WCE 2017: Which Position is Best: Prone vs. Supine

Vancouver, Canada (UroToday.com) Dr. Lipkin, associate professor of urologic surgery from Duke University, opened up this plenary session stating that the prone position for percutaneous nephrolithotomy (PCNL) is better. He considers stone free rates, complications, anesthetic concerns, operating room (OR) time and cost. He begins by referencing the CROES study and two recent meta-analyses which showed a higher stone-free rate with the prone position compared to the supine position. However, Dr. Lipkin does agree that the complication rates and anesthetic concerns are equivalent between the two positions. For the OR time, a meta-analysis had shown an 18-minute time saving with the supine position, but one study had shown that when all things are considered the supine PCNL procedure is more costly.

WCE 2017: Predicting Risk of Pathological Upstaging of Clinical T1 Renal Masses in the Era of Renal Mass Biopsy

Vancouver, Canada (UroToday.com) Smith et al. presented a retrospective study of 98,936 patients identified using the National Cancer Database (NCDB). The final analytical cohort included 6,409 patients who were initially diagnosed with cT1 renal cell carcinoma, treated with partial or radical nephrectomy from 2004-2013, and subsequently upstaged to pT3-4. 

WCE 2017: Impact of Positive Surgical Margins on Overall Survival after Partial Nephrectomy, a Matched Comparison Based on the National Cancer Database

Vancouver, Canada (UroToday.com) Shum et al. present a retrospective, propensity-matched study of 2,530 patients identified using the National Cancer Database (NCDB). The final analytical cohort included patients who were diagnosed with T1/T2N0M0 renal cell carcinoma and treated with partial nephrectomy between 2004 and 2009. Propensity-matching using variables for age, Charlson Comorbidity Index (CCI), tumor size, histology, and grade was used to create two groups based on the presence or absence of positive surgical margins.  

WCE 2017: The Utility of Axial Abdominal Imaging after Partial Nephrectomy for T1 Renal Cell Carcinoma Surveillance

Vancouver, Canada (UroToday.com) Dr. Brett Johnson, endourology fellow from the University of Texas Southwestern Medical Center, presented data comparing the recurrence rates of T1a and T1b renal cell carcinoma (RCC) after partial nephrectomy. The average recurrence rates of T1a and T1b in patients is 1-3% and 5-10%, respectively. Despite these differences, the guidelines for follow-up and surveillance of these tumors are largely the same. Dr. Johnson and his research team sought to determine the best possible way to monitor these different tumors without causing overtreatment. 

WCE 2017: Urology Residents’ Experience and Attitude Towards Surgical Simulation: Presenting Our Four Year Experience With A Multi Institutional, Multi Modality Simulation Model

Vancouver, Canada (UroToday.com) Dr. Chow, a resident from Rush University Medical Center presented his data on the resident’s experience with simulation training. Surgical simulation with authentic and high fidelity simulators is increasingly used to improve surgical technical skills, decrease the learning curve and to improve surgical outcomes and patient safety. 

WCE 2017: Trifecta Outcomes of Robot-assisted Partial Nephrectomy in Solitary Kidney – A VCQI Database Analysis

Vancouver, Canada (UroToday.com) Arora et al. presented a retrospective study of 2,755 patients from the Vattikuti Global Quality Initiative in Robotic Urologic Surgery (GQI-RUS) database. The final analytical cohort included 74 patients who had a history of solitary kidney and underwent robotic-assisted laparoscopic partial nephrectomy (RAPN) between 2007 to 2016. 

WCE 2017: Effectiveness of Procedural Virtual Reality Simulation in Surgical Training

Vancouver, Canada (UroToday.com) Mr. Patrick Harrison, a medical student from the Kings College London, presented data that compared the effectiveness of procedural virtual reality (VR) training to basic virtual reality training and other types of simulation training. As an introduction to his talk, Mr. Harrison explained how basic VR provides computer generated images to create tasks that replicate the skills needed for real life surgery. However, procedural VR has specific modules to replicate a real-life environment with increasingly accurate anatomy to not only replicate the skills needed, but the environment these skills will be used for. Their aim was to evaluate if there was a difference in the effectiveness and acquisition of surgical skills between basic VR, procedural VR, and other types of simulation training.

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