications positioning access size complications Results stonefree stone free rate Additionally Conclusion welldesigned well designed efficacy safety costeffectiveness, costeffectiveness cost effectiveness, effectiveness cost-effectiveness (PCNL 20 202 1 (RCTs 2

ABSTRACT Purpose: We reported, as a referral center in prostate cancer, our perspectives and experience performing Telesurgery using robotic surgery and 5G network. Material and methods: We described and illustrated the Telesurgery applications and outcomes to treat a patient with prostate cancer located 1300 kilometers away from the surgeon (Beijing-Harbin) in China. We used the Edge Medical Robot (MP1000) in November 2023 in a 71-year-old patient with Gleason 6 (ISUP 1) in 8 cores from 13, PSA of 14 ng/dL, and clinical stage cT2a. MRI described a PIRADS 5 nodule on the left peripheral zone at the base, and 20gr prostate. We described details about the connection between centers, perioperative outcomes, and our perspectives as a referral center in prostate cancer. Results: We had no delays, or problems with network connection between the centers. The procedure was performed in 60 minutes, with no intra- or postoperative complications. Estimated blood loss was 100 mL. The patient was ambulating soon after anesthesia recovery. Final pathology described a Gleason 6 (ISUP 1) involving the left base and left seminal vesicle, negative surgical margins, and no lymph node involvement (pT3bN0). The patient was continent soon after catheter removal (7 days). Conclusion: As technological progress introduced novel robotic platforms and high-speed networks, the concept of Telesurgery became a tangible reality while 5G technology solved latency and transmission concerns. However, with these advancements, ethical considerations and regulatory frameworks should underline the importance of transparency and patient safety with responsible innovation in the field. Purpose reported G methods 130 BeijingHarbin Beijing Harbin (Beijing-Harbin China MP1000 MP (MP1000 202 71yearold yearold 71 year old ISUP 1 13 ngdL ng dL ng/dL cT2a cTa cT gr centers Results delays minutes intra complications 10 mL recovery vesicle margins pT3bN0. pT3bN0 pTbN . pT bN (pT3bN0) 7 ( days. days days) Conclusion highspeed high speed networks concerns However advancements field MP100 (MP100 20 pT3bN (pT3bN0 MP10 (MP10 2 (pT3bN MP1 (MP1 (MP

ABSTRACT Introduction: The introduction of Single-Port (SP) platform opened the field to new surgical options, allowing to perform major urological robot-assisted procedures extraperitoneally and with a supine patient positioning (1–3). Nevertheless, a comprehensive description of different supine access options is still lacking (4–6). In this light, we provided a step-by-step guide of SP extraperitoneal supine access options also exploring preliminary surgical outcomes. Materials and methods: Transvesical access was performed by a transversal incision 3cm above the pubic bone, after the anterior abdominal sheet incision, the bladder was insufflated with a flexible cystoscope and the detrusor muscle was incised at the level of the bladder dome. Similarly, the extraperitoneal access was carried out with a 4cm incision above the pubic bone, once visualized the preperitoneal space the prevesical fat was gently spread. The Low Anterior Access was performed with a 3cm incision at the McBurney point, the abdominal muscles were then spread. A gentle dissection was used laterally to develop the retroperitoneal space. Results: Overall, sixteen different procedures were performed with supine extraperitoneal access on 623 consecutive patients. No intraoperative conversions occurred. The median access time was 16 (IQR 12-21), 11 (IQR 7-14) and 14 (IQR 10-18) minutes in case of transvesical, extraperitoneal and low anterior access, respectively. Notably, 81.5 % of patients were discharged on the same day with a postoperative opioid free rate of 73%. Conclusion: The Atlas provides a comprehensive step-by-step guide to successfully perform all major urological SP procedures extraperitoneally and with supine patient positioning. Introduction SinglePort Single Port (SP robotassisted robot assisted 1–3. 13 1–3 . 1 3 (1–3) Nevertheless 4–6. 46 4–6 4 6 (4–6) light stepbystep step outcomes methods cm bone dome Similarly spread point Results Overall 62 occurred IQR 1221, 1221 12 21 , 12-21) 714 7 7-14 1018 10 18 10-18 transvesical respectively Notably 815 81 5 81. 73 73% Conclusion 1– (1–3 4– (4–6 122 2 12-21 71 7-1 101 10-1 8 (1– (4– 12-2 7- 10- (1 (4 12- (

