Semi-Live Surgery 4

16 Aug 2025 15:30 17:00

TICC - 3F Plenary Hall

Time	Session

15:30 15:45	Robotic Prostatectomy Using da Vinci SP System Victor C. LinTaiwan Moderator Chit Sin LohMalaysia Moderator Rajeev TPIndia Moderator Newer Advances in the Endourological Management of Stones – Have We Reached the Zenith Po-Hung LinTaiwan Speaker Robotic Prostatectomy Using da Vinci SP SystemIn this semi-live section I will demonstrate the steps of extraperitoneal-approach radical prostatectomy using DAVINCI SP system.How to Make the Best Decision with Systemic Therapy Sequence in Respective of Genetic AnalysisRenal cell carcinoma (RCC) is a biologically heterogeneous disease driven by a limited set of convergent pathways that together shape oncogenesis, immune evasion, and therapeutic response. Across clear-cell RCC (ccRCC), recurrent alterations include VHL, PBRM1, BAP1, and SETD2, mapping onto five dominant axes: hypoxia signaling (VHL–HIF), PI3K/AKT/mTOR, chromatin remodeling, cell-cycle control, and metabolic rewiring. These lesions variably interact—e.g., mTORC1 enhances HIF translation—creating therapeutic opportunities (VEGF tyrosine-kinase inhibitors, HIF-2α inhibition, mTOR blockade) and constraints (adaptive resistance via metabolic plasticity). While immune checkpoint inhibitors (ICIs) and ICI–TKI combinations have improved outcomes in metastatic RCC, robust predictive biomarkers remain elusive. Tumor mutational burden is typically low and noninformative; PD-L1 shows assay- and context-dependent utility; PBRM1 and BAP1 are more prognostic than predictive. Emerging signals include angiogenic versus T-effector/myeloid transcriptional signatures, sarcomatoid/rhabdoid histology as a surrogate of immune-inflamed state, and host factors such as HLA genotype and gut microbiome composition. Liquid-biopsy modalities (ctDNA and methylome profiling) and spatial/single-cell atlases reveal intratumoral heterogeneity, T-cell exclusion niches, and myeloid programs (e.g., TREM2⁺ macrophages) linked to recurrence or ICI benefit. Early data support metabolism-targeted strategies (e.g., glutaminase inhibition) and rational combinations co-targeting angiogenesis, hypoxia signaling, and immune checkpoints; however, toxicity management and resistance evolution require prospective, biomarker-integrated trials. A clinical schema that pairs baseline multi-omic and microenvironmental profiling with adaptive surveillance (serial liquid biopsies, functional imaging) can lead to dynamically select among ICI–ICI, ICI–TKI, targeted, and experimental regimens. Robotic Prostatectomy Using da Vinci SP System
15:45 16:00	Extravasculare Renal Denervation to Treat Resistant Hypertension Victor C. LinTaiwan Moderator Chit Sin LohMalaysia Moderator Rajeev TPIndia Moderator Newer Advances in the Endourological Management of Stones – Have We Reached the Zenith Chang Wook JeongKorea (Republic of) Speaker Extravasculare Renal Denervation to Treat Resistant HypertensionResistant hypertension is defined as uncontrolled blood pressure above the target, despite the concurrent use of three or more antihypertensive medications. Individuals with resistant hypertension are at a high risk for severe cardiovascular events and mortality. Managing resistant hypertension is challenging, and many non-pharmacological treatments, including renal denervation (RDN), have been introduced. This presentation will demonstrate the surgical technique of the extravascular RDN (eRDN) using the HyperQure™ System performed as part of the first-in-human trial. The surgeries were performed as a retroperitoneal approach in a modified prone position. The preliminary results will be presented, too. In the United States, a prospective, multicenter, early feasibility study is also underway.
16:00 16:15	Game Changer or Gimmick? Evaluating the shift to Retzius Sparing Victor C. LinTaiwan Moderator Chit Sin LohMalaysia Moderator Rajeev TPIndia Moderator Newer Advances in the Endourological Management of Stones – Have We Reached the Zenith Aaron GohMalaysia Speaker Game Changer or Gimmick? Evaluating the shift to Retzius SparingRetzius-sparing radical prostatectomy (RS-RP) offers a significant functional advantage, particularly in terms of immediate continence recovery. Despite early skepticism, non-inferior oncological outcomes have been observed in our personal case series, supporting its wider adoption. However, many surgeons still perceive the transition from the conventional anterior approach as technically challenging. A practical way to bridge this gap is through the hood-sparing technique, which modifies the anterior approach to preserve anterior support structures while gradually introducing the anterior dissection plane in a more familiar sequence. One critical but often overlooked determinant of success is the role of the bedside assistant. In academic centres, assistants are usually well-trained fellows; in many other settings, assistance is limited to rotational nurses or junior trainees. A clipless RS-RP technique simplifies the assistant’s role, requiring mainly suctioning and instrument passage. Concerns regarding nerve injury can be addressed using pinpoint monopolar or low-power bipolar energy, which allows for precise dissection with minimal lateral thermal spread. This session will demonstrate the RS-RP technique in a semi-live format, highlighting steps to safely adopt it outside high-volume centres. With structured modifications and thoughtful case selection, the shift to RS-RP can be both practical and beneficial.
16:15 16:30	Transperineal Fusion Biopsy of Prostate: Tips and Tricks Victor C. LinTaiwan Moderator Chit Sin LohMalaysia Moderator Rajeev TPIndia Moderator Newer Advances in the Endourological Management of Stones – Have We Reached the Zenith Guan Hee TanMalaysia Speaker Transperineal Fusion Biopsy of Prostate: Tips and TricksTransperineal MRI-ultrasound fusion biopsy has emerged as a highly accurate and safe approach for prostate cancer diagnosis. The transperineal approach to prostate biopsy offers high precision in diagnosing clinically-significant prostate cancer while minimizing infection risks. This semi-live video presentation demonstrates a step-by-step approach to the procedure using the Koelis platform, focusing on optimal setup, image registration, and targeted sampling techniques. Key aspects include patient positioning, probe fixation, and system calibration to ensure accurate fusion of pre-procedural MRI with real-time ultrasound. I will highlight strategies for efficient lesion targeting, including trajectory planning, and needle deployment when performing this procedure. This video aims to provide viewers with a clear, practical guide to performing transperineal fusion biopsy on the Koelis system, enhancing diagnostic accuracy and procedural efficiency.
16:30 16:45	Robotic Partial Nephrectomy: Beyond Technique Victor C. LinTaiwan Moderator Chit Sin LohMalaysia Moderator Rajeev TPIndia Moderator Newer Advances in the Endourological Management of Stones – Have We Reached the Zenith Henry HoSingapore Speaker Technical Pearls: Wheel-Barrow TechniquesBringing Innovation to PatientRobotic Partial Nephrectomy: Beyond Technique
16:45 17:00	Nephro-Ureterectomy with Cystectomy & Other Uncommon Uro-Oncology Cases Victor C. LinTaiwan Moderator Chit Sin LohMalaysia Moderator Rajeev TPIndia Moderator Newer Advances in the Endourological Management of Stones – Have We Reached the Zenith Lih-Ming WongAustralia Speaker Nephro-Ureterectomy with Cystectomy & Other Uncommon Uro-Oncology CasesTo generate discussion and interest, a selection of uncommon tumours excised robotically will be presented. These will be chosen from a selection of prostate sarcoma, pelvic liposarcoma, retroperitoneal schwannoma, distal ureterectomy and urachal adenocarcinoma.
17:00 17:10	Discussion