Valutazione dei profili proteici in urine di pazienti affetti da renal cell carcinoma con tecniche avanzate di proteomica per la ricerca di biomarcatori ad uso diagnostico

Advanced urologic procedures necessitate new technologies for dissection and vascular control. The aim of this study was to review the papers comparing the effect of new hemostat modalities used in endoscopic urology. The English literature from January 2001 through December 2005 was reviewed on the basis of the keywords "(ultrasonic dissection OR bipolar vessel sealing) AND laparoscopy". Bursting pressure and thermal spread were considered the most significant outcomes in evaluating the effect of device for hemostat in urologic surgery. Experimental ex vivo studies demonstrated that the electrothermal bipolar vessel sealers (EBVS). were able to seal arteries up to 6 mm and veins up to 12 mm in diameter at supraphysiological bursting pressure whereas the ultrasonic coagulating shears (UCS) did not reliably seal vessel larger than 3 mm. No difference in the thermal spread of UCS and EBVS was observed by histologic studies of tissue after coagulation of vessels. However EBVS devices perform poorly as graspers and require more time to seal and transect vessels. Therefore the choice of the equipment greatly depends on the type of procedure and the personal preference of the surgeon.