Pub Date : 2025-12-01DOI: 10.23736/S2724-6051.25.06767-9
Cristian Fiori, Marco Cossu, Alberto Quarà, Matteo Manfredi
{"title":"\"Shine a light\": thulium fiber laser in UTUC.","authors":"Cristian Fiori, Marco Cossu, Alberto Quarà, Matteo Manfredi","doi":"10.23736/S2724-6051.25.06767-9","DOIUrl":"10.23736/S2724-6051.25.06767-9","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"77 6","pages":"884-886"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.23736/S2724-6051.25.06596-6
Luca A Morgantini, Rebecca Canneto, Rogerio G Nespolo, Deepa Dhillon, Yannek Leiderman, Simone Crivellaro
Background: Robotic-assisted surgery, particularly with the da Vinci Single-Port system, enables precise operations in confined anatomical spaces like the retroperitoneum. However, the complexity of retroperitoneal anatomy challenges spatial orientation, especially for novice surgeons. This study aimed to develop and validate an Artificial Intelligence (AI)-based framework for real-time segmentation and feature tracking in Single-Port retroperitoneal robotic-assisted nephrectomies.
Methods: A convolutional neural network based on YOLACT++ was used for instance segmentation. The model was trained on annotated video frames from 15 patients who underwent SP nephrectomies. Key anatomical landmarks and surgical instruments were segmented and detected in real-time. Model performance was evaluated using the Area Under the Precision-Recall Curve.
Results: The model achieved Area Under the Precision-Recall Curve values ranging from 0.759 to 0.901 for anatomical landmarks and up to 0.887 for surgical instruments. Limitations include a small dataset (150 annotated frames), which may lead to overfitting, and lower segmentation precision for some features, such as the ureter. Further validation in live surgical settings and diverse procedures is needed.
Conclusions: This study demonstrates the potential of AI for real-time surgical guidance in Single-Port retroperitoneal procedures. The proposed framework could enhance spatial orientation, improve training for novice surgeons, and streamline complex retroperitoneal surgeries. Future research will focus on expanding the dataset, improving segmentation accuracy, and integrating the model into live surgeries for broader applicability.
背景：机器人辅助手术，特别是达芬奇单端口系统，可以在腹膜后等狭窄解剖空间进行精确手术。然而，腹膜后解剖的复杂性对空间定位提出了挑战，特别是对于外科新手。本研究旨在开发和验证基于人工智能（AI）的框架，用于单端口腹膜后机器人辅助肾切除术的实时分割和特征跟踪。方法：采用基于yolact++的卷积神经网络进行实例分割。该模型是根据15名接受SP肾切除术患者的带注释的视频帧进行训练的。对关键解剖标志和手术器械进行实时分割和检测。使用精确召回曲线下的面积来评估模型的性能。结果：该模型对解剖标志的精确召回曲线下面积（Area Under Precision-Recall Curve）达到0.759 ~ 0.901，对手术器械的精确召回曲线下面积达到0.887。局限性包括一个小的数据集（150个带注释的帧），这可能导致过拟合，并且对某些特征（如输尿管）的分割精度较低。需要在现场手术环境和各种程序中进一步验证。结论：本研究证明了人工智能在单孔腹膜后手术中实时手术指导的潜力。提出的框架可以增强空间定位，改善新手外科医生的培训，并简化复杂的腹膜后手术。未来的研究将侧重于扩展数据集，提高分割精度，并将模型集成到现场手术中以获得更广泛的适用性。
{"title":"Artificial intelligence based real-time segmentation and feature tracking in urological retroperitoneal robotic assisted surgery.","authors":"Luca A Morgantini, Rebecca Canneto, Rogerio G Nespolo, Deepa Dhillon, Yannek Leiderman, Simone Crivellaro","doi":"10.23736/S2724-6051.25.06596-6","DOIUrl":"10.23736/S2724-6051.25.06596-6","url":null,"abstract":"<p><strong>Background: </strong>Robotic-assisted surgery, particularly with the da Vinci Single-Port system, enables precise operations in confined anatomical spaces like the retroperitoneum. However, the complexity of retroperitoneal anatomy challenges spatial orientation, especially for novice surgeons. This study aimed to develop and validate an Artificial Intelligence (AI)-based framework for real-time segmentation and feature tracking in Single-Port retroperitoneal robotic-assisted nephrectomies.