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Special Issue "Personalized Medicine in Minimally Invasive Urological Surgery"

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A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Methodology, Drug and Device Discovery".

Deadline for manuscript submissions: 10 February 2024 | Viewed by 2582

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Special Issue Editors

Prof. Dr. Costantino Leonardo

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Guest Editor

Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, 00185 Rome, Italy
Interests: bladder cancer; urology; robotic surgery

Dr. Antonio Tufano

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Guest Editor

Department of Maternal-Child and Urological Sciences, Policlinico Umberto I Hospital, Sapienza University Rome, 00162 Rome, Italy
Interests: Uro-oncology; Renal cancer; Urothelial cancer; Nephroureterectomy; Bladder cancer; Testis cancer; Penile cancer; Prostate cancer
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Special Issue Information

Dear Colleagues,

Modern medicine faces numerous challenges, including the tendency to swing between overtreatment and undertreatment. The challenge is striking the right balance between adequate treatment and avoiding harm. Thanks to innovations in technology and progress in our understanding of biology, personalized medicine offers a solution to this challenge by delivering the right therapy at the right time to the right patient. Personalized medicine takes into account individual differences in people’s characteristics to create a unique and effective treatment plan. This approach allows for more precise and targeted therapy, reducing the risk of overtreatment or undertreatment and improving patient outcomes.

This Special Issue of the Journal of Personalized Medicine is open to all minimally invasive surgical procedures for the treatment of either benign or malignant genitourinary diseases.

Prof. Dr. Costantino Leonardo
Dr. Antonio Tufano
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

minimally invasive surgery
personalized surgery
tailored surgery
robotic surgery
urology

Published Papers (4 papers)

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Research

11 pages, 568 KiB

Open AccessArticle

Laparoscopic versus Ultrasound-Guided Transversus Abdominis Plane Block for Postoperative Analgesia Management after Radical Prostatectomy: Results from a Single Center Study

Ester Maria Alba Forastiere

Alberto Ragusa

Francesco Tedesco

Salvatore Mario Prata

and

J. Pers. Med. 2023, 13(12), 1634; https://doi.org/10.3390/jpm13121634 - 23 Nov 2023

Viewed by 241

Abstract

(1) Background: Regional anesthesia, achieved through nerve blocks, has gained widespread acceptance as an effective pain management approach. This research aimed to evaluate the efficacy of laparoscopic (LAP) transversus abdominis plane (TAP) block in patients undergoing laparoscopic radical prostatectomy. (2) Methods: From January 2023 to July 2023, 60 consecutive patients undergoing minimally invasive radical prostatectomy were selected. Patients were split into two groups receiving ultrasound-guided (US) or laparoscopic-guided TAP block. The primary outcome was a pain score expressed by a 0−10 visual analog scale (VAS) during the first 72 h after surgery. (3) Results: Both LAP-TAP and US-TAP block groups were associated with lower pain scores postoperatively. No statistically significant differences were observed between the two groups in surgery time, blood loss, time to ambulation, length of stay, and pain after surgery (all p > 0.2). In the LAP-TAP block group, the overall operating room time was significantly shorter than in the US-TAP block group (140 vs. 152 min, p = 0.04). (4) Conclusions: The laparoscopic approach, compared to the US-TAP block, was equally safe and not inferior in reducing analgesic drug use postoperatively. Moreover, the intraoperative LAP-TAP block seems to be a time-sparing procedure that could be recommended when patient-controlled analgesia cannot be delivered. Full article

(This article belongs to the Special Issue Personalized Medicine in Minimally Invasive Urological Surgery)

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12 pages, 2969 KiB

Open AccessArticle

Three-Dimensional Customized Imaging Reconstruction for Urological Surgery: Diffusion and Role in Real-Life Practice from an International Survey

J. Pers. Med. 2023, 13(10), 1435; https://doi.org/10.3390/jpm13101435 - 26 Sep 2023

Viewed by 699

Abstract

Despite the arising interest in three-dimensional (3D) reconstruction models from 2D imaging, their diffusion and perception among urologists have been scarcely explored. The aim of the study is to report the results of an international survey investigating the use of such tools among urologists of different backgrounds and origins. Beyond demographics, the survey explored the degree to which 3D models are perceived to improve surgical outcomes, the procedures mostly making use of them, the settings in which those tools are mostly applied, the surgical steps benefiting from 3D reconstructions and future perspectives of improvement. One hundred responders fully completed the survey. All levels of expertise were allowed; more than half (53%) were first surgeons, and 59% had already completed their training. Their main application was partial nephrectomy (85%), followed by radical nephrectomy and radical prostatectomy. Three-dimensional models are mostly used for preoperative planning (75%), intraoperative consultation and tailoring. More than half recognized that 3D models may highly improve surgical outcomes. Despite their recognized usefulness, 77% of responders use 3D models in less than 25% of their major operations due to costs or the extra time taken to perform the reconstruction. Technical improvements and a higher availability of the 3D models will further increase their role in surgical and clinical daily practice. Full article

