Pierluigi Bove, MD, presented “Preoperative Nightmares In Urology: Patients Who Have Undergone Multiple Procedures” during the 44th Annual Ralph E. Hopkins Urology Seminar on February 8, 2025, in Jackson Hole, Wyoming.
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How to cite: Bove, Pierluigi. “Preoperative Nightmares In Urology: Patients Who Have Undergone Multiple Procedures.” February 8, 2025. Accessed Apr 2025. https://grandroundsinurology.com/preoperative-nightmares-in-urology-patients-who-have-undergone-multiple-procedures/
Preoperative Nightmares In Urology: Patients Who Have Undergone Multiple Procedures – Summary
Pierluigi Bove, MD, explores the complexities of performing major urologic surgery in patients with a history of multiple previous procedures. In this 20-minute presentation, Dr. Bove emphasizes the unique challenges of altered anatomy, adhesions, and higher complication risks.
Dr. Bove highlights the lack of a standardized scoring system to assess surgical difficulty in patients with prior procedures, with only the Hostile Abdominal Index from general surgery providing some guidance. He presents a personal framework for assessing risk, including the number, type, and location of prior surgeries, the presence of complications, and whether prior procedures were in-field or out-of-field relative to the planned surgery.
Dr. Bove shares three complex cases, with video of his modified procedures, to demonstrate the need for adaptability in surgical strategy. He underscores that prior surgery does not necessarily preclude complex procedures but necessitates careful preoperative assessment and intraoperative flexibility. He emphasizes the importance of experienced surgical judgment, the ability to modify approaches as needed, and the need for improved preoperative risk stratification tools. Despite challenges, meticulous surgical planning, adherence to oncological principles, and real-time adaptability enable successful outcomes in these high-risk patients.
About The 44th Annual Ralph E. Hopkins Urology Seminar:
The Ralph E. Hopkins Urology Seminar is a multi-day meeting focused on training urologists in the latest in assessing, diagnosing, and treating urologic conditions in the clinical setting. Updates are provided on urologic cancers, stone disease, urologic reconstruction, female urology, infertility, sexual function, emerging surgical techniques, and general urology. The 44th iteration of the meeting took place from February 5th to February 8th, 2025, in Jackson Hole, Wyoming.
For further educational activities from this conference, visit our collection page.
ABOUT THE AUTHOR
Pierluigi Bove, MD, is an associate professor of urology at the Tor Vergata University of Rome in Italy. He graduated from the Tor Vergata University of Rome in medicine and surgery and earned a post-graduate degree in urology. Dr. Bove completed a research fellowship under Prof. Louis R. Kavoussi at the Johns Hopkins University School of Medicine’s James Buchanan Brady Urological Institute in Baltimore, Maryland. He completed a surgical fellowship under Prof. Fernando J. Kim at the University of Colorado Denver and a masterclass in laparoscopic radical prostatectomy under Prof. Guy Vallancien at the Université René Descartes in Paris, France. Dr. Bove earned a Second Level Master’s Degree in andrology at the University of Pisa in Italy and is qualified as a console surgeon for the da Vinci® surgical system.
Dr. Bove is a member of several scientific societies, including Società Italiana di Urologia (SIU), European Association of Urology (EAU), Italian Endourology Association (IEA) and Italian Group for Advanced Laparo-Endoscopic and Robotic Urologic Surgery (AGILE). He is author and co-author of approximately 150 scientific publications (H-index 28, www.scopus.com, last update October 2023); furthermore, he is the principal investigator for several scientific studies. He is a member of the scientific board of Associazione Italiana di Endourologia (IEA), Italian Group for Advanced Laparo‐Endoscopic Surgery (AGILE), Torvergata Oncoscience Research (TOR) group, Surgical Advisory Board Boston Scientific – Benign Prostatic Hyperplasia, and several multicentric research groups. Dr. Bove has performed over 4,500 major urological surgery procedures as first operator, primarily with a minimally invasive approach (pure laparoscopic or robot-assisted).
