Walter Artibani1, Vincenzo Ficarra2, Ben J Challacombe3, Clement-Claude Abbou4, Jens Bedke5, Rafael Boscolo-Berto6, Maurizio Brausi7, Jean J M C H de la Rosette8, Serdar Deger9, Louis Denis10, Giorgio Guazzoni11, Bertrand Guillonneau12, John P F A Heesakkers13, Didier Jacqmin14, Thomas Knoll15, Luis Martínez-Piñeiro16, Francesco Montorsi11, Alexander Mottrie17, Pierre-Thierry Piechaud18, Abhay Rane19, Jens Rassweiler20, Arnulf Stenzl5, Jeroen Van Moorselaar21, Roland F Van Velthoven22, Hendrik van Poppel23, Manfred Wirth24, Per-Anders Abrahamsson25, Keith F Parsons26. 1. Department of Urology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy. Electronic address: walter.artibani@univr.it. 2. University of Udine, Department of Urology, Udine, Italy. 3. Department of Urology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom. 4. Service d'Urologie CHU Henri Mondor, Créteil, France. 5. Klinik für Urologie, Eberhard-Karls-Universität Tübingen, Tübingen, Germany. 6. Department of Cardiac, Thoracic and Vascular Sciences, Section of Legal Medicine, University Hospital of Padova, Padova, Italy. 7. New S. Agostino-Estense Hospital, AUSL, Modena, Italy. 8. Department of Urology, Academisch Medisch Centrum, Amsterdam, The Netherlands. 9. Department of Urology, Paracelsus-Krankenhaus Ruit, Ostfildern, Germany. 10. Oncology Centre Antwerp, Antwerp, Belgium. 11. Department of Urology, Università Vita-Salute San Raffaele, Milan, Italy. 12. Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris, France. 13. Department of Urology, UMC St Radboud, Nijmegen, The Netherlands. 14. Department of Urology, Hôpitaux Universitaires, Strasbourg, France. 15. Department of Urology, Klinikum Sindelfingen-Böblingen, Sindelfingen, Germany. 16. Department of Urology, Hospital Universitario Infanta Sofia, Madrid, Spain. 17. Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium. 18. Department of Urology, Clinic Saint Augustin, Bordeaux, France. 19. Department of Urology, East Surrey Hospital, Redhill, United Kingdom. 20. Department of Urology, SLK-Kliniken Heilbronn GmbH, Heilbronn, Germany. 21. Department of Urology, VU Medisch Centrum, Amsterdam, The Netherlands. 22. Department of Urology, Institut Jules Bordet, Brussels, Belgium. 23. Department of Urology, University Hospital Leuven, Leuven, Belgium. 24. Department of Urology, Universitätsklinikum Carl Gustav Carus an der Technischen Universität, Dresden, Germany. 25. Department of Urology, Skåne University Hospital, Malmö, Sweden. 26. Honorary Consultant Urological Surgeon, The Royal Liverpool & Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom.
Abstract
CONTEXT: Live surgery is an important part of surgical education, with an increase in the number of live surgery events (LSEs) at meetings despite controversy about their real educational value, risks to patient safety, and conflicts of interest. OBJECTIVE: To provide a European Association of Urology (EAU) policy on LSEs to regulate their organisation during urologic meetings. EVIDENCE ACQUISITION: The project was carried out in phases: a systematic literature review generating key questions, surveys sent to Live Surgery Panel members, and Internet- and panel-based consensus finding using the Delphi process to agree on and formulate a policy. EVIDENCE SYNTHESIS: The EAU will endorse LSEs, provided that the EAU Code of Conduct for live surgery and all organisational requirements are followed. Outcome data must be submitted to an EAU Web-based registry and complications reported using the revised Martin criteria. Regular audits will take place to evaluate compliance as well as the educational role of live surgery. CONCLUSIONS: This policy represents the consensus view of an expert panel established to advise the EAU. The EAU recognises the educational role of live surgery and endorses live case demonstration at urologic meetings that are conducted within a clearly defined regulatory framework. The overriding principle is that patient safety must take priority over all other considerations in the conduct of live surgery. PATIENT SUMMARY: Controversy exists regarding the true educational value of live surgical demonstrations on patients at surgical meetings. An EAU committee of experts developed a policy on how best to conduct live surgery at urologic meetings. The key principle is to ensure safety for every patient, including a code of conduct and checklist for live surgery, specific rules for how the surgery is organised and performed, and how each patient's results are reported to the EAU. For detailed information, please visit www.uroweb.org.
CONTEXT: Live surgery is an important part of surgical education, with an increase in the number of live surgery events (LSEs) at meetings despite controversy about their real educational value, risks to patient safety, and conflicts of interest. OBJECTIVE: To provide a European Association of Urology (EAU) policy on LSEs to regulate their organisation during urologic meetings. EVIDENCE ACQUISITION: The project was carried out in phases: a systematic literature review generating key questions, surveys sent to Live Surgery Panel members, and Internet- and panel-based consensus finding using the Delphi process to agree on and formulate a policy. EVIDENCE SYNTHESIS: The EAU will endorse LSEs, provided that the EAU Code of Conduct for live surgery and all organisational requirements are followed. Outcome data must be submitted to an EAU Web-based registry and complications reported using the revised Martin criteria. Regular audits will take place to evaluate compliance as well as the educational role of live surgery. CONCLUSIONS: This policy represents the consensus view of an expert panel established to advise the EAU. The EAU recognises the educational role of live surgery and endorses live case demonstration at urologic meetings that are conducted within a clearly defined regulatory framework. The overriding principle is that patient safety must take priority over all other considerations in the conduct of live surgery. PATIENT SUMMARY: Controversy exists regarding the true educational value of live surgical demonstrations on patients at surgical meetings. An EAU committee of experts developed a policy on how best to conduct live surgery at urologic meetings. The key principle is to ensure safety for every patient, including a code of conduct and checklist for live surgery, specific rules for how the surgery is organised and performed, and how each patient's results are reported to the EAU. For detailed information, please visit www.uroweb.org.
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