Video Archives

Integration of Augmented Reality (AR) and Extended Reality (XR) into Urology Training and Practice

Posted by Nelson N. Stone, MD | Aug 2023

Nelson N. Stone, MD, examines the immense transformative potential of augmented reality in the realm of surgical education and training. With a comprehensive approach, he dives deep into the concepts of augmented reality, virtual reality, and extended reality, shedding light on their applications within the field of Urology.

Throughout his presentation, Dr. Stone places a strong emphasis on the pressing need for advanced training methods in response to the rapid evolution of technology and the increasing prominence of minimally invasive surgical techniques. He delves into the utilization of simulation models as a crucial tool for training, while also addressing the unique challenges posed by the COVID-19 pandemic and its impact on traditional training approaches.

Venturing further into the realm of augmented reality, Dr. Stone explores the development of wearable headsets that harness the power of augmented reality, along with web-based platforms that facilitate remote training opportunities. He illustrates how augmented reality enables remote training, empowering instructors to provide guidance and facilitating hands-on practice for trainees, regardless of their physical location.

Dr. Stone showcases real-life scenarios, including transperineal biopsy and renal puncture procedures. These examples highlight the tangible benefits of augmented reality in enhancing hand-eye coordination and improving overall training efficacy.
Concluding his presentation, Dr. Stone presents a survey received from practitioners who have experienced augmented reality training. The survey findings underscore the potential benefits of augmented reality in revolutionizing surgical education by fostering enhanced skill development and promoting a more immersive learning experience.

Point-Counterpoint: Cystectomy vs. Trimodal Therapy for Muscle Invasive Bladder Cancer – Trimodal Therapy

Posted by Tyler F. Stewart, MD | Jul 2023

Dr. Tyler F. Stewart, MD, presents a comprehensive discussion on the topic of cystectomy versus trimodal therapy for muscle invasive bladder cancer. Highlighting the importance of a multidisciplinary approach, he emphasizes that the decision-making process involves urologists, medical oncologists, and radiation oncologists working as a team.

Dr. Stewart explores the current treatment strategies, comparing the outcomes of cystectomy and chemoradiation based on existing studies. He acknowledges the life-saving potential of cystectomies and recognizes specific scenarios where it remains the preferred option. However, he also highlights the complications associated with cystectomy, such as quality of life issues and post-surgical challenges.

Additionally, Dr. Stewart discusses trimodal therapy, which involves a combination of maximal debulking, chemoradiation, and ongoing surveillance. He addresses the lack of definitive randomized trials in this area and presents retrospective studies demonstrating comparable oncologic outcomes between trimodal therapy and cystectomy with neoadjuvant chemotherapy.

Dr. Stewart delves into the complications and late toxicities associated with trimodal therapy while discussing its potential benefits in terms of quality of life outcomes. He concludes by mentioning the exciting advancements in systemic therapies and ongoing research to improve local disease control in bladder sparing options.

This lecture is part of a Point-Counterpoint debate. Its opposing lecture is “Point-Counterpoint: Cystectomy vs. Trimodal Therapy for Muscle Invasive Bladder Cancer–Cystectomy.”

About the 30th Annual Perspectives in Urology: Point Counterpoint conference: Presented by Program Chair and Grand Rounds in Urology Editor-in-Chief E. David Crawford, MD, this conference brought together leading experts in urology, medical oncology, and radiation oncology to discuss and debate the latest topics in genitourinary cancers, primarily prostate cancer and bladder cancer. This interactive conference offered topical lectures, pro/con debates, interesting-case presentations, interactive panel discussions, and interactive audience and faculty networking.

Point-Counterpoint: Cystectomy vs. Trimodal Therapy for Muscle Invasive Bladder Cancer – Cystectomy

Posted by Aditya Bagrodia, MD | Jul 2023

Aditya Bagrodia, MD, FACS, discusses the standard treatment for muscle-invasive bladder cancer, cystectomy, focusing on the effectiveness of cystectomy in comparison to trimodal therapy. He highlights the weaknesses of trimodal therapy, focusing on the importance of selecting highly suitable candidates for trimodal therapy, emphasizing factors such as tumor size, absence of extra bladder disease, proper bladder function, and lymph node evaluation.

Dr. Bagrodia presents data from German and Mass General Hospital experiences, demonstrating the negative outcomes of trimodal therapy. The results show that while trimodal therapy can achieve disease-free status in about two-thirds of patients initially, a significant proportion may require subsequent treatment, including cystectomy. Cancer-specific and overall survival rates at 10 years vary depending on the extent of the disease, with more advanced stages showing a decline in outcomes. The study also compares these outcomes to those of cystectomy, highlighting the higher recurrence-free survival rates associated with organ-confined disease and the potential benefits of neoadjuvant chemotherapy.

Overall, the data suggests that highly selected patients receiving cystectomy may have better outcomes compared to those receiving trimodal therapy. However, individual patient characteristics and preferences should be considered when deciding the most appropriate treatment approach.

This lecture is part of a Point-Counterpoint debate. Its opposing lecture is “Point-Counterpoint: Cystectomy vs. Trimodal Therapy for Muscle Invasive Bladder Cancer–Trimodal Therapy.”

About the 30th Annual Perspectives in Urology: Point Counterpoint conference: Presented by Program Chair and Grand Rounds in Urology Editor-in-Chief E. David Crawford, MD, this conference brought together leading experts in urology, medical oncology, and radiation oncology to discuss and debate the latest topics in genitourinary cancers, primarily prostate cancer and bladder cancer. This interactive conference offered topical lectures, pro/con debates, interesting-case presentations, interactive panel discussions, and interactive audience and faculty networking.

Management of Disease Recurrence in Localized Prostate Cancer

Posted by Laurence Klotz, MD, FRCSC | Jul 2023

Laurence Klotz, MD, FRCSC, discusses the complexities surrounding salvage therapy and focal therapy. Dr. Klotz explores the challenges that arise when managing local failure after radiation, providing insights into the polarized perspectives on the significance of focal therapy. He highlights the striking similarities in disease control achieved through various modalities of salvage therapy, shedding light on the potential benefits of radiation in mitigating genitourinary (GU) and gastrointestinal (GI) toxicity.

Dr. Klotz emphasizes the need to redefine treatment goals in focal therapy, urging a shift towards preventing metastasis and mortality as primary objectives, rather than seeking complete cancer eradication. Furthermore, the presentation discusses the captivating concept of “invisible tumors” and their favorable genetic features, aligning with the emerging principles of image-based management and its integration with focal therapy, allowing for personalized, targeted treatments that hold promise for improved patient outcomes.

Clinical Trials for BCG-Naive and BCG-Unresponsive NMIBC

Posted by Amirali Salmasi, MD | Jul 2023

Amirali Salmasi, MD, delves into a comprehensive discussion on risk stratification and treatment options for BCG-naive and BCG-unresponsive bladder cancer. In his enlightening presentation, Dr. Salmasi provides a thorough examination of the diverse risk groups, elucidating the distinctions between low risk, intermediate risk, and high risk based on tumor grade and size. Moreover, he delves into the crucial aspects of adequate BCG treatment and outlines the criteria for BCG unresponsiveness, enhancing our understanding of these critical factors.

Furthermore, Dr. Salmasi takes us on an exploratory journey through the realm of treatment approaches for bladder cancer. He shares insights on the exciting possibilities offered by sequential chemo, hyperthermia, immunotherapy, and targeted therapy, elaborating on their respective mechanisms and potential benefits. To bolster his insights, Dr. Salmasi highlights key studies and trials conducted, underscoring the promising outcomes that have been observed.