Five historical innovations that have shaped modern urological surgery.

Throughout history, many innovations have contributed to the development of modern urological surgery, improving patient outcomes and expanding the range of treatment options available to patients. This article explores five key historical innovations that have shaped modern urological surgery: External shockwave lithotripsy, transurethral resection of prostate, cystoscope, perioperative prostate-specific antigen and robotic surgery. The selection of innovations for inclusion in this article was meticulously determined through expert consensus and an extensive literature review. We will review the development, impact and significance of each innovation, highlighting their contributions to the field of urological surgery and their ongoing relevance in contemporary and perioperative practice.

Future Platforms of Robotic Surgery.

Among the various robotic devices that exist for urologic surgery, the most common are synergistic telemanipulator systems. Several have achieved clinical feasibility and have been licensed for use in humans: the standard da Vinci, Avatera, Hinotori, Revo-i, Senhance, Versius, and Surgenius. Handheld and hands-on synergistic systems are also clinically relevant for use in urologic surgeries, including minimally invasive and endoscopic approaches. Future trends of robotic innovation include an exploration of more robust haptic systems that offer kinesthetic and tactile feedback; miniaturization and microrobotics; enhanced visual feedback with greater magnification and higher fidelity detail; and autonomous robots.

First surgical care of Mexican children in the nineteenth century.

Here, two papers are presented, which constitute the first reports of surgical procedures in Mexican children performed at the 19th century. The two publications refer to surgical operations for the extraction of bladder stones. At that time, there was no anesthesia, so part of the description alludes to the suffering of the patients and the operative difficulties. The first case, is referred to as a lithotomy in a 17-year-old girl, performed by surgeon José Victoriano Guerrero in Guadalajara in 1822. The publication is not an academic report, but a pamphlet written as a gift to Emperor Augustin I to celebrate his ascension to the throne. The second work, is a lateral lithotomy in a 5-year-old boy, published by Dr. Luis Jecker in the first issue of the Periódico de la Academia de Medicina de Mégico in 1836.

Se presentan dos trabajos que constituyen los primeros informes de procedimientos quirúrgicos en niños mexicanos en el siglo XIX. Las dos publicaciones se refieren a operaciones para la extracción de cálculos vesicales. En ese tiempo no existía anestesia, por lo que parte de la descripción incluye el sufrimiento de los pacientes y las dificultades operatorias. El primer caso está referido como una litotomía en una joven de 17 años, operada por el cirujano José Victoriano Guerrero en Guadalajara en 1822. La publicación no constituye un informe académico, sino un folleto escrito como un obsequio para el emperador Agustín I para celebrar su ascensión al trono. El segundo trabajo es una talla lateral en un niño de 5 años edad, publicado por el doctor Luis Jecker en el primer número del Periódico de la Academia de Medicina de Mégico en 1836.

What Is Moses Effect: A Historical Perspective.

Introduction and Objectives: The Moses effect (ME) was described >30 years ago during normal laser functioning in a fluid medium. Recently, a laser device equipped with a pulse-modulating system called Moses™ technology (MT; Lumenis®) was marketed for both stone lithotripsy and prostate endoscopic surgery. We aimed to perform a literature revision of ME from a historical perspective up until its present-day applications. Evidence Acquisition: A search of Medline, PubMed, and Scopus was performed to identify articles published in English within the past 30 years addressing both ME and MT in relation to their urologic applications. Relevant studies were then screened, and the data were extracted, analyzed, and summarized. The preferred reporting items for systematic reviews and meta-analysis criteria were applied. Results: ME was first described in 1986 during endovascular laser tissue ablation. During the late 1980s and the early 1990s, the interest raised around ME led to its characterization and better definition. Despite this initial interest, ME gradually disappeared from the focus of researchers and clinicians. In 2017, MT was launched on the market, although postmarketing comparative efficacy and safety data are lacking. Conclusions: Although ME had been described and characterized during normal laser functioning >30 years ago, only very recently it began to regain some consideration after the marketing of MT, whose clinical outcomes are still awaited.

