Urology boot camp for medical students: Using virtual technology to enhance undergraduate education.

Objectives: The study aims to describe the methodology of converting the urology boot camp for medical students into a virtual course with key take home points for a successful conversion and to present quantitative and qualitative data demonstrating the impact of the boot camp on improving delegates' knowledge and clinical acumen. Materials and methods: The face-to-face boot camp was converted to a virtual format employing a variety of techniques including; utilizing an online platform to deliver live screened lectures, using online polling software to foster an interactive learning environment and displaying pre-recorded videos to teach practical skills. Validated Multiple Choice Questionnaires (MCQs) were used prior to and after the course. This enabled the assessment of delegates' knowledge of urology according to the national undergraduate curriculum, and paired t tests were used to quantify the level of improvement. Thematic analysis was carried out on post-course delegate feedback to identify highlights of the course and ways of improving future iterations. Results: In total, 131 delegates took part in the pilot virtual course. Of these, 105 delegates completed the pre- and post-course MCQs. There was a statistically significant improvement in the assessment following the course (p = <0.001) with mean score increasing from 47.5% pre-course to 65.8% post-course. All delegates who attended the most recent implementation of the virtual course (n = 31) felt it improved their knowledge and confidence in urology. Twenty delegates (64.5%) felt that it prepared them for both final year medical school examinations and working as a foundation year doctor. Positive themes in feedback were identified, which included the interactive nature of the course, the quality of teaching, the level and content of information provided and the high yield, concise organization of the teaching schedule. Conclusion: Using virtual technology and innovative educational frameworks, we have demonstrated the successful conversion of the urology boot camp for medical students to a virtual format. At a national level, with support from the British Association of Urological Surgeons, the face-to-face component of the course will continue to run in parallel with the virtual course with the aim of standardizing and improving UK undergraduate urological education. The virtual course has been implemented on an international scale, and this has already shown promising results.

14F Super-Mini Percutaneous Cystolitholapaxy: A Novel Technique in the Treatment of Bladder Stones.

Introduction: This single-center experience describes the indications, novel technique, and outcomes of performing 14F super-mini percutaneous cystolitholapaxy (14F-SMPCCL). Materials and Methods: Cases between 2019 and 2022 were retrospectively identified with surgical outcomes recorded. Using percutaneous access to the bladder, an endoscope was inserted through the ClearPetra 14F super-mini sheath and laser lithotripsy completed with stone fragments suctioned out. Results: Sixteen cases were included in the study and all patients were adults. Average conglomerate stone size was 28.1 mm (range = 10-50 mm). Average operative time was 60.0 minutes (range = 23-110 minutes). Visual stone-free rate was 91.7%, radiologic stone-free rate was 81.3%, and average postoperative length of stay was 1 day. One patient developed urosepsis postoperatively and there were no other complications. Conclusion: The novel technique of 14F-SMPCCL is safe and feasible for treating large burdens of bladder stones with a conglomerate size of ∼2.5 to 5 cm. Active suction allows for efficient removal of stone fragments.

Comparing robotic, laparoscopic and open cystectomy: a systematic review and meta-analysis.

OBJECTIVE: To conduct a systematic review and meta-analysis comparing outcomes between Open Radical Cystectomy (ORC), Laparoscopic Radical Cystectomy (LRC) and Robot-assisted Radical Cystectomy (RARC). RARC is to be compared to LRC and ORC and LRC compared to ORC. MATERIAL AND METHODS: A systematic review of the literature was conducted, collating studies comparing RARC, LRC and ORC. Surgical and oncological outcome data were extracted and a meta-analysis was performed. RESULTS: Twenty-four studies were selected with total of 2,104 cases analyzed. RARC had a longer operative time (OPT) compared to LRC with no statistical difference between length of stay (LOS) and estimated blood loss (EBL). RARC had a significantly shorter LOS, reduced EBL, lower complication rate and longer OPT compared to ORC. There were no significant differences regarding lymph node yield (LNY) and positive surgical margins (PSM.) LRC had a reduced EBL, shorter LOS and increased OPT compared to ORC. There was no significant difference regarding LNY. CONCLUSION: RARC is comparable to LRC with better surgical results than ORC. LRC has better surgical outcomes than ORC. With the unique technological features of the robotic surgical system and increasing trend of intra-corporeal reconstruction it is likely that RARC will become the surgical option of choice.