(This article belongs to the Special Issue Personalized Medicine in Minimally Invasive Urological Surgery)

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11 pages, 4640 KiB

Open AccessArticle

Robot-Assisted Renal Surgery with the New Hugo Ras System: Trocar Placement and Docking Settings

Salvatore Mario Prata

and

J. Pers. Med. 2023, 13(9), 1372; https://doi.org/10.3390/jpm13091372 - 13 Sep 2023

Cited by 1 | Viewed by 616

Abstract

The current literature relating to the novel Hugo^TM RAS System lacks consistent data concerning the bedside features of robot-assisted partial nephrectomy (RAPN). To describe the trocar placement and docking settings for RAPN with a three-arm configuration to streamline the procedure with Hugo^TM RAS, between October 2022 and April 2023, twenty-five consecutive off-clamp RAPNs for renal tumors with the Hugo^TM RAS System were performed. We conceived a trouble-free three-arm setting to ease and standardize RAPN trocar placement and docking settings with Hugo^TM RAS. Perioperative data were collected. Post-operative complications were reported according to the Clavien–Dindo classification. The eGFR was calculated according to the CKD–EPI formula. Continuous variables were presented as the median and IQR, while frequencies were reported as categorical variables. Off-clamp RAPNs were successfully performed in all cases without the need for conversion or additional port placement. The median age and BMI were 69 years (IQR, 60–73) and 27.3 kg/m² (IQR, 25.7–28.1), respectively. The median tumor size and R.E.N.A.L. score were 32.5 mm (IQR, 26–43.7) and 6 (IQR, 5–7), respectively. Two patients were affected by cT2 renal tumors. The median docking and console time were 5 (IQR, 5–6) and 90 min (IQR, 68–135.75 min), respectively, with slightly progressive improvements in the docking time achieved. No intraoperative complications occurred alongside clashes between instruments or with the bed assistant. In experienced hands, this simplified three-instrument configuration of the Hugo^TM RAS System for off-clamp RAPN resulted in feasible and safe practice, providing patient-tailored trocar placement and docking with non-inferior peri-perioperative outcomes to other robotic platforms. Full article

(This article belongs to the Special Issue Personalized Medicine in Minimally Invasive Urological Surgery)

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12 pages, 1496 KiB

Open AccessArticle

“Single Knot–Single Running Suture” Vesicourethral Anastomosis with Posterior Musculofascial Reconstruction during Robot-Assisted Radical Prostatectomy: A Step-by-Step Guide of Surgical Technique

and

J. Pers. Med. 2023, 13(7), 1072; https://doi.org/10.3390/jpm13071072 - 29 Jun 2023

Cited by 1 | Viewed by 721

Abstract

Background: Our aim is to describe Gallucci’s (VV-G) technique for vesicourethral anastomosis and posterior musculofascial reconstruction (PMFR) during robot-assisted radical prostatectomy (RARP) and to assess early urinary continence recovery and perioperative outcomes. VV-G consists of a “single knot–single running suture” vesicourethral anastomosis with PMFR. Methods: Between September 2019 and October 2021, we prospectively compared VV-G vs. conventional Van Velthoven anastomosis (VV-STD) during RARP. We excluded patients with urinary incontinence, pelvic radiotherapy, and urethral and BPH surgery prior to RARP. Social continence (SC) recovery, perioperative complications, and length of hospital stay (LOS) were compared between VV-G vs. VV-STD. SC was defined as 0–1 pad/die. We applied 1:1 propensity score matching (PSM) adjusting for different covariates (age, Charlson Comorbidity Index, BMI, prostate volume, nerve-sparing and lymph node dissection). Results: From 166 patients, 1:1 PSM resulted in two equally sized groups of 40 patients each with no residual differences (all p ≥ 0.2). VV-G yielded higher 3-month SC rates than VV-STD (97.5 vs. 55.0%, p < 0.001). A tiny difference was still recorded at one-year follow-up (97.5 vs. 80.0%, p = 0.029, HR: 2.90, 95% CI: 1.74–4.85, p < 0.001). Conversely, we observed no differences in any perioperative complications (15.0 vs. 22.5%, OR: 0.61, 95% CI 0.19–1.88, p = 0.4) and LOS (3 vs. 4 days, Δ: −0.69 ± 0.61, p = 0.1). Conclusions: VV-G significantly improved early SC recovery without increasing perioperative morbidity. In our opinion, VV-G represents an easy-to-learn and easy-to-teach technique due to its single-suture, single-knot, and symmetrical design. Full article

(This article belongs to the Special Issue Personalized Medicine in Minimally Invasive Urological Surgery)

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Special Issue "Personalized Medicine in Minimally Invasive Urological Surgery"

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