Video 492- by S. B. Kulkarni and colleagues from Pune, India, described a novel technique to repair a urethra-perineal fistula that occurred after an abdomino-perineal resection for rectal cancer. The technique involved a posterior approach to the fistula and the creation of a U- shaped local flap of Denonvilliers fascia that was rotated to close the urethral defect.

Video 493- by R. J. Sotelo and colleagues from Venezuela describes a laparoscopic extra- and intraperitoneal and trans-vesical approach to the management of a rectourethral fistula. The technique allowed the concomitant creation of a colostomy and tissue interposition without an additional incision or patient repositioning.

Video 494- by Guido Barbagli from Abrezzo Italy, described the use of fibrin glue to secure and fix a dorsal onlay buccal mucosa graft for use in bulbar urethroplasties. The technique has a potential benefit to shorten OR time as the need for the meticulous and monotonous suturing required to fix the graft to the corporal bodies is replaced by the use of the fibrin glue.

Video 495- by L. A. Ribiero-Filho and colleagues from Sao Paulo, Brazil describes the use of an acellular matrix for urethral reconstruction. The graft, obtained from cadavers and treated with enzymes to create an acellular matrix graft, was used as a ventral onlay in a patient with BXO and a long 15 cm urethral stricture.

Video 496- by E. M. Uchio and colleagues from New haven, Connecticut, describes a novel minimally invasive approach to the harvest of a sural nerve graft for use in nerve reconstruction in non-nerve sparing radical retropubic prostatectomy. The technique involves the use of a special device that is placed around the nerve which is exposed through a 1-cm incision posterior to the lateral malleolus. The device is directed axially to the popliteal fossa where a second incision is made to transect and remove the near 20 cm graft.

Video 497- by F. P. Secin and colleagues from New York, attempts to more accurately describe the anatomical landmarks necessary for the safe dissection of the seminal vesicles and vas deferens during a laparoscopic radical prostatectomy. The authors dispel the notion that a layer of Denonvilliers fascia exists between the posterior bladder wall and the seminal vesicles and coined the term "vesicoprostatic muscle" to describe this layer of longitudinally directed smooth muscle fibers that must be cut to gain access to the seminal vesicles after division of the posterior bladder wall.

Videos 500 and 501- both describe robotic bladder diveticulectomies. Video 500 by V. Pansadoro and colleagues from Italy describe a novel transvesical approach to the management of the problem of symptomatic bladder diverticulum. The method and video were quite unique and the description deserves praise. Video 501, by A. D. Berger and colleagues from New York, describe an extravesical robotic approach to the management of a bladder diverticulum ridden with urothelial carcinoma. The technique and procedure were elegantly described although some questions about the adherence to sound oncologic principles were raised in discussion.

Written by Michael J. Metro, MD, a Contributing Editor with UroToday.

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