</p><p><strong>Methods: </strong>A convolutional neural network based on YOLACT++ was used for instance segmentation. The model was trained on annotated video frames from 15 patients who underwent SP nephrectomies. Key anatomical landmarks and surgical instruments were segmented and detected in real-time. Model performance was evaluated using the Area Under the Precision-Recall Curve.</p><p><strong>Results: </strong>The model achieved Area Under the Precision-Recall Curve values ranging from 0.759 to 0.901 for anatomical landmarks and up to 0.887 for surgical instruments. Limitations include a small dataset (150 annotated frames), which may lead to overfitting, and lower segmentation precision for some features, such as the ureter. Further validation in live surgical settings and diverse procedures is needed.</p><p><strong>Conclusions: </strong>This study demonstrates the potential of AI for real-time surgical guidance in Single-Port retroperitoneal procedures. The proposed framework could enhance spatial orientation, improve training for novice surgeons, and streamline complex retroperitoneal surgeries. Future research will focus on expanding the dataset, improving segmentation accuracy, and integrating the model into live surgeries for broader applicability.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"77 6","pages":"854-858"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.23736/S2724-6051.25.06794-1
Igino A Magli, Giovanni B Clemente, Francesco Chiaramonti, Stefano Masciovecchio, Vincenzo Iossa, Alfonso B DI Pasquale
{"title":"Comment on \"Robotic retrohepatic inferior vena cava thrombectomy using the caudate lobectomy technique: indications and initial outcomes\".","authors":"Igino A Magli, Giovanni B Clemente, Francesco Chiaramonti, Stefano Masciovecchio, Vincenzo Iossa, Alfonso B DI Pasquale","doi":"10.23736/S2724-6051.25.06794-1","DOIUrl":"10.23736/S2724-6051.25.06794-1","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"77 6","pages":"897-899"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.23736/S2724-6051.25.06724-2
Maria C Sighinolfi, Francesco Rossi, Giovanni B Filomena, Giuseppe Pallotta, Filippo Gavi, Simona Presutti, Pierluigi Russo, Simone Assumma, Carlo Gandi, Filippo Turri, Nazario Foschi, Giuseppe Palermo, Riccardo Bientinesi, Angelo Totaro, Emilio Sacco, Vipul Patel, Ela Patel, Marcio C Moschovas, Bernardo Rocco
{"title":"New robotic systems: preclinical evaluation of the Toumai MT-1000 from robotic-naïve users.","authors":"Maria C Sighinolfi, Francesco Rossi, Giovanni B Filomena, Giuseppe Pallotta, Filippo Gavi, Simona Presutti, Pierluigi Russo, Simone Assumma, Carlo Gandi, Filippo Turri, Nazario Foschi, Giuseppe Palermo, Riccardo Bientinesi, Angelo Totaro, Emilio Sacco, Vipul Patel, Ela Patel, Marcio C Moschovas, Bernardo Rocco","doi":"10.23736/S2724-6051.25.06724-2","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06724-2","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"77 6","pages":"743-747"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.23736/S2724-6051.25.06773-4
Pierluigi Russo, Maria C Sighinolfi, Francesco P Bizzarri, Filippo Gavi, Bernardo Rocco
{"title":"Comment on \"The anesthesia impact of regionalized insufflation with trans-vesical single port robot-assisted radical prostatectomy\".","authors":"Pierluigi Russo, Maria C Sighinolfi, Francesco P Bizzarri, Filippo Gavi, Bernardo Rocco","doi":"10.23736/S2724-6051.25.06773-4","DOIUrl":"10.23736/S2724-6051.25.06773-4","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"77 6","pages":"873-875"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Bilateral complex ureteral strictures pose a significant challenge to all urologists. Conventional reconstructive techniques, such as oral mucosal grafts or Boari flap, have limited ability to repair extensive ureteral damage. This study aims to evaluate the feasibility and outcomes of bilateral ileal ureteral replacement with Y-shaped configuration for the treatment of bilateral complex ureteral strictures.
