Video labelling robot-assisted radical prostatectomy and the role of artificial intelligence (AI): training a novice.

Video labelling is the assigning of meaningful information to raw videos. With the evolution of artificial intelligence and its intended incorporation into the operating room, video datasets can be invaluable tools for education and the training of intelligent surgical workflow systems through computer vision. However, the process of manual labelling of video datasets can prove costly and time-consuming for already busy practising surgeons.

Superior Mesenteric Artery Injury During Robot-assisted Laparoscopic Nephrectomy: A Robotic Nightmare.

Unlabelled: Major vascular injuries during robotic renal surgery are rare, but the close proximity of the superior mesenteric artery (SMA) to the left renal artery means that it is liable to iatrogenic injury with potentially catastrophic implications. In this review, we present a case of accidental SMA ligation during a robot-assisted laparoscopic nephrectomy for a 12-cm upper pole renal mass. Prompt recognition and early vascular surgical assistance with conversion to open surgery allowed a primary vascular anastomosis to be made.

Extended-spectrum β-lactamase in the rectal flora of patients undergoing transrectal prostate biopsy: a study of the prevalence in a major metropolitan hospital.

Objectives: To determine the prevalence of extended-spectrum β-lactamase (ESBL) in patients undergoing transrectal prostate biopsy, to assess the incidence of postoperative sepsis, to correlate the development of sepsis with the presence of preoperative ESBL on rectal swabs, and to assess the adequacy of prophylactic antibiotic guidelines in the context of local ESBL prevalence.

Methods: Patients undergoing transrectal ultrasonography (TRUS)-guided biopsy at the Royal Melbourne Hospital between January 2012 and July 2016 had rectal swabs taken immediately prior to TRUS with specific cultures to identify the presence of ESBL. Patients were given a prophylactic antibiotic, 500 mg oral ciprofloxacin, 1 h before the TRUS procedure.

A urinary microRNA signature can predict the presence of bladder urothelial carcinoma in patients undergoing surveillance.

Background: The objective of this study was to determine whether microRNA (miRNA) profiling of urine could identify the presence of urothelial carcinoma of the bladder (UCB) and to compare its performance characteristics to that of cystoscopy.

Methods: In the discovery cohort we screened 81 patients, which included 21 benign controls, 30 non-recurrers and 30 patients with active cancer (recurrers), using a panel of 12 miRNAs. Data analysis was performed using a machine learning approach of a Support Vector Machine classifier with a Student's t-test feature selection procedure.

Streamlining the assessment of haematuria: 3-year outcomes of a dedicated haematuria clinic.

Background: Urgent assessment of haematuria is critical to exclude malignancy. The objective of this study is to report the outcomes of the first 3 years of a dedicated haematuria clinic at the Royal Melbourne Hospital, a Victorian tertiary hospital.

Methods: All patients assessed in the haematuria clinic from April 2010 to April 2013 were included in the analysis.

Bladder cancer biorepositories in the "-omics" era: integrating quality tissue specimens with comprehensive clinical annotation.

Advances in genomic platforms have led to the need for well-characterized, high quality biospecimens for research. Bladder cancer, despite being a major epidemiological concern, has been under-represented in genomic programs due to unique challenges in collection of clinical informatics and tissues. Currently no targeted therapy exists for management of the disease.

Molecular biomarkers for predicting outcomes in urothelial carcinoma of the bladder.

Molecular biomarkers are used routinely in the clinical management of several tumours such as prostate, colon, ovarian and pancreatic cancer but management decisions in bladder cancer remain dependent on clinical and pathological criteria, which are limited in their ability to predict outcomes. Molecular markers are urgently needed in detection, surveillance and prognostication of bladder cancer as well as to predict treatment response to intravesical and systemic therapies. Advances in cancer genomics and platforms for biomarker profiling have led to a plethora of biomarkers, which must now be rigorously validated in the clinical setting.

Curated microRNAs in urine and blood fail to validate as predictive biomarkers for high-risk prostate cancer.

Purpose: The purpose of this study was to determine if microRNA profiling of urine and plasma at radical prostatectomy can distinguish potentially lethal from indolent prostate cancer.

Materials And Methods: A panel of microRNAs was profiled in the plasma of 70 patients and the urine of 33 patients collected prior to radical prostatectomy. Expression of microRNAs was correlated to the clinical endpoints at a follow-up time of 3.

Tumor vascularity in prostate cancer: an update on circulating endothelial cells and platelets as noninvasive biomarkers.

In order to individually tailor prostate cancer (PCa) treatment, clinicians need better tools to predict prognosis and treatment response. Given the relationship between angiogenesis and cancer progression, circulating endothelial cells (CECs) and their progenitors have logically been proposed as potential biomarkers. The utility of their baseline levels and kinetics has been investigated for years.

Gene-based urinary biomarkers for bladder cancer: an unfulfilled promise?

