EAU18 – Day-long Live Surgery session examines new surgical techniques

Under the watchful ‘3D eyes’ of hundreds of congress participants, more than a dozen live surgeries were presented via direct transmission from Herlev Hospital in Denmark, a complex  programme that involved surgeons from various countries.

Organised by the EAU Section of Uro-technology (ESUT) in collaboration with the EAU Robotic Urology Section (ERUS) and the EAU Section of Urolithiasis (EULIS), a combination of live and pre-recorded videos showed a wide range of sophisticated techniques in laparoscopic prostatectomy, percutaneous nephrolithotripsy, robot-assisted prostatectomy, various stone removal techniques, robotic bladder resection, and radical nephrectomy among many others.

The live and pre-recorded operations were presented in four parts during the day-long session titled “Technology Strikes Back,” which formed part of the annual tradition of the ESUT to share educational content and practical insights regarding some of the most cutting-edge techniques in urological surgery.

Four sets of moderators provided commentary and asked questions to the participating surgeons for them to explain the rationale of the surgical steps they have taken, or shed insights on the pre-operative planning.  Coordinating on the eURO Auditorium were Dr. Alberto Breda (ES) and Prof. Dr. Andreas Gross (DE).

The first set showed a 3D laparoscopic prostatectomy performed by Prof. Jens Stolzenburg (DE), followed by a mini-prone percutaneous nephrolithotripsy by Prof. Udo Nagele (AT). Nagele demonstrated the laser ‘hammering’ of stones, and his attempts to retrieve a bigger stone fragment.

Following Nagele’s procedure was a flexible ureteroscopic lithotripsy by Dr. Guido Giusti (IT) and a single-use ureteroscopic lithotripsy by Assoc. Prof. Kim Andreassen (DK) and robotic partial nephrectomy by Prof. Stefan Siemer (DE).

During Siemer’s operation, moderator Breda commented on the vein thrombosis that Seiner encountered. They also discussed clamping techniques and the pre-operative strategy to anticipate potential problems during the operation. Questions from the audience also included resection techniques and whether the option to shift to a radical nephrectomy is considered by the lead surgeon. Surprisingly, during a hands-vote, many of the audience opted for a radical nephrectomy when asked if they would consider the option.

The second part of the session covered pre-recorded video of confocal and endomicroscopy technology in upper tract tumours, robotic intracorporeal neobladder using the Wiklund technique and presented by Prof. Peter Wiklund (SE) himself. Former ESUT chairman Prof. Jens Rassweiler (DE) was also scheduled to demonstrate a 4K laparoscopic extraperitoneal radical nephrectomy, to be followed by current ESUT chair Prof. Evangelos Liatsikos (GR) performing a prone percutaneous nephrolithotripsy.

The two other sessions covered a combination of live and pre-recorded procedures that will show prostate, stone, bladder and kidney treatments that use novel tools such as flexible ureteroscopy, 4K laparoscopy, enucleation techniques and Narrow Band Imaging –assisted resection of bladder tumours, to name a few.