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Now showing 1 - 10 of 17
  • Publication
    Comparison of transperitoneal laparoscopic nephrectomy outcomes in atrophic and hydronephrotic kidneys
    (2015-12-01T00:00:00Z) GÜLPINAR, MURAT TOLGA; AKÇAY, MUZAFFER; SANCAK, EYÜP BURAK; Akbas, Alpaslan; Tepeler, Abdulkadir; REŞORLU, BERKAN; Armagan, Abdullah; AKÇAY, MUZAFFER
    Objective: To compare the results of transperitoneal laparoscopic nephrectomy in patients with atrophic and hydronephrotic kidneys. Material and methods: Clinical data were collected from 35 patients who had undergone laparoscopic nephrectomies for atrophic or hydronephrotic non-functioning kidneys between January 2010 and March 2014. Comparative analysis was carried out between the two groups examining demographic characteristics, imaging modalities, etiology, operative times, port numbers, conversion to open surgery, complications, pre- and post-operative hemoglobin and creatinine values, transfussion rates and length of hospital stays. Results: Laparoscopic nephrectomy was performed for atrophic kidneys in 20 (57%) patients and for hydronephrotic kidneys in 15 (42%) patients. In the atrophic group, 3 patients (15%) required transfusion because of bleeding but none of the patients required conversion to open surgery. In the hydronephrotic group one patient (6.6%) required transfusion and conversion to open surgery because of bleeding. Both of the groups were similar in terms of postoperative hospital stay but compared to the atrophic kidneys, hydronephrotic ones were associated with a longer total operative times (90.1 min vs. 73.6 min, p=0.03). Any serious complication (except for bleeding) and mortality were not encountered in both groups. Conclusion: Laparoscopic nephrectomy is a safe and effective minimally invasive technique that can be used in atrophic and hydronephrotic non-functioning kidneys.
  • Publication
    Comparison of Scoring Systems in Predicting Success of Percutaneous Nephrolithotomy
    Background: Scoring systems are useful to inform the patients about the success and complication rates of the operation prior the surgery. Aims: To determine the applicability of the popular scoring systems (Guy’s, stone size, tract length, obstruction, number of involved calices, and essence/stone density and Clinical Research Office of the Endourological Society) by means of examining preoperative data of patients treated with percutaneous nephrolithotomy. Study Design: Cross sectional study. Methods: We retrospectively reviewed files of the patients who had undergone percutaneous nephrolithotomy in our center between 2011 and 2015. Excluded from the study were patients aged <18 years, and those who were not assessed preoperatively with computed tomography. Preoperative computed tomography images of all patients were assessed by a single observer, and patients were graded based on three scoring system. Demographic data were analyzed along with perioperative data (operation, fluoroscopy, length of hospital stay, changes in hematocrit values, location, and number of access sites, stone-free and complication rates). Results: A total of 298 patients who had been treated with 300 procedures were enrolled into the study. Mean age, stone burden, number of stones, and density were 48.1±12.9 years, 663.5±442.8 mm2, 1.8±1.1 and 888.3±273 HU respectively. Scores of the cases based on Guy’s, stone size, tract length, obstruction, number of involved calices, and essence/stone density, and Clinical Research Office of the Endourological Society scoring system were calculated as 2, 7.6, and 222.1 points respectively. 81.6% of the patients were stonefree. Complications were detected in 30 (9.9%) patients. Based on receiver operating characteristic curve analysis a positive correlation was detected between success rate and scoring systems, i.e., Guy’s (p=<0.001, r=-0.309), stone size, tract length, obstruction, number of involved calices, and essence/stone density (p=<0.001, r=-0.295), and Clinical Research Office of the Endourological Society (p=<0.001, r=0.426). The Clinical Research Office of the Endourological Society scoring system had the highest predictive value. The sensitivity rates rates for Guy’s, Clinical Research Office of the Endourological Society and Stone scoring system were as 78.78%, 80% and 82.34% respectively. Conclusion: All of scoring systems predicted correctly the success of the percutaneous nephrolithotomy procedures. The Clinical Research Office of the Endourological Society scoring system had the highest predictive value. Keywords: Percutaneous nephrolitotomy, scoring methods, specificity and sensitivity, urinary calculi
  • Publication
    The All-Seeing Needle Instead of the Veress Needle in Pediatric Urologic Laparoscopy
    (2013-11-01T00:00:00Z) Silay, Mesrur Selcuk; Tepeler, Abdulkadir; Sancaktutar, Ahmet Ali; Kilincaslan, Huseyin; ALTAY, BÜLENT; Erdem, Mehmet Remzi; Hatipoglu, Namik Kemal; AKÇAY, MUZAFFER; Akman, Tolga; Armagan, Abdullah; AKÇAY, MUZAFFER
    Purpose: To investigate the feasibility of the all-seeing needle for safe entry and creation of pneumoperitoneum in pediatric urologic laparoscopy. Patients and Methods: A total of 14 children underwent various transperitoneal urologic laparoscopic procedures. The all-seeing needle, which is 4.85F in diameter, was used for safe entry into the abdominal cavity at the site of the umblicus in all cases. The microoptic was integrated with the light system and connected via a zoom ocular enabling direct visualization of the layers between the skin and the peritoneal cavity. Once the intraperitoneal access was obtained, CO2 pneumoperitoneum was created from one port of the three-way connector attached to the proximal part of the needle. Then the laparoscopic trocars were placed under vision of the microoptical system. Results: Mean age of the children was 4.52.9 years. In all children, the all-seeing needle was safely introduced into the abdominal cavity under direct vision. Then, CO2 pneumoperitoneum was succesfully performed. The mean time for optical puncture was calculated as 1.1 +/- 0.8 minutes. No complication was encountered during the introduction of the needle, creation of the pneumoperitoneum, and placement of the trocars. Conclusions: The all-seeing needle appears to be beneficial in safe entry and for creating pneumoperitoneum in laparoscopic pediatric urology cases. It eliminates the disadvantages of the Veress needle, which is blunt insertion, and may possibly prevent complications.
