Expert challenges the expert: Thematic session looks at nerve-sparing nephrectomy and laparoscopic partial nephrectomy

Mon, 18 Mar 2013

Following Plenary Session 3, which covered lower urinary tract management, a series of thematic sessions took place on a variety of topics. Thematic Session 9 was notable for its discussive nature. Two sets of presentations took place under the chairmanship of Prof. Alexandre De La Taille (FR), with one expert questioning the other on his video case presentation.

Prof. George Thalmann (CH) explained his technique for doing a nerve-sparing cystectomy, with his video presentation coming under scrutiny of Dr. Rafael Sanchez Salas (FR), who asked questions to Thalmann on behalf of the audience. Thalmann was commended for his world-leading work on the procedure.

The second half of the Thematic Session was a series of case presentations by Dr. Inderbir Singh Gill (USA), with questions and comments from EAU Robotic Urology Section (ERUS) Chairman Dr. Alexander Mottrie (BE). Gill showed examples of laparoscopic and robotic partial nephrectomy, and the value of conventional clamping, early unclamping and revolutionary zero-ischemia techniques.

Gill: “We’ve been pushing this field for 10 years now. With initial laparoscopic procedures, we had a 30-minute ischemia time, which we cut to 14 minutes by using the early unclamping technique. Now we’re down from 14 to zero minutes. People are concerned, and they have questions and doubts, which is totally valid. As we work through it, we go from main artery clamping to segmental clamping, and from segmental to zero is the next step.”

The value of Expert vs Expert sessions“I think this challenge session is a great idea,” Dr. Inderbir Singh Gill said after the session was over. “To have two experts talking is a powerful teaching tool, where intricate details of procedure can be discussed in a real world scenario, as opposed to just one person talking. I loved it.”The session drew a lot of attention, which Dr. Gill considered unusual for kidney surgery. “This is a unique set-up for a session. I just heard from one of the delegates that they were looking to organise a similar series of presentations in Australia.”

“At a congress like this, people are interested in two things,” Gill observed. “Firstly, to expand their knowledge. Secondly, people want to learn something specific, and go back to their clinics and start practising tomorrow. If they come to a session like this with a bit of expertise, and some questions in mind, they return home with confidence.”