Uretrotomía interna 'tipo Maisonneuve' / Maisonneuve type internal urethrotomy

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Prohibición de la litotomía y derivación a expertos en los juramentos médicos de la genealogía hipocrática / Lithotomy's prohibition and referral to experts in medical oaths of hippocratic stemma

Objetivo: Analizar cómo el compromiso del juramento hipocrático de no usar el cuchillo en quienes tienen cálculos y derivar a estos pacientes a expertos fue modificado en juramentos médicos de la genealogía (stemma) hipocrática de diferentes épocas. Métodos: Diecinueve juramentos de stemma hipocrática fueron estudiados: 4 medievales, 2 modernos y 13 contemporáneos. Los juramentos fueron seleccionados de acuerdo con el nombre de los mismos cuando incluían el término «hipocrático» o porque sus autores reconocieron haberse basado en el juramento hipocrático. También se tuvo en cuenta la significación y representatividad en relación con el período histórico, escuelas médicas de renombre, importancia y confiablidad de las fuentes. Resultados: Cuatro juramentos prohíben operar el cálculo (uno medieval, 2 modernos, uno contemporáneo); 4 juramentos mencionan buscar consejo en relación con pacientes (contemporáneos), 3 hacen referencia a no realizar operaciones criminales (contemporáneos); 8 no hacen mención a estos compromisos (3 medievales, 5 contemporáneos). Conclusión: El compromiso del juramento hipocrático de no usar el cuchillo en quienes tienen cálculos y derivarlos a expertos ha sido modificado principalmente en los juramentos contemporáneos. La prohibición original parece haberse dividido en 2 tendencias: aquellos juramentos que mencionan el pedir consejo, y aquellos que refieren no realizar operaciones criminales. Debido al movimiento bioético de la segunda mitad del siglo XX, derivar a colegas más idóneos a aquellos pacientes que exceden las limitaciones del médico constituye una obligación ética. Por lo tanto, es un compromiso que debería estar presente en todos los juramentos contemporáneos

Objective: The aim is to analyse how the Hippocratic Oath's commitments of not cutting for stone and referral to experts was modified in medical oaths of Hippocratic stemma from different time periods. Methods: Nineteen oaths of Hippocratic stemma were studied: 4 Medieval, 2 Modern, and 13 Contemporary. They were selected according to: name of the oath when it includes the word «Hippocratic» or because their authors recognized having based their oaths on the Hippocratic Oath. Their historical significance and representativity regarding time period, renowned medical schools, and importance and reliability of the sources was also taken into consideration. Results: Four oaths prohibit cutting for stone (one Medieval, 2 Modern, one Contemporary); 4 oaths mention seeking consultation about patients (all Contemporary); 3 mention not performing criminal operations (all Contemporary); 8 do not mention these commitments (3 Medieval, 5 Contemporary). Conclusion: The commitment of the Hippocratic Oath of not cutting for stone and referral to experts has been modified mainly in Contemporary oaths. The original commitment seems to have been split into 2 tendencies: those that mention obtaining consultation, and those that refer to not performing criminal operations. Due to the bioethics movement in the second half of the 20th century, referring patients that exceed the physician's limitations to more skilled colleagues constitutes an ethical obligation. Thus, it should be a commitment present in every Contemporary oath

[From "Karzinos" to modern urologic oncology : A long way from the first surgical procedures to targeted therapy]. / Von "Karzinos" zur modernen Uroonkologie : Der lange Weg von den ersten Operationen zur "targeted therapy".

Cancer can be traced back to the Iron Age. Both the ancient Egyptians and Hippocrates dealt with the disease. Urological tumor treatment is an integral part of urology and has undergone interesting developments. Today, it comprises all possible forms of treatment-from radical surgery to the most modern radiological therapies, including antihormal therapy, chemotherapy, and modern targeted therapy.

Charriere's scale.

The writer explains the origin of the scale measuring the external diameter of different types of bougies, catheter or probes. That scale has turned out to be an essential tool for the best of several specialities created in the 19th century, namely urology. An instrument maker close to the surgeons whose ideas he would quickly grasp, Joseph F. B. Charriere, proposed a scale with thirty holes that would make it possible to get external gauge of the third of a millimetre. Several people tried to imitate his device but his scale was eventually recognized as the most efficient one all over Europe, accepted even by the British and then the Americans. Its usefullness goes on to this day as the French scale has become universal together with the unit that it entails, the Charrire unit, which is still the reference to measure all the diameters used by surgeons and doctors.