Video Archives

Robotic Urinary Diversion Ilial Conduit

Posted by Janet B. Kukreja, MD, MPH, FACS | Jan 2025

Janet B. Kukreja, MD, MPH, FACS, provides a detailed overview of performing robotic-assisted ileal conduit surgery, focusing on practical techniques and strategies for effective urinary diversion.

In this 12-minute presentation, Dr. Kukreja shares a video of one of her procedures, beginning with port placement and tool selection. Using both handheld and robotic staplers, she demonstrates methods to minimize complications and ensure precision during bowel anastomosis. She discusses techniques to avoid complications, such as meticulous ureter preparation, vascular supply preservation, and strategic suture placement. The demonstration covers methods for managing the ureters, including tunneling under the sigmoid and spatulating to ensure optimal flow and reduce the risk of narrowing.
This comprehensive overview provides practical insights into optimizing robotic urinary diversion procedures, making it a valuable guide for surgeons managing complex cases requiring ileal conduits.

Key Principles from the 2024 AUA Guidelines Updates on Salvage Prostate Cancer Therapy

Posted by Justin J. Badal, MD | Jan 2025

Justin J. Badal, MD, reviews the updated 2024 guidelines for advanced prostate cancer, reflecting substantial advancements since the last revision in 2013. The revision synthesizes evidence from numerous trials to reshape recommendations, focusing particularly on treatment strategies for biochemical recurrence (BCR) following radical prostatectomy.

In this 18-minute presentation, Badal shares guidelines emphasizing utilizing prognostic factors, such as PSA doubling time and Gleason grade, to stratify patient risk and guide treatment timing. He notes that ultra-sensitive PSA testing for high-risk individuals and PET imaging, particularly PSMA PET scans, is recognized as valuable tools for detecting biochemical recurrence.

The integration of androgen deprivation therapy (ADT) with SRT is advised for patients showing high-risk features, while, for those without high-risk markers, radiation monotherapy remains an option. For recurrent or node-positive cases post-primary therapy, combined modality approaches, including the use of expanded radiation fields and intensified androgen receptor suppression, are encouraged within a clinical trial setting.

Alternative Access Approaches for Less-invasive Nephron-sparing Surgery

Posted by Richard E. Link, MD, PhD | Jan 2025

Richard E. Link, MD, PhD, explores advances in robotic kidney surgery, focusing on nephron-sparing approaches and alternative access strategies, specifically through the low anterior access with the SP (single-port) robot. Historically, while only about 10% of nephron-sparing surgeries employed the retroperitoneal technique due to challenges in positioning and multiport access, the advent of the SP robot has significantly altered this landscape.

In this 18-minute presentation, Dr. Link shares the low anterior access technique, which offers a versatile approach to addressing tumors located anywhere in the kidney—anterior, posterior, medial, or lateral—while minimizing the need for complex patient positioning. The primary advantage of this approach is reduced postoperative complications, faster recovery, and less pain, which are of greater importance to patients.

Data from Link’s practice indicate a marked increase in adopting retroperitoneal access using the SP robot, rising from 15% to 80% over recent years. This shift has led to a significant reduction in hospital stays and a streamlined surgical process, resulting in shorter operative times. Dr. Link shares video of the process and includes practical tips for optimizing this approach.

Results of the PRIME Trial Biparametric Versus Multiparametric MRI for Prostate Cancer Detection – Impli

Posted by Veeru Kasivisvanathan, MBBS, BSc, FRCS, PhD, MSc, PGCert | Dec 2024

Veeru Kasivisvanathan, MBBS, BSc, FRCS, PhD, MSc, PGCert, shares results from the PRIME study, which explores the potential of biparametric MRI (bpMRI) as a non-inferior alternative to multiparametric MRI (mpMRI) for diagnosing clinically significant prostate cancer. In this 14-minute presentation, Dr. Kasivisvanathan shares that the results demonstrate that bpMRI detects clinically significant cancers at rates comparable to mpMRI, with no significant differences in false-positive rates or biopsy recommendations. Quality control analyses confirmed that imaging quality was critical, with optimization efforts ensuring high diagnostic reliability across centers.

The study concludes that bpMRI is a viable, cost-effective alternative for primary prostate cancer diagnosis, offering broader access without compromising clinical outcomes. The adoption of bpMRI as the new standard of care has the potential to streamline diagnostics and expand access to advanced prostate imaging globally.

Year in Review: Emerging Data and Advances in Prostate Cancer Screening

Posted by Sigrid V. Carlsson, MD, PhD, MPH | Dec 2024

Sigrid Carlsson, MD, PhD, MPH, reviews groundbreaking advancements in prostate cancer screening and data from the past year. In this 9-minute presentation, Carlsson highlights the Swedish Berg trial, which showed a 30% reduction in prostate cancer mortality with regular PSA screening, while data from the UK CAP trial confirm that even a single PSA test reduces mortality. She stresses the utility of PSA as the strongest prognostic marker for lethal prostate cancer, with guidelines evolving to recommend tailored screening for high-risk groups like Black men.

Carlsson also shares that advances in MRI have proven pivotal. She references recent trials that underscore the efficacy of MRI-targeted biopsy in minimizing overdiagnosis. Innovations in AI for MRI interpretation promise to improve equity and diagnostic accuracy.

Dr. Carlssson shares that active surveillance is the standard for managing low-risk cancers and addressing concerns about overdiagnosis. Together, these developments mark a transformative year in personalized and effective prostate cancer screening.