Getting ready for the first robotic prostatectomy, from basics to real practice.

PURPOSE OF REVIEW: Robot-assisted radical prostatectomy (RARP) has been embraced by urologists and has become a treatment standard in many countries already. Learning how to perform a RARP is challenging and has not yet been standardized. The current review summarizes the latest concepts regarding the most effective way of training for RARP. RECENT FINDINGS: The strategy to learn RARP should comprise didactic activities, skills lab training, participating in surgeries and mentorship. Skills lab and virtual simulators are valuable tools to develop manual abilities and to overcome the initial technical learning curve. Participating in surgeries is crucial for familiarization with the robot installation, steps of the surgical procedure and is essential for troubleshooting. Mentorship improves learning and is the safest way to initiate real practice. Innate and individual background variances were suggested to influence the learning process; however, there is paucity of robust evidence correlating previous surgical experience and, for example videogame playing with faster learning of RARP. Structured curricula were proposed to orient the training for robotic surgery; currently, only one is focused exclusively on urology. SUMMARY: Systematic training is the most effective way to learn and surpass the possibly intense learning curve of RARP. Training activities should focus on developing cognitive and manual abilities. The existing curricula for robotic surgery training still require constant refinement; however, they offer good and structured guidance to train for RARP.

Spontaneous formation of nanopatterns in velocity-dependent dip-coated organic films: from dragonflies to stripes.

We present an experimental study of the micro- and mesoscopic structure of thin films of medium length n-alkane molecules on the native oxide layer of a silicon surface, prepared by dip-coating in a n-C32H66/n-heptane solution. Electron micrographs reveal two distinct adsorption morphologies depending on the substrate withdrawal speed v. For small v, dragonfly-shaped molecular islands are observed. For a large v, stripes parallel to the withdrawal direction are observed. These have lengths of a few hundred micrometers and a few micrometer lateral separation. For a constant v, the stripes' quality and separation increase with the solution concentration. Grazing incidence X-ray diffraction and atomic force microscopy show that both patterns are 4.2 nm thick monolayers of fully extended, surface-normal-aligned alkane molecules. With increasing v, the surface coverage first decreases then increases for v > v(cr) ∼ 0.15 mm/s. The critical v(cr) marks a transition between the evaporation regime, where the solvent's meniscus remains at the bulk's surface, and the entrainment (Landau-Levich-Deryaguin) regime, where the solution is partially dragged by the substrate, covering the withdrawn substrate by a homogeneous film. The dragonflies are single crystals with habits determined by dendritic growth in prominent 2D crystalline directions of randomly seeded nuclei assumed to be quasi-hexagonal. The stripes' strong crystalline texture and the well-defined separation are due to an anisotropic 2D crystallization in narrow liquid fingers, which result from a Marangoni flow driven hydrodynamic instability in the evaporating dip-coated films, akin to the tears of wine phenomenology.