Objective: Noninvasive biomarkers are used routinely in the clinical management of several cancers but bladder cancer detection and surveillance remains dependent on invasive procedures such as cystoscopy. No validated biomarker currently exists in routine clinical practice other than cytology. Gene-based testing has shown great promise for biomarker profiling and this review addresses the current state of biomarker research in bladder cancer.

Percutaneous image-guided biopsy of prostate cancer metastases yields samples suitable for genomics and personalised oncology.

Personalised oncology through mutational profiling of cancers requires the procurement of fresh frozen tumour samples for genomics applications. While primary cancers are often surgically excised and therefore yield such tissue, metastases in the setting of a known cancer diagnosis are not routinely sampled prior to systemic therapy. Our study aimed to determine the suitability of extracted nucleic acids for genomics applications using distant metastatic prostate cancer samples obtained via percutaneous or surgical biopsy.

Circulating MicroRNAs as Biomarkers of Prostate Cancer: The State of Play.

MicroRNAs are key regulators of gene expression and play critical roles in both normal physiology and pathology. Recent research has demonstrated that these molecules are present in body fluids, such as serum, plasma, and urine, and can be readily measured using a variety of techniques. More importantly, emerging evidence suggests that circulating or urine miRNAs are useful indicators of disease.

Re-evaluating the biological significance of seminal vesicle invasion (SVI) in locally advanced prostate cancer.

Objective: • To examine the impact of seminal vesicle invasion (SVI) in patients with locally advanced (pT3) prostate cancer on clinical outcome. • To explore the clinical association of SVI with metastatic disease. • To distinguish between the possibilities that either seminal vesicles possess their own biological significance and represent a privileged staging site for systemic tumour cell dissemination, or that their invasion is a surrogate marker for an aggressive large-volume poorly differentiated cancer.

Management of local recurrences in the irradiated bladder: a systematic review.

Objective: • To review and report the management and outcomes of patients with recurrence of bladder cancer (BC) who initially had complete response to bladder conservation therapy.

Methods: • A comprehensive review of all published literature reporting outcomes in bladder-sparing treatments for muscle-invasive BC (MIBC) was conducted in a systematic fashion by two independent authors across several databases including PubMed and Medline using the following keywords, alone or in combination: bladder cancer, radiotherapy, recurrence, outcome, cystoscopy, follow up, combined modality therapy, and organ preservation. • In all, 17 studies reporting prevalence and management of local recurrences were included in final analysis.

Nurse-led flexible cystoscopy in Australia: initial experience and early results.

Objective: • To present our initial experience implementing a nurse-led flexible cystoscopy (NLFC) service in a Victorian tertiary hospital and our initial results from that service, as NLFC has developed over the past decade with reports suggesting that adequately trained nurses can undertake FC competently.

Patients And Methods: • We describe the implementation of a NLFC service including approval, funding, nurses' training, and protocols. • Outcomes of all patients having a NLFC or subsequent interventions were recorded prospectively and analysed retrospectively.

Prostate tumour volume is an independent predictor of early biochemical recurrence in a high risk radical prostatectomy subgroup.

Aims: To assess if accurately determined tumour volume variables could serve as independent predictors of early biochemical recurrence in high risk prostate cancer patients who underwent radical prostatectomy.

Methods: Tumour volume variables were calculated by digital planimetry in 269 prostatectomy specimens of patients with high risk prostate cancer. The associations to biochemical progression of tumour volume and clinicopathological variables, including age, pre-operative prostate specific antigen (PSA) levels, final Gleason score, pathological T stage, and surgical margins, were examined using univariate and multivariate Cox proportional hazards analyses.

Pregnancy following gastric bypass surgery: what is the expected course and outcome?

Aim: To examine the course of pregnancy, labour, and the neonatal period in a group of women who have become pregnant following gastric bypass surgery for severe obesity.

Methods: Women who had experienced pregnancy following gastric bypass surgery were identified by an initial questionnaire. A second questionnaire was sent to those identified by the first questionnaire, who were willing to provide details concerning such pregnancies.

Nurturing of surgical careers by the Wellington Surgical Interest Club.

The Royal Australasian College of Surgeons (RACS) has recently introduced the new Surgical Education and Training programme. The purpose of this was, in part, to help address the anticipated shortage of surgeons in the future, by streamlining the surgical training programme. The formation of the Wellington Surgical Interest Club (WSIC), a student-led initiative, had several complementary goals.

In sight, in mind: retailer compliance with legislation on limiting retail tobacco displays.

We investigated retailer compliance with point-of-sale display legislation, using a New Zealand region as a case study. An observational survey was conducted of nonspecialist tobacco retailers in the lower North Island of New Zealand during 2006. Compliance was assessed in relation to store type (dairies, convenience stores, supermarkets, and service stations) and by characteristics of the population of the census area unit in which the store was situated.