Live surgery in reconstructive urology: evaluation of the surgical outcome and educational benefit of the international meeting on reconstructive urology (IMORU)

Abstract

Purpose

The international meeting on reconstructive Urology (IMORU) is a live surgery event (LSE) where expert surgeons perform various reconstructive surgeries. To evaluate patient safety, an extended follow-up of the complications of two subsequent IMORU meetings were gathered. Also, a detailed survey concerning the participant’s assessment of the educational benefit was performed.

Methods

All patients that were operated during the IMORU V and VI were included. Primary endpoint was the analysis of complications. Outcome was reviewed 36 months postoperatively via telephone survey and clinical database assessment, registrating any complications. At IMORU VII all participants were able to participate in a survey using a standardized, not-validated questionnaire concerning the learning effect and the quality of the surgeries.

Results

57 operations by 32 different surgeons were reviewed. The total number of any complications (peri- or postoperative) was n = 9 (15.8%) with three major complications. Four (7%) perioperative complications and five (8.8%) postoperative complications were noted. The Charlson score proved to be the only significant recorded predictor of the incidence of any complication (p = 0.019; univariate logistic regression analysis). Participant survey showed that the surgeons, surgical technique, and surgical presentation were perceived as excellent. Improvement of knowledge and of the surgical armamentarium both received positive ratings.

Conclusions

This is to our knowledge the first follow-up of LSE in the field of reconstructive urology. Rate of complications in general was acceptable. The performed survey showed participants value the quality and the educational benefit. Further studies are needed to improve learning possibilities.

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Abbreviations

LSE:

Live surgery event

LBS:

Live broadcasted surgeries

IMORU:

International meeting on reconstructive urology

EAU:

European Association of Urology

AAGUS:

American Association of Genitourinary Surgeons

UKE:

University Medical Center Hamburg-Eppendorf

References

  1. 1.

    Artibani W, Ficarra V, Challacombe BJ et al (2014) EAU policy on live surgery events. Eur Urol 66:87

    Article  Google Scholar 

  2. 2.

    Sade RM, American Association for Thoracic Surgery Ethics C, Society of Thoracic Surgeons S et al (2008) Broadcast of surgical procedures as a teaching instrument in cardiothoracic surgery. J Thorac Cardiovasc Surg 136:273

    Article  Google Scholar 

  3. 3.

    Smith A (2012) Urological live surgery—an anathema. BJU Int 110:299

    Article  Google Scholar 

  4. 4.

    Mullins JK, Borofsky MS, Allaf ME et al (2012) Live robotic surgery: are outcomes compromised? Urology 80:602

    Article  Google Scholar 

  5. 5.

    Rocco B, Grasso AAC, De Lorenzis E et al (2018) Live surgery: highly educational or harmful? World J Urol 36:171

    CAS  Article  Google Scholar 

  6. 6.

    Elsamra SE, Fakhoury M, Motato H et al (2014) The surgical spectacle: a survey of urologists viewing live case demonstrations. BJU Int 113:674

    Article  Google Scholar 

  7. 7.

    Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205

    Article  Google Scholar 

  8. 8.

    Legemate JD, Zanetti SP, Baard J et al (2017) Outcome from 5-year live surgical demonstrations in urinary stone treatment: are outcomes compromised? World J Urol 35:1745

    Article  Google Scholar 

  9. 9.

    Ogaya-Pinies G, Abdul-Muhsin H, Palayapalayam-Ganapathi H et al (2017) Safety of live robotic surgery: results from a single institution. Eur Urol Focus. https://doi.org/10.1016/j.euf.2017.08.004

    Article  Google Scholar 

  10. 10.

    Al-Qudah HS, Santucci RA (2005) Extended complications of urethroplasty. Int Braz J Urol 31:315

    Article  Google Scholar 

  11. 11.

    Lacy JM, Madden-Fuentes RJ, Dugan A et al (2018) Short-term complication rates following anterior urethroplasty: an analysis of national surgical quality improvement program data. Urology 111:197

    Article  Google Scholar 

  12. 12.

    Mori R, Wood H, Angermeier K (2014) Multistage buccal mucosa graft urethroplasty for complex anterior urethral strictures. J Urol 191:e19

    Google Scholar 

  13. 13.

    Salami SS, Elsamra SE, Motato H et al (2014) Performing in the surgical amphitheater of today: perception of urologists conducting live case demonstrations. J Endourol 28:1121

    Article  Google Scholar 

  14. 14.

    Philip-Watson J, Khan SA, Hadjipavlou M et al (2014) Live surgery at conferences—clinical benefits and ethical dilemmas. Arab J Urol 12:183

    Article  Google Scholar 

  15. 15.

    Duty B, Okhunov Z, Friedlander J et al (2012) Live surgical demonstrations: an old, but increasingly controversial practice. Urology 79(1185):e7

    Google Scholar 

  16. 16.

    Khan SA, Chang RT, Ahmed K et al (2014) Live surgical education: a perspective from the surgeons who perform it. BJU Int 114:151

    Article  Google Scholar 

  17. 17.

    Finch W, Masood J, Buchholz N et al (2015) Would you want to be the patient? “Live Surgical Broadcast” or “As-Live Unedited Surgical Broadcast”. J Endourol 29:821

    Article  Google Scholar 

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Acknowledgements

Parts of this study were presented at AUA 2016.

Funding

This study was not funded in any way.

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Affiliations

Authors

Contributions

VMS: data collection and management, data analysis, and manuscript writing/editing. JS: data collection and manuscript writing/editing. CMR: manuscript writing/editing. TAL: manuscript writing/editing. MWV: manuscript writing/editing. S-RL-B: manuscript writing/editing. VM: manuscript writing/editing. CPM: manuscript writing/editing. RD: manuscript writing/editing. MF: manuscript writing/editing. C-PR: data analysis and manuscript writing/editing

Corresponding author

Correspondence to Victor M. Schuettfort.

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Conflict of interest

All authors have nothing to disclose. The authors declare that they have no conflict of interest. While the IMORU meeting itself was sponsored by different companies, none of the authors received any kind of compensation.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Human and animal rights

This article does not contain any studies with animals performed by any of the authors.

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Schuettfort, V.M., Schoof, J., Rosenbaum, C.M. et al. Live surgery in reconstructive urology: evaluation of the surgical outcome and educational benefit of the international meeting on reconstructive urology (IMORU). World J Urol 37, 2533–2539 (2019). https://doi.org/10.1007/s00345-019-02666-1

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Keywords

  • Live surgery events
  • Surgical education
  • IMORU
  • Reconstructive urology