Ureteric Duplication is not a Contraindication for Robot-Assisted Laparoscopic Radical Cystoprostatectomy and Intracorporeal Studer Pouch Formation

The authors found that duplicated ureters was not a contraindication to robot-assisted laparoscopic radical cystoprostatectomy in this case

COVİD-19 pandemisi döneminde ilk online üroonkoloji kongresi: 10. Online Avrasya Üroonkoloji Kongresi

Objective: COVID-19 has rapidly spread and has become a pandemic by affecting the whole world. During this period, many scientific congresses and educational meetings had to be canceled because of preventive measures. In this report, we aimed to share our first live virtual congress experience, described its process of transformation from face to face to virtual congress and report the attendees and speakers’ satisfaction. Material and Methods: Eurasian Uro-oncological Association (EUA) decided to organize the 10th Eurasian Uro-oncology congress in June 2020 at Göbeklitepe, Şanlıurfa in Turkey. However, due to the COVID-19 pandemic, the organizing committee decided to organize the first virtual scientific congress in Turkey. The planned duration of the congress was reduced from 4 days to 2 days and each speaker was planned to give the speech online during the presentation via ZOOM program (San Jose, CA). Results: A total of 704 persons registered to the congress. It was the highest number of participants among whole congresses that was organized by EUA. In this congress, there were 199 oral presentations, 25 interactive e-posters and 12 video presentations. During the congress, each participant attended the congress for an average of 387 minutes. It was identified that the majority of the participants were quite satisfied with the program offered. In general, participants were fairly satisfied with the quality of images and sound, chat functionality, questions & answers section and technical support In this report, we shared the outcomes of our first virtual congress experience in Turkey through the 10th Eurasian Uro-oncology Congress. Today, virtual congresses have become the “new normal” and offer cheaper events with larger participation in the comfort of home.Amaç: COVİD-19 hızlıca yayılarak kısa sürede tüm dünyayı etkileyen bir pandemi haline gelmiş ve bu süreçte koruyucu önlemler nedeniyle birçok bilimsel kongre ve eğitim toplantısı iptal edilmek zorunda kalınmıştır. Bu çalışmada, ilk canlı, online kongre deneyimimizi paylaşmayı, yüz yüze geleneksel kongreden online kongreye geçiş sürecini anlatmayı ve katılımcı ve konuşmacıların memnuniyetlerini ortaya koymayı amaçladık. Gereç ve Yöntemler: Avrasya Üroonkoloji Derneği (AÜD), 10. Avrasya Üroonkoloji Kongresi’ni Haziran 2020’de Şanlıurfa-Göbeklitepe, Türkiye’de düzenlemeye karar vermişti. Ancak organizasyon komitesi COVİD-19 pandemisi nedeniyle Türkiye’deki ilk online kongreyi düzenlemeye karar verdi. Planlanan kongre süresi 4 günden 2 güne düşürüldü ve her konuşmacının sunumlarını ZOOM programı (San Jose, CA) üzerinden yapmaları planlandı. Bulgular: Toplam 704 kişi kongreye kayıt yaptırdı. Bu sayı ile AÜD tarafından düzenlenen tüm kongreler arasında en fazla katılımcı sayısına sahip kongre bu kongre oldu. Kongrede 199 sözlü sunum, 25 interaktif e-poster ve 12 video sunumu yer aldı. Kongre süresince her katılımcı ortalama 387 dakika kongreye katıldı. Katılımcıların çoğunluğunun sunulan programdan oldukça memnun olduğu tespit edildi. Katılımcıların genel olarak görüntü ve ses kalitesinden, sohbet fonksiyonundan, soru-cevap bölümünden ve teknik destekten oldukça memnun olduğu saptandı. Sonuç: Bu makalede, Türkiye’deki ilk online kongre deneyimimizin sonuçlarını 10. Avrasya Üroonkoloji Kongresi ile sunduk. Günümüzde online kongreler “yeni normal” haline gelmiş durumdadır ve ev konforunda daha fazla katılımcı ile daha az maliyetli etkinlikler sunmaktadır

Robotic intracorporeal urinary diversion: practical review of current surgical techniques

In this practical review, we discuss current surgical techniques reported in the literature to perform Intracorporeal Urinary Diversion (ICUD) after Robotic Radical Cystectomy (RARC), emphasizing criticisms of single approaches and making comparisons with Extracorporeal Urinary Diversion (ECUD). Although almost 97% of all RARCs use an ECUD, ICUD is gaining in popularity, in view of its potential benefits (i.e., decreased bowel exposure, etc.), although there are a few studies comparing ICUD and ECUD. Analysing single experiences and the data from recent metanalyses, we emphasize the current critiques to ICUD, stressing particular technical details which could reduce operative time, lowering the postoperative complications rate, and improving functional outcomes. Only analysis of long-term follow-up data from large-scale homogeneous series can ascertain whether robotic intracorporeal urinary diversion is superior to other approaches

What if the Hand Piece Spring Disassembles During Robotic Radical Prostatectomy?