  • Publication
    (2012-09-01T00:00:00Z) Tepeler, Abdulkadir; Resorlu, Berkan; Ozyuvali, Ekrem; Akman, Tolga; ERSÖZ, CEVPER; AKÇAY, MUZAFFER; Silay, Mesrur Selcuk; Armagan, Abdullah; Unsal, Ali; ERSÖZ, CEVPER; AKÇAY, MUZAFFER
  • Publication
    (2012-09-01T00:00:00Z) Tepeler, Abdulkadir; Binbay, Murat; Akman, Tolga; AKÇAY, MUZAFFER; Erbin, Akif; Kezer, Cem; Armagan, Abdullah; Muslumanoglu, Ahmet Yaser; AKÇAY, MUZAFFER
  • Publication
    Laparoscopic-Assisted -Microperc- of a Stone in a Pelvic Kidney of a 3-Year-Old Girl
    (2013-02-01T00:00:00Z) Tepeler, Abdulkadir; Silay, Mesrur Selcuk; Armagan, Abdullah; Basibuyuk, Ismail; Akman, Tolga; AKÇAY, MUZAFFER; Onol, Sinasi Yavuz; AKÇAY, MUZAFFER
    Treatment of kidney stones in pelvic ectopic kidneys of children is a challenging procedure for urologists. Herein we report a case of laparoscopy-assisted -microperc- in a 3-year-old girl with a stone in her pelvic ectopic kidney. This micro-optical system is helpful in confirming the percutaneous access and provides the possibility of fragmenting the stone without the necessity of dilating the tract.
  • Publication
    Laparoscopic Decortication of Hilar Renal Cysts Using LigaSure
    (2014-04-01T00:00:00Z) Erdem, Mehmet Remzi; Tepeler, Abdulkadir; Gunes, Mustafa; Silay, Mesrur Selcuk; Akman, Tolga; AKÇAY, MUZAFFER; Armagan, Abdullah; Onol, Sinasi Yavuz; AKÇAY, MUZAFFER
    Background and Objectives: In this study, we evaluated the safety and efficacy of using the LigaSure sealing system (Valleylab, Boulder, Colorado) for laparoscopic decortication of symptomatic hilar renal cysts.
  • Publication
    (2012-09-01T00:00:00Z) Tepeler, Abdulkadir; Armagan, Abdullah; Akman, Tolga; Silay, Mesrur Selcuk; AKÇAY, MUZAFFER; Basibuyuk, Ismail; Erdem, Mehmet Remzi; Onol, Sinasi Yavuz; AKÇAY, MUZAFFER
  • Publication
    Is micro-percutaneous nephrolithotomy surgery technically feasible and efficient under spinal anesthesia?
    (2015-06-01T00:00:00Z) Karatag, Tuna; Tepeler, Abdulkadir; Buldu, Ibrahim; AKÇAY, MUZAFFER; TOSUN, MUHAMMED; Istanbulluoglu, Mustafa Okan; Armagan, Abdullah; AKÇAY, MUZAFFER; TOSUN, MUHAMMED
    The objective of the study was to present the clinical and operative effects of two types of anesthesia on micro-percutaneous nephrolithotomy (-microperc-). We retrospectively reviewed 116 patients who underwent microperc between August 2011 and September 2013. Patients were sorted into one of the two groups according to the type of anesthesia received: general (Group 1, n:53) or spinal (Group 2, n:63). Perioperative variables (age, stone size, location) and outcomes (operation time, success, complication rate) were evaluated and compared. Although there was a statistically significant difference in the mean age of patients (30.3 +/- A 22.1 vs. 45.8 +/- A 14.6, respectively, p < 0.001), mean body mass indexes were similar (p = 0.689). There was no substantial difference in terms of sizes and localizations of stones in the two groups (p = 0.970 and p = 0.795). While a significant difference was found in comparison of operative times (59.62 +/- A 32.56 vs. 40.98 +/- A 26.45 min, p < 0.001), there was no statistically significant difference in mean fluoroscopy times (124.92 +/- A 84.2 vs. 105.2 +/- A 61.0 s, p = 0.441). Stone-free rates were similar (90.5 % vs. 93.6 %, p = 0.297). We found no statistical differences between the two groups with respect to mean hemoglobin drop and hospitalization time (p = 0.015 and p = 0.917, respectively). The complication rates and analog pain scores were also similar (p = 0.543 and p = 0.365). Our results show that microperc is a feasible surgical modality in the treatment of kidney stone disease under both spinal and general anesthesia. Spinal anesthesia may be considered for patients at a high risk for general anesthesia, and also may be an alternative for patients who are concerned about and/or fearful of general anesthesia.