Methods: In this prospective study, eleven patients underwent bilateral ileal ureteral replacement with Y-shaped configuration at two medical centers from June 2020 to March 2024. Perioperative data were collected, and clinical outcomes were systematically assessed.
Results: All patients successfully underwent bilateral ileal ureteral replacement with Y-shaped configuration. The median length of the harvested ileal segment was 40 (range 20-85) cm, the operative duration was 390 (range 240-660) min, the estimated blood loss was 200 (range 50-600) mL, and the duration of postoperative hospitalization was 21 (range 10-33) days. At a median follow-up of 32 (11-50) months, the subjective and function success rates were 100% and 72.7%.
Conclusions: Our findings indicate that bilateral ileal ureteral replacement with Y-shaped configuration (even with ileocystoplasty) is a safe, feasible, and effective approach to manage bilateral complex ureteral strictures.
{"title":"Bilateral ileal ureteral replacement with Y-shaped configuration for bilateral complex ureteral strictures: the initial dual-center experience.","authors":"Guanpeng Han, Xiang Wang, Zhihua Li, Wencong Han, Liqing Xu, Silu Chen, Chen Huang, Peng Zhang, Kunlin Yang, Liqun Zhou, Hongjian Zhu, Xuesong Li","doi":"10.23736/S2724-6051.25.06574-7","DOIUrl":"10.23736/S2724-6051.25.06574-7","url":null,"abstract":"<p><strong>Background: </strong>Bilateral complex ureteral strictures pose a significant challenge to all urologists. Conventional reconstructive techniques, such as oral mucosal grafts or Boari flap, have limited ability to repair extensive ureteral damage. This study aims to evaluate the feasibility and outcomes of bilateral ileal ureteral replacement with Y-shaped configuration for the treatment of bilateral complex ureteral strictures.</p><p><strong>Methods: </strong>In this prospective study, eleven patients underwent bilateral ileal ureteral replacement with Y-shaped configuration at two medical centers from June 2020 to March 2024. Perioperative data were collected, and clinical outcomes were systematically assessed.</p><p><strong>Results: </strong>All patients successfully underwent bilateral ileal ureteral replacement with Y-shaped configuration. The median length of the harvested ileal segment was 40 (range 20-85) cm, the operative duration was 390 (range 240-660) min, the estimated blood loss was 200 (range 50-600) mL, and the duration of postoperative hospitalization was 21 (range 10-33) days. At a median follow-up of 32 (11-50) months, the subjective and function success rates were 100% and 72.7%.</p><p><strong>Conclusions: </strong>Our findings indicate that bilateral ileal ureteral replacement with Y-shaped configuration (even with ileocystoplasty) is a safe, feasible, and effective approach to manage bilateral complex ureteral strictures.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"77 6","pages":"828-839"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-27DOI: 10.23736/S2724-6051.25.06747-3
Fernando Munoz
{"title":"Are we ready for stereotactic body radiotherapy in unfavorable intermediate and high-risk prostate patient cancer?","authors":"Fernando Munoz","doi":"10.23736/S2724-6051.25.06747-3","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06747-3","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-25DOI: 10.23736/S2724-6051.25.06802-8
Roberto Passera, Lorenzo Monasta, Giulia Zamagni
{"title":"The burden of prostate cancer in Italy from 1990 to 2023, compared to the European Union and the Socio-Demographic Index (SDI) quintile countries: results from the Global Burden of Disease Study 2023.","authors":"Roberto Passera, Lorenzo Monasta, Giulia Zamagni","doi":"10.23736/S2724-6051.25.06802-8","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06802-8","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145598009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-18DOI: 10.23736/S2724-6051.25.06633-9
Katharina Lederer, Orestis Briasoulis, Antonio Olivieri
{"title":"Comment on: \"From nocturnal awakenings to nocturnal voiding: the relationship between insomnia and nocturia: a systematic review\".","authors":"Katharina Lederer, Orestis Briasoulis, Antonio Olivieri","doi":"10.23736/S2724-6051.25.06633-9","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06633-9","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145543870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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