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    Assistant port is unnecessary for robotic-assisted laparoscopic pyeloplasty in children: a comparative cohort study
    (Springer, 2022) Danacioglu, Yavuz Onur; Keser, Ferhat; Polat, Salih; Gunaydin, Bilal; Comez, Yusuf Ilker; Silay, Mesrur Selcuk
    Objective To compare the postoperative outcomes including the cosmetic results of robotic-assisted laparoscopic pyeloplasty (RALP) performed with and without assistant port in pediatric population. Methods 47 patients with ureteropelvic junction obstruction consecutively underwent RALP were stratified as: three-port (Group 1, n = 26) and four-port (Group 2, n = 21). In Group 1, no assistant port was placed and double-J stent was introduced with the aid of an angiocatheter via the percutaneous route. In group 2, an assistant port was placed. The Patient and Observer Scar Assessment Scale (POSAS), the Vancouver Scar Scale(VSS), Satava, Clavien classification systems, and success rates were compared. Results We found similar success rates for both groups (group 1:96.2%, group 2:100%). Two groups were similar in terms of improvement in the postoperative anteroposterior diameter of the renal pelvis and parenchymal thickness. There was no difference in terms of perioperative and postoperative complication rates (group 1:19.2%, group 2:9.5%). The total PSAS was significantly lower in Group 1 (p < 0.008). No difference was observed for VSS and OSAS. Conclusions Using an assistant port does not improve the success or complications of RALP, while the cosmetic outcomes are inferior to three-port RALP in children. We suggest avoiding the use of assistant port during RALP in children.
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    Laparoscopy training in Turkey through the view of residents;Turkish European Society of Residents in urology questionnaire
    (2022) Atış, Ramazan Gökhan; Uçar, Taha; Ekşi, Mithat; Keser, Ferhat; Sılay, Mesrur Selçuk; Yıldırım, Asıf; Çaşkurlu, Turhan
    Objective: Laparoscopy is a minimal invasive surgery technique and getting more important nowadays. The success rate of the techniques used in laparoscopy education and the qualification of urology residents who finished their urology training, is unclear. In our study, qualification of Turkish urology residents for laparoscopy, the preferred educational techniques and the education models were investigated with a national survey. Material and Methods: The laparoscopy questionnaire that is used in our study has been prepared by modification of a questionnaire which was formed by Belgium European European Society of Residents in Urology. The techniques used in laparoscopy education, qualification of the education and the expectations from laparoscopy education were the main focus. All of the questions were Turkish and was sent to a total of 295 residents who are registered to the ESRU database. A total of 70 (23%) residents answered. SurveyMonkey was used for composing and distribution. All the data gathered from the survey was statistically investigated. Results: The biggest contribution was from the Marmara Region (39.29%). Laparoscopy is used in 91,07% of the clinics all around Turkey. The distribution of the residents in regards of year of urology training were: 14% 1st year, 23% 2nd year, 23% 3rd year, 12.7% 4th year, 25% 5th year. Training and Research Hospital and University Hospital participation rates were 46.77% and 53.23% respectively. The rate of residents who feel they will become capable of doing laparoscopic surgery after their residency period finished, was 28.5% and 71.4% of the residents expressed the laparoscopic training they take would not be sufficient. Assistance and observing are used as a training method by nearly all residents (91.07%). In addition being the primary surgeon, training videos, training boxes, animal practices are used by residents with the rate of 26.7%, 25%, 21.4%, 3.5% respectively. According to participants, to be given less opportunity, educational disinterest and limited laparoscopic cases were defined as the major 3 problems in laparoscopy training. Conclusion: The laparoscopy education differs between the urology clinics in Turkey without any standardization. An appropriate standardization of laparoscopy training can improve laparoscopy education and urology training