• Site Overview

    These are step-by-step "operative recipes" for urologic procedures accumulated throughout training at the following locations: (1) Residency at the University of Pittsburgh Medical Center urology residency program chaired by Dr. Joel Nelson and directed by Dr. Stephen Jackman; (2) Urologic Trauma & Reconstruction Fellowship at Detroit Medical Center with Dr. Richard Santucci; and (3) Urethral Surgery Workshop at the Kulkarni Center for Reconstructive Urology in Pune, India with Dr. Sanjay Kulkarni.
  • Disclaimer

    These documents are for informational purposes only. It is not intended to replace the care and attention of your physician or other professional medical services. Please speak with your doctor if you have questions about your health. The University of Pittsburgh, University of Pittsburgh Medical Center, Detroit Medical Center, Michigan State University, and Kulkarni Center for Urethral Reconstruction Web sites do not provide specific medical advice and do not endorse any medical or professional service obtained through information provided on this site or any links to this site.

Recent Articles

RRP Hrebinko

Ronald Hrebinko, MD and Mang L Chen, MD

Preop: – flex cysto in room sterile – ancef – prep perineum for perineal pressure – iliac crest at break of bed – loops and head lamp Procedure: – incision from under umbilicus to above pubis;be sure to incise transversalis fascia – Bluntly dissect bladder from side wall with hands to expose Pelvic LNs – […]

Pan-Urethral One-Sided Urethroplasty

Sanjay B. Kulkarni MS, FRCS and Mang L. Chen, MD

Preop: – male sounds (must have 16 and 20F sounds) – angled needle driver – social lithotomy (yellow fins – knees 90 degrees from hip, ankles 90 degrees from knees) – urethroscopy with 4.5F ureteroscope to learn number, quality, and length of stricture (if ureteroscope won’t pass, put wire across, dilate to 8F max, and […]

SARLE Robotic Reimplant

Richard Sarle, MD and Mang L Chen, MD

Preop: – pt should have stent – Position: RRP style with arms tucked and legs in yellow fins; tape patient criss/cross around chest/shoulders so pt can be placed in steep T-burg – Ancef, gent – Robo should be positioned in between legs – sucker for lap – 3-0 monocryl sutures 7” x many – carter […]

SANTUCCI Buried Penis procedure

Richard A Santucci MD and Mang L Chen MD

Preop: – ancef, gent – lithotomy w yellow fins – mayo stand for large scrotum – many 2-0 vicryls on SH and CT1 – skin dermotome 0.15 cm/in? – mineral oil Note: if pt does not have large scrotum or eschutcheon, place supine POSITIONING: – dorsal lithotomy, SCDs on outside – L leg straight (or […]

SANTUCCI Anastomotic urethroplasty (EPA)

Richard A Santucci MD and Mang L Chen MD

Positioning: – high lithotomy; – drape as usual; bookwalter post placed prior to final drape and final drape is secured around post Procedure: – place 22F red rubber to locate stricture – make midline perineal incision around stricture – use bovie on cut to get thru subQ tissue – use L hand with “peace” sign […]

SANTUCCI Ventral Onlay BMG

Richard A Santucci MD and Mang L Chen MD

Preop: – Thigh hid TED hose – SCDs – abx: ancef 1g and gent 240mg; if catheter give amp instead of ancef (enterococcus concern) – shave – two lights down, one up for buccal harvest POSITIONING: – bean bag on top half of pt table; gel pad should be on top of this – candy […]

SANTUCCI Positioning high lithotomy

Richard A Santucci MD and Mang L Chen MD

Preop: – Thigh hid TED hose – SCDs – abx: ancef 1g and gent 240mg; if catheter give amp instead of ancef (enterococcus concern) – shave – two lights down, one up for buccal harvest POSITIONING: – bean bag on top half of pt table; gel pad should be on top of this – candy […]

NELSON RRP

Joel Nelson MD, Ben Davies MD, and Mang Chen MD

Preop: Positioning: Belly button at break on bed; completely flex bed; slight T burg leather belt over shins; ankles at corner of bed lower bed all the way down Pre-Prepping pt: 4 blue towels, two on sides, one scrunched under scrote, one to dry later razor and clipper: clipper for periumbilical hair lather: water inside […]

DAVIES Radical Cystectomy Neobladder

Ben Davies MD and Mang Chen MD

Preop: Bowel prep Abx: ancef, flagyl Position: top iliac crest at break of table CYSTOPROSTATECTOMY 1. insert foley sterily 2. make incision (top of pubis to infraumbilical) 3. spread thru rectus 4. make cell-layer incision over transversalis fascia 5. bluntly dissect bladder side walls; bovie peritoneum as needed 6. locate vas superolaterally and ligate with […]

JACKMAN RALP

Stephen Jackman MD and Mang L Chen MD

Preop: – heparin sc, ancef – lithotomy – tuck arms – tape across chest w/ foam – test total trendelenburg stability -prepxiphoid to scrotum w/ penis Site marks: total 6 ports – umbilicus and top of pubic symphysis (draw line) – once insufflated via RUQ veress: – 8cm to L and R of umbilicus – […]