2nd ESU-ESUT Masterclass on Operative Management of BPO A focussed and intensive masterclass Dr. Jan-Thorsten Klein Universitätsklinikum Ulm Dept. of Urology & Pediatric Urology Ulm (DE) jan-thorsten.klein@ uniklinik-ulm.de
The 2nd ESU-ESUT Masterclass on Operative Management of Benign Prostate Obstruction (BPO) took place in Heilbronn, Germany last May 19 and 20 and attracted 40 participants from across Europe. The format of the one-a-half-day Masterclass course was launched last year and is now an annual event attracting 40 mostly young urologists in the beginning of their surgical careers as well as urologists who are specialising in the endourological treatment of the prostate. Day 1 was focussed on surgical therapy strategies of BPO including live-surgeries via OR transmissions, semi-live cases and dedicated lectures on the theoretical background. A busy schedule for a whole day began with a short welcome by Evangelos Liatsikos, chairman of the ESUT and Jens Rassweiler, chairman of the EAU Section Office. Thereafter, the first surgeries were transmitted showing bipolar prostate resection techniques. During the surgeries, the surgeons had the opportunity to show the main aspects of their surgical strategies and answer questions from the audience and the moderators. After the first surgical session the first part of the expert theory took place, covering the whole range of indications for surgery, such as: guidelines on BPO, how to choose the correct therapy method and understanding the surgical anatomy of the prostate. After the lectures and a short break, Part 2 of the live transmissions started. This session focussed on the monopolar management of BPO and the green light laser vaporisation of the prostate using a high power laser energy. Both surgeries showed exactly how to handle the instruments und devices to achieve excellent surgical results. The second expert theory session included lectures about irrigation solutions and lubricants in the different endoscopic BPO treatments, the principles of HF-surgery and a further discussion on what instruments to use. In the meantime the patients in the OR were changed and the third live surgery session started. This time enucleation
techniques were highlighted. The techniques of TURis enucleation and bipolar enucleation of the prostate were demonstrated. Thereafter, as the newly introduced component of surgical education, semi-live cases were presented and discussed with the surgeons. Among the issues taken up were the crucial steps of laparoscopic adenomectomy and roboticassisted adenomectomy, and green-light enucleation of the prostate were shown. Discussions with the audience and the moderators showed a growing interest in minimal invasive surgical strategies even in big prostate adenomas. Prostate enucleation techniques The fourth live session covered prostate enucleation techniques using either holmium- or thulium-lasers. These techniques were previously considered as ‘newcomers’ but are nowadays standard procedure in many centres. The type of technique, whether single-lobe, dual or triple lobe techniques, were intensively discussed.
For the second time, a highly intensive Masterclass workshop on surgical management of BPO ended with fully satisfied participants.
Below is a list of participating surgeons and the surgical procedures in the live surgeries: • Bipolar Resection T. Knoll, Sindelfingen (DE) • Bipolar TURIS A.G. Martov, Moscow (RU) • Thulium laser enucleation of the prostate C. Netsch, Hamburg (DE) • Holmium laser enucleation with high energy S. Piesche, Hof (DE) • TURIS Enucleation of the prostate J. Rassler, Leipzig (DE) • Bipolar enucleation of the prostate T. Herrmann, Hannover (DE) • Monoploar Resection of the prostate V. Pansadoro, Rome (IT) • Greenlight laser vaporisation A. Bachmann, Basel (CH) • TUR-B with PDD system blue J. Rassweiler, Heilbronn (DE)
Session moderators interact with surgeons and the audience
Live surgeries are transmitted to the lecture hall
the hands-on training, the group was divided into sub-groups and rotated through the different work stations. The training facility was equipped with different VR-Trainers and TURSimulators using different models. The subgroups of trainees rotated every 20 minutes. This included also four Meet-theExpert roundtable work stations, which focussed on resection techniques (shown through videos), catheters, instruments and technical devices and the handling of the instruments. Every group was trained intensively. After 3.5 hours of concentrated training, the event ended with the debriefing and a final discussion round.
"Every group was trained intensively. After 3.5 hours of concentrated training, the event ended with the debriefing and a final discussion round." The last expert lecture session included future technical developments and gadgets. The BPO will be surgically managed with high-pressure water streams, steam and other technical devices for tissue ablation and/or temporary symptom relief. At the end of Day 1, the TUR-B resection technique with support of a new PDDSystem was demonstrated. This strengthened once again the rapid evolution of endoscopic armamentarium in endourology. In the evening, after a full day covering all aspects on surgical management of BPO, the surgeons and participants met for discussion of the eventful day. The participants and the surgeons had a good night. The patients from the live surgery had a good night as well. There were no revisions or major bleedings. The ward round the following day showed no significant problems, which reflected the excellent results. Day 2 included a full workshop on 7 workstations including different TUR models and a mentored training approach. After a short clinical report on the cases of the previous day, including showing photographs of the patients’ urine bags and a briefing on the organisation of
Lectures provide theorectical background to the surgical cases
Teaching activities 2017 European School of Urology July 9-15
November ESU – Weill Cornell Masterclass in General urology, Salzburg (AT)
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September
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16-19
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15th European Urology Residents Education Programme (EUREP), Prague (CZ) ESU-ERUS courses at the 15th Meeting of the EAU Robotic Urology Section (ERUS), Bruges (BE) ESU course on Recent developments in diagnosis and treatment of stone disease at the Urological Section of Serbian Medical Society, Belgrade (RS)
October 12 12 12-13 13 17 19
June/July 2017
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December 2
ESU course on The management of small renal masses at the national congress of the Tunisian Urological Society, Hammamet (TN) ESU course on Clinical and histopathological basics in bladder cancer: unmet needs at the 24th Meeting of the EAU Section of Urological Research (ESUR), Paris (FR) 10th ESU-ESFFU Masterclass on Female and functional reconstructive urology at the European Lower Urinary Tract Symptoms meeting (ELUTS17), Berlin (DE) ESU course on Update on Uro-oncology at the national congress of the Turkish Association of Urology, Girne (CY) 4th Confederación Americana de Urologia Residents Education Programme (CAUREP), Santa Cruz (BO) ESU course on Diagnosis and management of complications after radical cystectomy at the national congress of the Czech Urological Society, Pilzen (CZ)
ESU course on The current role of laparoscopy in urology at the national congress of the Scientific Society of Urologists of Uzbekistan, Tashkent (UZ) ESU course Management of surgical complications in urology at the national congress of the Russian Society of Urology, Moscow (RU) ESU courses on Bladder and Kidney cancer at the 9th European Multidisciplinary Meeting in Urological Cancers (EMUC), Barcelona (ES) 4th ESU-ESUT Masterclass on Lasers in urology, Barcelona (ES)
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ESU course on Metastatic and castrate resistant prostate cancer at the national congress of the Georgian Association of Urology, Tbilisi (GE) ESU course on Erectile dysfunction at the national congress of the Egyptian Association of Urology, Cairo (EG) 2nd ESU-ESUT Masterclass on Focal therapy for localised prostate cancer, Paris (FR) ESU course on Bladder cancer and endoscopic stone management: 2017 update, at the national congress of the Algerian Association of Urology, Algiers (DZ)
Contact: esu@uroweb.org
European Urology Today
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