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WRITTEN CONFERENCE COVERAGE SUMMARIES BY CLINICIANS FOR CLINICIANS |
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| Artificial Intelligence (AI) in Endourology and Robotic Surgery |
| Timothy C. Chang, MD, Ahmed Ghazi, MD, FEBU, MHPE, Russell S. Terry, Jr., MD, Bhaskar Somani, MRCS, FEBU, FRCS(Urol) |
| At WCET 2024, Timothy Chan moderated a panel of urologists who discussed the impact of AI in urologic surgery. Topics included AI's role in bladder tumor detection, kidney stone growth prediction, and robotic surgery performance. The session highlighted AI's potential to enhance patient care and surgical outcomes. |
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| Robotic Platforms: Which Way Should We Go?
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| Lui Shong Lee, MBBS, MRCS, FAMS; Benjamin I. Chung, MD; Jeremy Teoh, MD; and Sung-Hoo Hong, MD, PhD
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| This panel moderated by Lui Shong Lee discussed the advantages and limitations of multi-port and single-port robotic platforms in urologic surgery. Benjamin Chung highlighted the widespread adoption and surgeon autonomy offered by multi-port robots. Ken-ichi Tabata shared insights on the Hugo RAS system, noting comparable results to the da Vinci system despite a steeper learning curve. Sung-Hoo Hong reviewed single-port robots, emphasizing their optimization for minimally invasive procedures but also noting limitations in range of motion and ergonomics.
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| Is Open Surgery Training Necessary in the Era of Robotics?
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| John Davis, MD, and Philipp Mandel, MD, Ph.D.
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| At WCET 2024, a debate focused on whether open surgery training is necessary in an era dominated by robotics. John Davis argued that open surgery skills are crucial for developing adaptable surgeons capable of managing complex cases. In contrast, Philipp Mandel contended that robotic surgery's advantages and the declining need for open procedures make such training less essential, though he acknowledged the benefit of having one open-trained surgeon per department for emergencies.
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| Development of Patient-Specific Nomogram for Clinical Decision-Making Between Single-Port versus Multi-Port Robotic Partial Nephrectomy: A Report from the Single Port Advanced Robotic Consortium |
| Nicolas Soputro, MD |
| Nicolas Soputro presented a study focused on developing a patient-specific nomogram to enhance decision-making between Single Port and Multi Port robotic partial nephrectomy. Using data from 1,021 patients, the study identified key factors—such as lower comorbidity, history of abdominal surgery, and lower tumor complexity—that favor the SP approach. The resulting nomogram showed strong predictive accuracy and is expected to help guide personalized surgical strategies in clinical practice. |
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| Retroperitoneal Approach-Xi and SP |
| Richard Link, MD, PhD |
| Richard Link discussed the evolution of urological surgical techniques, emphasizing adaptability and innovation. He compared transperitoneal and retroperitoneal approaches for partial nephrectomies, highlighting the benefits of the retroperitoneal approach, particularly with the da Vinci SP system. Dr. Link noted that retroperitoneal access offers faster recovery times and less invasiveness, advising careful selection of surgical techniques based on patient and tumor characteristics |
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| Xi and SP Nephroureterectomy and Bladder Cuff |
| Ravi Munver, MD, FACS, and Jeffery Nix, MD, MHSA, FACS, |
| Ravi Munver and Jeffery Nix compared the Xi and SP robotic approaches for nephroureterectomy and bladder cuff excision. Dr. Munver emphasized the advantages of the Da Vinci Xi system, including improved maneuverability and reduced recovery times, while Dr. Nix highlighted the challenges and benefits of the single-port system, particularly in retroperitoneal and lower anterior approaches. Their discussion provided valuable insights into optimizing surgical outcomes for urothelial cancer. |
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| Getting into Focal Therapy: Why Your Robotic Practice Should Include FT |
| Inderbir Gill MD |
