Decision Making in Endourology

When you're watching live surgery demonstrations do you ever wish you could stop the action, rewind a little bit and have another look at something that was going on, pause it all to ask surgeon a question, or fast-forward through the boring bits?

Well now you can - this course takes a series of live surgical procedures, performed by the faculty members and plays, pauses, rewinds and fast-forwards as required to squeeze as much educational discussion out of the cases as possible. Our aim is to prove that pre-recorded surgery is more educational than live surgery, because you can safely ask the surgeon as many questions as you like, without any risk to the patient at all.

Educationally this course takes its lead from Francis Spencer who in 1978 was one of the first to point out that “A skillfully performed operation is about 75% decision making and 25% dexterity”[1].

As we grow in experience and maturity as surgeons, we realise this to be true - the major and minor decisions we make before, during and after surgery are as important to the patient’s outcome as any technical skills we have mastered.

Yet most training still focusses on technical skill acquisition.

This course is different, it assumes you have technical skills and knowledge in abundance, we even know that you can make good decisions, but are your decisions evidence based? Would your peers do the same thing? There are many ways to skin a cat, so what makes is the right decision?

Exploring these grey areas and looking to the evidence, observing the outcomes (good and bad) of these decisions as they play out during the procedure, is what makes this course unique.

1. F.C. Spencer Teaching and measuring surgical techniques: the technical evaluation of competence Bull Am Coll Surg, 64 (1978), pp. 9-12

Experienced endourologists and Fellwoship level trainees who are open to examining how they make decisions, and the impact these decisions make on their patients outcomes.

Carla M. Pugh, Susan Santacaterina, Debra A. DaRosa, Richard E. Clark, Intra-operative decision making: More than meets the eye,

Journal of Biomedical Informatics, Volume 44, Issue 3, 2011, Pages 486-496,

Mr Luca Martinelli or his deputy will meet you at the hotel at departure time to go to the IAS or direct you to the location needed.

Program for Boston Scientific Decision Making in Endourology “as-live” Masterclass December 1^st  and 2nd 2020 Paris

 

Faculty: Oliver Wiseman, ,Esteban Emiliani, Mario Sofer, Daron Smith

 

 

3^rd Dec 2019

 

Am: Delegates arrive

 

12.30 - 1.30 Lunch

 

1.30-1.35:              Welcome:                        

 

1.35-3pm:              PCNL part 1

 

As-live cases and evidence base

 

As live Case: Prone PCNL with Trilogy

Case discussion: Access methods. Drainage afterwards

 

        As-live case: Supine PCNL.

 

        Encrusted stent:

 

 

Points to be covered include:

Positioning and access decisions: When for which and why?

How to dilate your track: evidence

Energy source: options

Drainage options post PCNL

Plus as above in intro

 

 

3-3.30                    Tea break

 

 

3.30-5.00pm:        PCNL part 2 Minaturisation        

 

 

Decision making for stone in horseshoe kidney.  (case discussion with video if available)

 

Decision making for stones in pregnancy ( case discussion with some video)

 

PCNL Cases: 3-4 cases to discuss if we have time. Each to bring 1-2 cases

 

5.00 to 7.00:  Free time.

 

7.30 pm: Meet for dinner with dinner at 8.00.

 

 

 

 

December 4th

 

8.30 am: Breakfast

 

 

9am: -10.30:          

 

URS: As-live cases and evidence base

 

Proximal ureteric stone                         As live case and tips and tricks:

 

Upper tract diagnosis of UC:                 As live case:

 

Tips and tricks in urs                    (tips and tricks, high level, with video to illustrate points if possible)

 

URS in recon pts                                                               

 

 

10.30-11.00           Tea break

 

11.00-12.30           URS: As-live cases Tricky lower pole .As live Case  (Why decision to go for URS. Was it correct? What does the data tell us about clearance of frags. Does it matter? Limitation of digital versus fibreoptic scope)

 

 

Calyceal diverticular stones                  As live case Review of tic management

 

 

 

 

12.30-1.30:  Lunch

 

1.30-2.00     Metabolic cases All faculty (One of the KOLs to chair and collate)

 

 

Nightmare cases PCNL and URS  All faculty (One of the KOLs to collate and chair)

 

3.30 onwards: Delegates depart