Innovations in Urologic Surgical Training

Ma, Runzhuo; Reddy, Sharath; Vanstrum, Erik; Hung, Andrew J.

doi:10.1007/s11934-021-01043-z

Cited by 22 publications

(10 citation statements)

References 99 publications

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“…An unintended positive outcome from the COVID-19 pandemic has been improved communication between and the virtual presence of HIC, or regional, trainers. The local trainers' pool in a LMIC can be augmented by international faculty members using video links, and this has become an increasingly popular tool in supporting the global dissemination of surgical education [46][47][48]. International tele-collaboration, mentoring, and augmented reality have become indispensable in maintaining strong international ties during the pandemic and have aided global efforts to reduce the carbon footprint of F-2-F education [48].…”

Section: New Technologies and Future Options In Simulation Trainingmentioning

confidence: 99%

The utility of urological clinical and simulation training for Sub‐Saharan Africa

et al. 2022

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Section: New Technologies and Future Options In Simulation Trainingmentioning

confidence: 99%

The utility of urological clinical and simulation training for Sub‐Saharan Africa

et al. 2022

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“…Distance learning had a positive effect on the improvement in surgical technologies, which had been achieved in multidisciplinary surgical training. 15,16 Our initial survey also indicates that surgeons more proficient in the theoretical knowledge of SLN mapping are more receptive to the procedure. A comparison between the two surveys found that the proportion of surgeons who chose SLN mapping following the symposium increased from 35.4% to 51.1%, and the proportion who did not adopt SLN mapping owing to a lack of training decreased from 35.4% to 18.7%.…”

Section: Discussionmentioning

confidence: 89%

Application of sentinel lymph node mapping in endometrial cancer: A survey among Chinese gynecological oncologists

Song

Zheng

Gao

et al. 2023

J of Obstet and Gynaecol

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To gain a better understanding of the use of sentinel lymph node mapping by Chinese oncologists for endometrial cancer staging and analyze factors influencing its application. Methods: Questionnaires were collected online before and by phone after the symposium to evaluate the general characteristics of oncologists who participated in the endometrial cancer seminar and factors associated with the application of sentinel lymph node mapping in endometrial cancer patients. Results: Gynecologic oncologists from 142 medical centers participated in the survey. 35.4% of doctors employed sentinel lymph node mapping for endometrial cancer staging, 57.3% chose indocyanine green as the tracer. Multivariate analysis revealed that cancer research center (odds ratio = 4.229, 95% CI 1.747-10.237), physician familiarity with sentinel lymph node mapping (odds ratio = 126.188, 95% confidence interval 43.220-368.425) and the use of ultrastaging (odds ratio = 2.657, 95% confidence interval 1.085-6.506) were related to the doctors' selection of sentinel lymph node mapping. There was a significant difference in the surgical procedure for early endometrial cancer, the number of removed sentinel lymph node, and the reason for not adopting sentinel lymph node mapping before and after the symposium. Conclusions: The theoretical knowledge of sentinel lymph node mapping, the use of ultrastaging, and cancer research center are related to a higher acceptance of sentinel lymph node mapping. Distance learning is conducive to the promotion of this technology.

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“…A common solution is to use objective assessment tools such as GEARS or DART to evaluate surgical skills [14][15][16] . Unfortunately, these tools suffer from subjectivity and do not capture surgical data at its most granular level 17 . An alternative method of quantifying surgical performance is by using automated performance metrics (APMs), such as the kinematic data of instruments 18 .…”

Section: Discussionmentioning

confidence: 99%

Surgical gestures as a method to quantify surgical performance and predict patient outcomes

Ramaswamy

et al. 2022

npj Digit. Med.

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How well a surgery is performed impacts a patient’s outcomes; however, objective quantification of performance remains an unsolved challenge. Deconstructing a procedure into discrete instrument-tissue “gestures” is a emerging way to understand surgery. To establish this paradigm in a procedure where performance is the most important factor for patient outcomes, we identify 34,323 individual gestures performed in 80 nerve-sparing robot-assisted radical prostatectomies from two international medical centers. Gestures are classified into nine distinct dissection gestures (e.g., hot cut) and four supporting gestures (e.g., retraction). Our primary outcome is to identify factors impacting a patient’s 1-year erectile function (EF) recovery after radical prostatectomy. We find that less use of hot cut and more use of peel/push are statistically associated with better chance of 1-year EF recovery. Our results also show interactions between surgeon experience and gesture types—similar gesture selection resulted in different EF recovery rates dependent on surgeon experience. To further validate this framework, two teams independently constructe distinct machine learning models using gesture sequences vs. traditional clinical features to predict 1-year EF. In both models, gesture sequences are able to better predict 1-year EF (Team 1: AUC 0.77, 95% CI 0.73–0.81; Team 2: AUC 0.68, 95% CI 0.66–0.70) than traditional clinical features (Team 1: AUC 0.69, 95% CI 0.65–0.73; Team 2: AUC 0.65, 95% CI 0.62–0.68). Our results suggest that gestures provide a granular method to objectively indicate surgical performance and outcomes. Application of this methodology to other surgeries may lead to discoveries on methods to improve surgery.

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Innovations in Urologic Surgical Training

Cited by 22 publications

References 99 publications

The utility of urological clinical and simulation training for Sub‐Saharan Africa

The utility of urological clinical and simulation training for Sub‐Saharan Africa

Application of sentinel lymph node mapping in endometrial cancer: A survey among Chinese gynecological oncologists

Surgical gestures as a method to quantify surgical performance and predict patient outcomes

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