Current laser therapy options for endoscopic treatment of upper tract urothelial carcinoma

Abstract. Endoscopic management via retrograde ureteroscopic laser ablation of upper tract urothelial carcinoma (UTUC) has become the preferred treatment modality for low-risk tumors. The most popular ablative lasers over the past 15–20 years have been the holmium:yttrium-aluminum-garnet (Ho:YAG) and neodymium (Nd:YAG) lasers, but recently the thulium (Th:YAG) laser has emerged as a potential alternative. This review compares the mechanism of action, physiological properties and effects, and oncologic outcomes of Ho:YAG/Nd:YAG lasers versus the Th:YAG laser for UTUC treatment. Potential advantages of the Th:YAG laser over existing technologies are outlined, followed by a discussion of emerging laser technologies in UTUC management

Evaluation of Surgical Improvement of Clinical Knowledge Ops (SICKO), an Interactive Training Platform.

Over the past two decades, there have been numerous attempts at using surgical simulation software for training purposes. There has been extensive prior success at using digital laparoscopic tools and virtual and augmented reality in strengthening specific surgical techniques, but clinical decision-making simulation has been limited to multiple choice question banks. Surgical Improvement of Clinical Knowledge Ops (SICKO) is a web-based educational application that takes users through various aspects of clinical decision-making in the field of surgery. App Specs App name: Surgical Improvement of Clinical Knowledge Ops (SICKO) App developer: James Lau M.D., Dana Lin M.D., Julia Park M.D. App website/URL*: http://med.stanford.edu/sm/archive/sicko/game/SICKOTitle.html App price: The website is free to use and has no microtransactions Category: educational, surgery simulation, clinical decision making Tags: web-based app, surgical simulation, learning, healthcare, gamification Works offline: no Browsers: Works on Google Chrome, Mozilla Firefox, Safari, and Microsoft Edge FDA approval: N/A *It should be noted that although the URL leads to a website with a tab header that reads “SEPTRIS,” an older iteration of the game, the interactive experience is actually SICKO, which the user can clearly see from the webpage itself. Quick Review (1 star, lowest; 5 stars, highest) Overall Rating (1–5): 4.5 Content (1–5): 5 Usability (1–5): 5 Design (1–5): 4 Ratings Disclosure: The SICKO application was reviewed by two independent medical student authors of this article, as well as a resident physician. The reviews were done anonymously through each reviewer’s own input and were blinded to each other’s ratings until completion of the simulation. Each reviewer completed full renditions of the game from beginning to end to experience a situation where the patient expired, as well as one where the patient was saved in order to observe the full user experience. Both authors felt that the game was remarkably useful, with the only criticism being the simple graphical design of the application. No reviewers or authors of this paper have any connection to the software content or development team of SICKO