Page 31 - NEWSLETTER_28

ΣΥΝΕΝΤΕΥΞΗ
nearly 30 years, I am still learning new things when I encounter a complication after surgery. Therefore, it is a continuous process of building experience, which can be challenging but also rewarding.
T.S.: What were your thoughts when minimally- invasive techniques started trending in Urology and subsequently expanded to Pediatric Urology? Do laparoscopic and robotic procedures really have a benefit for pediatric patients?
Prof. S.T.: Actually, I underwent training in laparoscopy for children in Seattle in 1994-1995. Specifically, we were performing laparoscopy for undescended (non- palpable) testes. In my department back home, I was the first to perform laparoscopy. Over time, the use of minimally-invasive techniques for Pediatric Urology became more popular. However, there are limitations to these techniques in children compared to adults. The smaller spaces and immediate rise in pressures make it challenging. Minimally-invasive procedures do not necessarily lead to faster recovery times in children. For example, in cases like pyeloplasty, the traditional method can be much quicker than the laparoscopic approach. Minimally-invasive techniques may not offer significant advantages in terms of recovery, especially for younger children. Hospital stays are not necessarily shorter with these techniques in children.
In certain cases, such as procedures in the bladder neck area, the robot can be useful. For tumors in hard-to-reach areas, minimally-invasive techniques can provide a benefit. Personally, I only use minimally- invasive techniques for undescended testes, nephrectomies, and upper pole nephrectomies. I do not prefer doing pyeloplasty with the robot, as I do not see a significant advantage especially in younger children.
It is important to carefully consider the use of minimally-invasive techniques to ensure they are truly beneficial. Pushing for their use in all areas may not always be necessary. Ultimately, the advantages of minimally-invasive surgery in children are limited.
F.N.: What advancements or new technologies in Pediatric Urology do you find the most promising or interesting ones?
Prof. S.T.: Every emerging technology is beneficial for children. I believe that if the lenses and endourology instruments were made smaller and more portable,
they would be extremely helpful for children. Currently, there are some limitations. Ureteroscopy can be performed in children, but it would be more effective with smaller instruments. In the future, there may be robots that can travel within the body. Some research is already being done in this area. I think this could be particularly beneficial for children, allowing doctors to examine the body in a way that is fascinating. However, what interests me more is the potential for tissue generation. Tissue engineering has shown promise, but has not yet reached its full potential. If we could achieve successful tissue engineering, it would be especially beneficial for the urethra and bladder. This is an area that still needs significant development. Despite efforts in this area, we are still far from where we would like to be.
Tεύχος 28 | Mάρτιος - Απρίλιος 2024
T.S.: Pediatric Urology is characterized by
lots of different techniques for treating the same disease, such as hypospadias repair,
like Snodgrass or Mathieu, and ureteral reimplantation. Do you believe that there will ever be reached a consensus regarding the best technique for each indication?
Prof. S.T.: No, if there are so many surgeons, it will be difficult to reach a consensus on anything. As I mentioned before, each patient is unique. I believe that a surgeon should be familiar with a variety of techniques. I am not suggesting that you need to
31