The three-day meeting of the EAU Robotic Urology Section in Amsterdam started on September 17th with a special programme for young urologists and others interested in getting involved in robotic surgery. Important topics include the economics of robotic surgery, a look at the literature, and the importance of a viable certification programme. Dr Carl Wijburg, Session co-chairman explains.
“The meeting was well-attended, perhaps even more people than we expected! In addition to local Dutch delegates, we had a fair share of international visitors. This is the sixth year of the Jr ERUS programme, and every year we draw a bigger crowd,” Wijburg told us after the morning’s programme had concluded.
“The programme was especially geared to young urologists who are interested in starting with robotic surgery, so we try to keep it approachable.” Dr. Wijburg also spoke at the session, looking at the total costs and benefits for institutions who are considering the purchase of a surgical robot. One big advantage of the robot is that patients spend less time recuperating and have a shorter hospital stay. The high purchase price of the robot can already be recouped within several years.
Wijburg: “Besides costs, we are more interested in the quality of care, so we also had an excellent session that looked at the best articles about outcomes of robotic surgery. What can we say about complications and the learning curve? We need standardised reports of complications to compare outcomes. The learning curve is probably never ending, because robotic urology is a fast-evolving field.”
And is robotic surgery the future of urology? “Well, we might be a bit biased of course, but we are seeing more and more indications than only robot-assisted prostatectomy. For eg. radical cystectomy we now know that it is oncologically equal to conventional procedures, with the added benefit of the patient making a faster recovery.”
Certification for robotic surgery
Also speaking at the YAU-Jr ERUS programme was Asst. Prof. Giacomo Novara, who presented the results of the second pilot of the ERUS Robotic Urology Fellowship Curriculum. Novara: “The pilot study was an initiative aimed at standardized training for robotic radical prostatectomy. Last year, with the first twelve-week pilot, we wanted to demonstrate efficacy of set modular training, joined with animal training.”
“The first leg of the study demonstrated that it was efficient, but for most participants it was clear that the study was not long enough. The second pilot study demonstrated that 6-month training was more effective and 90% of the participants were able to do the procedure in an appropriate way afterwards.”
Novara also talked to us about the long-term perspective for the programme. “Pilot II was a validation study, so I think starting from now, we can carefully start adopting the protocol without calling it a pilot any longer, but standard curriculum. The purpose is to build a formal EAU/ERUS-based curriculum to propose to all national academic societies in Europe in order to certify fellows as qualified for controlling a robot.”
Currently, there is no formal qualification for the use of surgical robots. Novara: “This is of course highly unethical and unprofessional. We are establishing criteria for surgeons to get access to machine and use it on their patients. The programme will be suitable for all residents and interested in urological surgery.”
For more information on the first pilot of the ERUS Robotic Urology Fellowship Curriculum, please vist the ERUS Section Page.