These authors report on the successful management of a disassembled hand piece spring during robotic radical prostatectomy

The Incidence and Management of Pleural Injuries Occurring during Open Nephrectomy

Objective. To evaluate the incidence, management, and risk factors of pleural injuries occurring during open nephrectomy. Methods. Between June 2004/and June 2008, 165 patients (167 renal units) underwent open simple (n = 37, 22.2%), partial (n = 39, 23.4%) or radical (n = 91, 54.5%) nephrectomy in our institution. Results. Flank, Chevron, and abdominal midline incisions were used in 148(88.6%), 17(10.2%), and in 2(1.2%) surgical procedures, respectively. Ribs were excised in 109(65.3%) procedures (11th rib, 10th-11th ribs, and 11th-12th ribs). Intraoperative pleural injuries were detected in 20(12%) procedures, 16(80%) were treated successfully with simple evacuation technique, and 4 required chest tube insertion. Age, sex, surgery type, incision type, and surgery site were not associated with pleural injury occurrence (P > .05). Rib resection was the only parameter associated with pleural injury occurrence. Conclusion. Pleural injuries occur in 12% of open nephrectomy procedures, and 80% can be repaired successfully. Few of them (2.4%) need chest tube insertion. Performing rib resection is a significant risk factor for pleural injury occurrence during nephrectomies

Retroperitoneal Extragonadal Nonseminomatous Germ Cell Tumor with Synchronous Orbital Metastasis

A huge retroperitoneal tumor with a right orbital mass was detected and proved to be an extragonadal nonseminomatous germ cell tumor on biopsy. BEP chemotherapy caused some regression in orbital mass however no change in retroperitoneal tumor size as well as serum tumor marker levels occurred. Herein, we present a rarely seen entity of extragonadal retroperitoneal nonseminomatous germ cell tumor with synchronous orbital metastases and discuss its diagnosis and management

Is Positron Emission Tomography Reliable to PredictPost-Chemotherapy Retroperitoneal Lymph NodeInvolvement in Advanced Germ Cell Tumors of theTestis?

PURPOSE: To evaluate if 18 fluorodeoxyglucose positron emission tomography(18FDG-PET) scan could identify post-chemotherapy retroperitoneal lymphnode (RPLN) involvement in advanced germ cell tumors of the testis.MATERIALS AND METHODS: Between January 2005 and January 2009, 16patients with advanced germ cell tumors of the testis underwent RPLNdissection (RPLND) following chemotherapy. Before RPLND, abdominalcomputed tomography (CT), magnetic resonance imaging (MRI), and18FDG-PET were performed in all the patients. Findings on 18FDG-PETwere compared with pathological evaluation of the removed lymphatic tissue.RESULTS: Both abdominal CT and MRI demonstrated retroperitonealmasses in all the patients following chemotherapy. Although PET did not demonstrate any activity in 8 patients, tumor was detected histopathologically.In 1 patient, 18FDG-PET demonstrated activity; however, no tumor wasdetected on pathology. Of the remaining 7 patients, 18FDG-PET findingswere concordant with the histopathological findings. No activity wasdetected in 2 patients with no tumors whereas all 5 patients harboring viabletumor cells showed positive 18FDG-PET activity. In our study, sensitivityand specificity of 18FDG-PET in detecting RPLN involvement were detectedto be 39% and 67%, respectively.CONCLUSION: 18FDG-PET imaging does not seem to be a reliable methodin detecting RPLN involvement in advanced germ cell tumors of the testisfollowing chemotherapy. Therefore, we neither recommend routine use of18FDG-PET scanning nor decide the treatment work-up by solely relying onthe 18FDG-PET findings in this patient group

Morbidity and mortality after robot-assisted radical cystectomy with intracorporeal urinary diversion in octogenarians: results from the European Association of Urology Robotic Urology Section Scientific Working Group

OBJECTIVES: To evaluate the postoperative complication and mortality rate following laparoscopic radical cystectomy (RARC) with intracorporeal urinary diversion (ICUD) in octogenarians. PATIENTS AND METHODS: We conducted a retrospective analysis comparing postoperative complication and mortality rates depending on age in a consecutive series of 1890 patients who underwent RARC with ICUD for bladder cancer between 2004 and 2018 in 10 European centres. Outcomes of patients aged <80 years and those aged ≥80 years were compared with regard to postoperative complications (Clavien–Dindo grading) and mortality rate. Cancer-specific mortality (CSM) and other-cause mortality (OCM) after surgery were calculated using the non-parametric Aalen-Johansen estimator. RESULTS: A total of 1726 patients aged <80 years and 164 aged ≥80 years were included in the analysis. The 30- and 90-day rate for high-grade (Clavien–Dindo grades III–V) complications were 15% and 21% for patients aged <80 years compared to 11% and 13% for patients aged ≥80 years (P = 0.2 and P = 0.03), respectively. In a multivariable logistic regression analysis adjusting for pre- and postoperative variables, age ≥80 years was not an independent predictor of high-grade complications (odds ratio 0.6, 95% confidence interval 0.3–1.1; P = 0.12). The non-cancer-related 90-day mortality was 2.3% for patients aged ≥80 years and 1.8% for those aged <80 years, respectively (P = 0.7). The estimated 12-month CSM and OCM rates for those aged <80 years were 8% and 3%, and for those aged ≥80 years, 15% and 8%, respectively (P = 0.009 and P < 0.001). CONCLUSIONS: The minimally invasive approach to RARC with ICUD for bladder cancer in well-selected elderly patients (aged ≥80 years) achieved a tolerable high-grade complication rate; the 90-day postoperative mortality rate was driven by cancer progression and the non-cancer-related rate was equivalent to that of patients aged <80 years. However, an increased OCM rate in this elderly group after the first year should be taken into account. These results will support clinicians and patients when balancing cancer-related vs treatment-related risks and benefits