| Inderbir Gill emphasized the importance of integrating Focal Therapy (FT) into robotic urologic practice, particularly for treating intermediate-risk prostate cancer. He argued that FT offers a balanced approach, preserving function while maintaining oncologic outcomes, and filling a critical gap between radical and conservative treatments. Dr. Gill highlighted that FT should be considered as a less harmful alternative to whole-gland treatment, especially given the emerging evidence and increasing patient demand. |
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| Managing Complications During Robotic Surgery |
| Rene Sotelo, MD |
| Rene Sotelo led a session on managing complications during robotic surgery, emphasizing the importance of learning from these incidents to improve patient outcomes. The discussion covered a range of complications, including those related to patient positioning, trocar placement, intraoperative bleeding, and nerve injuries. Dr. Sotelo and the panel provided practical advice on preventing and addressing these issues, highlighting the need for quick decision-making and collaboration with other surgical teams to enhance the safety and effectiveness of robotic procedures. |
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| Techniques of Robotic Simple Prostatectomy |
| David Lee, MD, FACS; Benjamin Waldorf, MD; Mutahar Ahmed, MD, FACS |
| Taek-Sang Kim moderated a panel discussion on three robotic techniques for simple prostatectomy. David Lee presented the transcapsular multiport approach, emphasizing meticulous bladder and prostate handling for optimal outcomes. Benjamin Waldorf covered the transvesical method, focusing on patient selection and adenoma removal with cystotomy and careful dissection. Mutahar Ahmed showcased the single-port transvesical approach, noting its efficiency and minimal invasiveness. Despite differences in technique, all approaches enable outpatient procedures with quick recovery and similar outcomes. |
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| An In Vitro Assessment of the ILY Robotics Assisted Tele-Console System in Ureteroscopy among Medical Students and Surgeons: Does Video-Gaming Experience Influence the Learning Curve? |
| Aideen Madden |
| Aideen Madden presented a study assessing the learning curve for the Ily robotics system in flexible ureteroscopy and the impact of video gaming experience. The study involved 14 surgeons and 14 students performing tasks with both the robotic system and traditional methods. Although gamers showed a slight initial advantage, this difference was not statistically significant, and surgeons performed faster with traditional ureteroscopy. |
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| What's Next in Urologic Robotics: Future Perspectives |
| TEOH Yuen Chun Jeremy, MBBS, FRCSEd (Urol), FCSHK, FHKAM (Surgery) |
| Jeremy Teoh discussed the future of urologic robotics, highlighting recent advancements and emerging technologies. He reviewed improvements in the Da Vinci system, including the new single-port robot and techniques like SARA for better access in confined spaces. The session also covered innovative robotic systems like Avatera and Hugo, as well as disruptive technologies such as the Zamenix Robotic Flexible Ureteroscopy System and Virtuoso’s Transurethral Robotic Surgery System. |
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| Robot Radical Prostatectomy: How to Achieve Better Continence Outcomes |
| Atsushi Takenaka, MD, PhD; Cheol Kyu Oh, MD, PhD; Jihad Kaouk, MD, FACS, FRCS; Sung Gu Kang, MD, PhD |
| The plenary session at WCET 2024 highlighted advancements in robotic radical prostatectomy aimed at improving continence outcomes. Cheol Kyu Oh showcased the Retzius-Sparing Approach for superior early continence recovery, Jihad Kaouk presented the Single-Port Transvesical Approach with benefits like reduced pain and faster recovery, and Sung Gu Kang discussed Minimal Apical Dissection (MAD) as a technique balancing cancer control with functional preservation. |
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PRESENTATION LECTURES FROM THE WCET 2024 |
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Ureteral Stricture Risk After Ureteroscopy: The PULS Score -"Presentation"
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Seyed Amiryaghoub Lavasani
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| Amir Lavasani presents a study on ureteral stricture formation following ureteroscopy, analyzing 550 cases from 2018 to 2022. The research examines the relationship between stricture formation and injury severity using the Post-Ureteroscopic Lesion Scale (PULS). The study concludes that stricture rates significantly increase with partial or transmural ureteral injuries, emphasizing the importance of this binary grading system for post-operative management of injured ureters.
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