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      Feasibility of a telementoring approach as a practical training for transurethral enucleation of the benign prostatic hyperplasia using bipolar energy: a pilot study

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          Abstract

          Introduction

          Telementoring is one of the applications of telemedicine capable of bringing highly experienced surgeons to areas lacking expertise. In the current study, we aimed to assess a novel telementoring application during the learning curve of transurethral enucleation of the prostate using bipolar energy (TUEB).

          Material and methods

          A telementoring system was developed by our engineering department. This application was used to mentor ten prospective cases of TUEB performed by an expert endourologist (novice to the TUEB). A questionnaire was filled by the operating surgeon and the mentor to provide subjective evaluation of the telementoring system. Finally, the outcomes of these patients were compared to a control group consisting of ten consecutive patients performed by the mentor.

          Results

          Ten consecutive TUEB were performed using this telementoring application. Delayed and interrupted connection were experienced in two and one patients, respectively; however, their effect was minor, and they did not compromise the safety of the procedure. None of the patients required conversion to conventional transurethral resection of the prostate. Only one patient in our series experienced grade IIIb complication.

          Conclusion

          The telementoring application for TUEB is promising. It is a simple and low-cost tool that could be a feasible option to ensure patients’ safety during the initial phase of the learning curve without time and locations constraints for both the mentor and the trainee; However, it should be mentioned that telementoring cannot yet replace the traditional surgical training with the mentor and trainee being in the operative room. Further studies are required to confirm the current results

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s00345-021-03594-9.

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          Most cited references34

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          Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey.

          Although quality assessment is gaining increasing attention, there is still no consensus on how to define and grade postoperative complications. This shortcoming hampers comparison of outcome data among different centers and therapies and over time. A classification of complications published by one of the authors in 1992 was critically re-evaluated and modified to increase its accuracy and its acceptability in the surgical community. Modifications mainly focused on the manner of reporting life-threatening and permanently disabling complications. The new grading system still mostly relies on the therapy used to treat the complication. The classification was tested in a cohort of 6336 patients who underwent elective general surgery at our institution. The reproducibility and personal judgment of the classification were evaluated through an international survey with 2 questionnaires sent to 10 surgical centers worldwide. The new ranking system significantly correlated with complexity of surgery (P < 0.0001) as well as with the length of the hospital stay (P < 0.0001). A total of 144 surgeons from 10 different centers around the world and at different levels of training returned the survey. Ninety percent of the case presentations were correctly graded. The classification was considered to be simple (92% of the respondents), reproducible (91%), logical (92%), useful (90%), and comprehensive (89%). The answers of both questionnaires were not dependent on the origin of the reply and the level of training of the surgeons. The new complication classification appears reliable and may represent a compelling tool for quality assessment in surgery in all parts of the world.
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            COVID-19 and Urology: A Comprehensive Review of the Literature

            To discuss the impact of COVID-19 on global health, particularly on urological practice and to review some of the available recommendations reported in the literature.
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              5G‐assisted telementored surgery

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                Author and article information

                Contributors
                Salvatore.micali@unimore.it
                Journal
                World J Urol
                World J Urol
                World Journal of Urology
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                0724-4983
                1433-8726
                4 February 2021
                : 1-7
                Affiliations
                [1 ]GRID grid.7548.e, ISNI 0000000121697570, Department of Urology, , University of Modena and Reggio Emilia, ; Via del Pozzo, 71, 41124 Modena, Italy
                [2 ]ORSI Academy, Melle, Belgium
                [3 ]GRID grid.412258.8, ISNI 0000 0000 9477 7793, Urology Department, Faculty of Medicine, , Tanta University, ; Tanta, Egypt
                [4 ]GRID grid.416672.0, ISNI 0000 0004 0644 9757, Department of Urology, , Onze Lieve Vrouw Hospital, ; Aalst, Belgium
                [5 ]GRID grid.7548.e, ISNI 0000000121697570, Department of Sciences and Methods for Engineering (DISMI), , University of Modena and Reggio Emilia, ; Reggio Emilia, Italy
                [6 ]Maria Degli Angeli Hospital, Azienda ULSS 5 Polesana, Adria, Italy
                [7 ]GRID grid.11696.39, ISNI 0000 0004 1937 0351, Department of Psychology and Cognitive Sciences, , University of Trento, ; Royereto, Italy
                Article
                3594
                10.1007/s00345-021-03594-9
                7859466
                33538866
                7fbf6515-1d26-45ea-95a6-aa6e884eadcf
                © The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature 2021

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 26 February 2020
                : 8 January 2021
                Categories
                Original Article

                Urology
                telementoring,telemedicine,learning curve,benign prostatic hyperplasia
                Urology
                telementoring, telemedicine, learning curve, benign prostatic hyperplasia

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