In the spotlight: Dr. Andrea Gallioli

The research and the accolade
The EAU Hans Marberger Award is given to the best published European paper on minimally-invasive surgery in urology. This year, Dr. Gallioli receives this recognition for his paper “Learning Curve in Robot-assisted Kidney Transplantation: Results from the European Robotic Urological Society Working Group”, which was published in the August 2020 edition of the European Urology journal.

Dr. Gallioli’s research began during his fellowship at Fundació Puigvert under the guidance of Dr. Alberto Breda, Director of the Transplant Division and Uro-Oncology Unit at the institution and Chairman of the EAU Robotic Urology Section (ERUS).

“In 2015, Dr. Breda gathered a group of pioneer surgeons under the ERUS-RAKT Working Group to shed light on robot-assisted kidney transplantation. The group published several key studies on the topic. However, Dr. Breda and I observed that there wasn’t any published study on the learning curve in robot-assisted kidney transplantation yet. We consider the learning curve of the technique crucial as one of the main issues of any new surgical technique relies on applicability and reproducibility among different surgeons.

“Together with Dr. Breda and other respected surgeons in the field such as Prof. Dr. Antonio Alcaraz, Prof. Dr. Karel Decaestecker, Prof. Dr. Sergio Serni, and Prof. Dr. Volkan Tuğcu, we studied the learning curve of this novel surgical technique in five centres with the highest volumes. We focused on the rewarming time, which is the time from the graft insertion in the abdominal cavity to the de-clamping of graft vessels,” stated Dr. Gallioli.

The conclusions of the study are the following:

• Robot-assisted kidney transplantation requires a learning curve of 35 cases to achieve reproducibility in terms of timing, complications, and functional results.
• Synergy between the surgeon and the assistant is crucial to reduce rewarming time.
• High-grade complications and delayed graft function are rare after 10 surgeries.
• Hands-on training and proctorship are highly recommended.

When asked about the future plans about this study, Dr. Gallioli said, “Since the study focuses on learning curve, there is no need for a follow-up. However, the ERUS-RAKT Working Group is continuing to evaluate hot topics in robot-assisted kidney transplantation such as technological advancements in graft cooling systems, long-term outcomes of the surgery, and finally, a comparison with open kidney transplantation.”

Urology as his calling
During the last two years of his medical education, Dr. Gallioli focused on oncologic abdominal surgery, particularly in general surgery. After graduation, he had the opportunity to gain more knowledge and experience at the Urology Unit of Fondazione IRCCS Ca’ Granda – Ospedale Maggiore Policlinico in Milan. “It was there where I discovered a world of opportunities in a single specialty; urology offers the possibility to approach oncologic surgery, reconstructive and functional surgery, and endoscopy. Urology is an innovative specialty because of two main reasons: it comprises a part of surgery and a part of clinics, similarly to gynaecology and otolaryngology; moreover, urology is strongly associated with technological advancements and the pursuit for innovation,” stated Dr. Gallioli.

Role models and inspirations
“My biggest role models include my parents, who are doctors as well. They were my inspiration in pursuing this profession and I’m truly grateful for their support. I was also fortunate to be under the tutelage of Prof. Emanuele Montanari, who was the Director of a residency programme in Milan. For five years, he imparted the principles of urology and encouraged me to join a fellowship abroad which I spent at Fundació Puigvert. There, I met Dr. Breda. His dedication to improving one’s capabilities, whether in the surgical or research field, taught me that one should never stop learning.

“I would like to express my gratitude to Dr. Breda for including me in this research team which gave me a valuable experience and the opportunity to pursue the research on the learning curve in robot-assisted kidney transplantation. I would also like extend my appreciation to Prof. Joan Palou, who is Chairman of the Urology Department at Fundació Puigvert and Chairman of the European School of Urology, for giving me the chance to work on such interesting studies. Last but not least, I would also like to thank the whole team of authors who advised and helped during the development of the manuscript.”

When asked what lies in the future for him, Dr. Gallioli shared, “My professional aspiration is to become a valuable surgeon and to pursue an academic career centred on oncologic urology and kidney transplantation. I hope to provide significant contributions that may help the urologic community in the coming years.”