Northeastern Section of the American Urological Association 69th Annual Meeting Abstracts

Abstract

P1Tying the knot on robotic transition: Results of a prospective study on the learning curve and operative time of robotic pediatric urology procedures Noah Stern, Roderick Clark, Aseem Shukla, Sumit Dave Western University, London, ON, Canada Introduction: The transition to robotic-assisted procedures in pediatric urology leads to an increase in operative times, which impacts healthcare costs and resources. Attempts to reduce the learning curve of robotic surgery in adults have focused on structured training to improve operative times at each step, but this work has not extended to pediatric urology. The objectives of this study are to investigate the learning curve and operative times of a single surgeon transitioning from laparoscopic pyeloplasty to robotic-assisted pyeloplasty (RAP) and from open ureteric re-implantation to robotic-assisted extravesical ureteral re-implantation (RUR) and to determine where efficiency gains are found early in the learning curve.Methods: This prospective cohort study includes all RAP and RUR procedures performed using a three-port technique between July 2013 and April 2016. Both operations were sectioned into discrete operative steps: ports insertion and closure, dissection of the ureteropelvic junction (RAP) or ureter (RUR), dismemberment of the renal pelvis and spatulation (RAP) or creation of the submucosal tunnel (RUR), ureteropelvic anastomosis (RAP) or closure of the submucosal detrusor tunnel (RUR) recorded by a trained unbiased coder. The primary outcome was the trends of total and step-specific operative times. Success was defined as resolution or significant decrease in the grade of hydronephrosis for the RAP group and resolution of urinary tract infections off antibiotic prophylaxis or negative voiding cystourethrogram (VCUG) in the RUR group. Operative times were compared using student's t-test by the first and last quartiles. Descriptive analyses were performed on other outcomes of interest. Results: See Table 1. Conclusions: A reduction in intracorporeal suturing time leads to the greatest efficiency gain when transitioning to RAP and RUR. At our center, despite a relatively low volume of robotic cases (14/year), this efficiency was achieved within the first 20 procedures for both RAP and RUR. This study will aid the design of structured residency training programs to improve the operative learning curve for novice surgeons initiating RAP and RUR. P2Natural history and predictors of parastomal hernia after robotassisted radical cystectomy Ahmed Aly Hussein Aly, Youssef Ahmed, Paul May, Peter Loud, Taimoor Ali, Basem Ahmad, Khurshid A. Guru Roswell Park Cancer Institute, Buffalo, NY, USA Introduction: Parastomal hernia (PH) is a frequent complication of urinary diversion after radical cystectomy. We investigated the prevalence, predictors, and outcomes of PH. Clinical and radiological evidence of PH was also investigated. Methods: Retrospective review of 446 patients who underwent RARC at our institution from 2005 was conducted. Data was reviewed for demograp...

Pop psychology and predatory journals

“…Di Lena and Nickel recently presented a similarly themed report of a single academic urologist's email requests for submissions to open-source journals. 4 Over two-thirds were suspected to be predatory, with false claims of legitimacy and such poor journal metrics that it is highly unlikely any work would have been read or cited. Interestingly, the majority of publishers appeared to originate in the U.S.…”