Abstract Objective Evaluate the level of information of pediatricians about the diagnosis and management of cryptorchidism. Method A cross-sectional observational study was conducted using a form via the "Google Forms" platform. The study population included pediatricians and pediatric residents associated with the Brazilian Society of Pediatrics. Seven hundred twenty-eight responses were recorded and analyzed using IBM SPSS v21. Results 728 valid responses were obtained. Of these answers, only 20.5 % answered that the physical examination was sufficient for the diagnosis, and 79.4 % responded that they requested ultrasound as the best test to aid in diagnosing cryptorchidism. When questioned about the ideal age for referring a patient with cryptorchidism, the survey recorded 56.3 % of the responses defending the correct age as six months old, 30.2 % shortly after birth, and 13.2 % at two years old. Other topics were addressed in the form, such as the frequency of evaluation of testicular position and investigation for DDS, among others. Still, the answers to these questions were compatible with current manuals and guidelines on cryptorchidism. Conclusion It is evident that the understanding of the professionals consulted about the diagnosis and management of cryptorchidism needs to be updated with the current practices adopted and that pediatricians, in general, must maintain periodic programs on this subject. Therefore, this topic should be part of a continuing education program with pediatric surgery. crosssectional cross sectional Google Forms platform Pediatrics twentyeight twenty eight v21 v 72 obtained 205 20 5 20. 794 79 4 79. 563 56 3 56. old 302 30 2 30. birth 132 13 13. DDS others Still general subject Therefore surgery v2 7 1

Resumen Esta revisión profundiza en el ámbito de la función y disfunción de la articulación temporomandibular (ATM), arrojando una luz sobre su naturaleza multifacética y ofreciendo información sobre estrategias diagnósticas y terapéuticas. La ATM, un componente vital del complejo craneofacial, desempeña un papel fundamental en actividades cotidianas como masticar, hablar y bostezar. Comprender su anatomía y fisiología es fundamental en el tratamiento y manejo de la disfunción de la ATM. Se ha explorado exhaustivamente la biomecánica de la función de la ATM, desde el disco articular hasta los ligamentos y músculos circundantes. Un aspecto crítico de esta revisión gira en torno a los diversos factores etiológicos que contribuyen a la disfunción de la ATM. Se analizan predisposiciones genéticas, parafunciones, irregularidades oclusales y estrés psicológico. Estas complejidades generaron la necesidad de un sistema de clasificación sólido que dilucidara las manifestaciones clínicas y los criterios de diagnóstico para diversos trastornos de la ATM. Las modalidades de diagnóstico modernas, incluída la evaluación clínica, las técnicas de imagen y la aspiración articular, son examinadas por su papel indispensable en el diagnóstico preciso. La descripción general integral incluyó estrategias de manejo, desde medidas conservadoras hasta intervenciones quirúrgicas. Al reconocer la influencia fundamental de los factores psicosociales, esta revisión subraya la importancia de la atención centrada en el paciente y las intervenciones cognitivo-conductuales. Además, las terapias regenerativas, las técnicas mínimamente invasivas y la medicina personalizada son tendencias emergentes en la investigación de la ATM. Esta revisión proporciona una hoja de ruta contemporánea para comprender, diagnosticar y tratar las afecciones relacionadas con la ATM.

Abstract This contemporary review delves into the intricate realm of temporomandibular joint (TMJ) function and dysfunction, shedding light on its multifaceted nature and offering insights into diagnostic and therapeutic strategies. The TMJ, a vital component of the craniofacial complex, plays a pivotal role in everyday activities such as chewing, speaking, and yawning. Understanding its anatomy and physiology is paramount in the treatment and management of TMJ dysfunction. The biomechanics of TMJ function, from the articular disc to the surrounding ligaments and muscles, have been explored comprehensively. A critical aspect of this review revolves around the diverse etiological factors contributing to TMJ dysfunction. Genetic predispositions, parafunctions, occlusal irregularities, and psychological stress are dissected to illuminate the roles of these factors in the development of TMJ disorders. These complexities prompted the need for a robust classification system elucidating the clinical manifestations and diagnostic criteria for various TMJ disorders. Modern diagnostic modalities, including clinical assessment, imaging techniques, and joint aspiration, are scrutinized for their indispensable roles in accurate diagnosis. The comprehensive overview included management strategies, from conservative measures to surgical interventions. In recognizing the pivotal influence of psychosocial factors, this review underscores the importance of patient-centered care and cognitive-behavioral interventions. Furthermore, regenerative therapies, minimally invasive techniques, and personalized medicine are emerging trends in TMJ research. This review provides a contemporary roadmap for comprehending, diagnosing, and managing TMJ-related conditions.