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New approach to live surgery debuts at EAU23

One of the best-attended sessions on the second day of EAU23 in Milan was without doubt the live surgery session “Technology developments never end”. Running continuously from 10:30 to 19:00, the programme featured more than thirty cases, each running a minimum of 30 minutes to ensure a more complete demonstration rather than offering just a snapshot of a few highlights from each procedure.

As at most Annual EAU Congresses in recent years, a full day is devoted to Live Surgery. However, this year the Scientific Congress Office decided on a new approach that allows for longer, uninterrupted procedures transmitted simultaneously with the use of three different screens and headphones for the audience. The new approach was deemed desirable by the Scientific Congress Office to enhance the educational value of the session and to offer new options for sponsored sessions to be integrated.

The latest developments were naturally featured in the programme, with extra attention for the newest generations of single-use scopes, and Thulium and Holmium laser enucleation of the prostate. The programme also featured less common cases, for instance two pre-recorded presentations on inflatable penile prostheses.

First cases on new robotic systems

In the afternoon sub-session on robotic surgery, Asst. Prof. Nina Harke (DE) joined  Auditorium 1 from Niguarda Hospital in Milan and performed a robotic partial nephrectomy with a highly distinguished panel of moderators: Profs. Alex Mottrie (BE), Henk Van Der Poel (NL) and Alessandro Antonelli (IT).

Her demonstration was followed by a retzius-sparing robotic prostatectomy by Dr. Antonio Galfano (IT) in place of Dr. Bocciardi (IT), using the new Hugo system, also in Niguarda. The system was installed just three months prior, and the team had performed fewer than twenty cases so far.

“We are still exploring the possibilities of the system,” said Dr. Galfano. “The system is brand new and no one knows what we can do with this. We are exploring standard and new indications but have so far not noticed major differences in docking or setting of the trocars.”

Prof. Antonelli was interested to know what Dr. Galfano’s expectations were considering the separate towers for each robotic arm, were they perhaps an advantage in some cases? Dr. Galfano indicated that so far he did not want to change his approach too much compared to prior systems, and wanted to see if the Hugo system could reproduce previous approaches before exploring new possibilities.

Notably, in terms of the robotic surgical systems used, according to ERUS Chairman Dr. Alberto Breda there was a rough 50/50 split between Intuitive and Medtronic systems, aided by the first Medtronic systems being installed in Milan’s centres. Adoption of the new systems seems to be progressing rapidly following the beginning of the rollout in Europe less than two years ago.

The marathon session was co-chaired by the Chairs of the EAU Sections of Uro-Technology, Urolithiasis and Robotic Urology (ESUT, EULIS and ERUS); Profs. Gözen (DE) and Seitz (AT) and Dr. Breda, respectively. Each section will have its own session on Sunday, with more detailed and specialised discussion  on each individual subspecialty. The three sections will be united again in January 2024 when they collaborate on UROtech24 in Vienna.