“Junior ERUS” from Bedside surgeon to console surgeon.

The wide spread adoption of robotic surgery throughout Europe has coincided with the
growth and development of the European Robotic Urology Society (ERUS). Attendance at
the annual ERUS congress has increased year on year; indeed the 10th ERUS congress, which
was held in Bordeaux, France, was the most attended robotic urology meeting in the world.
This congress was opened by the first Junior ERUS meeting, a new sub-section of ERUS
made by and for young urologists with an interest in robotic urological surgery.

As interest in the practice of robotic surgery grows amongst senior urologists, junior
urologists are increasingly regarding robotic knowledge as a “must have”. Use of the "Da
Vinci System" throughout Europe is growing at an exponential rate, highlighting the needskilled in the use of this technology as they are with open procedures. At present the training
for experts to teach the correct use of this new technology. In the next few years most major
hospitals may have a “Da Vinci System” and surgeons of the future will be expected to be as

opportunities in robotic surgery for a residents and young urologists are limited, moreover a
well designed training program has not yet been established.

The purpose of Junior ERUS is to help address this problem by reaching out to urologists
that want to start their robotic surgical experience, and to give them a basis with which
to approach robotic surgery. In essence Junior ERUS has been made by the "Juniors" for
the "Juniors". Whilst our main target audience are urologists younger than 40 and residents, it
is important to state that nobody is excluded.

Some of you may ask how and why was Junior ERUS born? During the 9th ERUS congress
in 2009, we as group of junior robotic surgeons felt the need to share our experiences with
other like minded collegues. With the help and support of ERUS, Junior ERUS was officially
unveiled during the ERUS congress in 2010. We held a symposium during the first day of
the ERUS congress. Encouragingly more than 60 urologists both junior and senior actively
participated during the session. The program covered, in the first part, aspects of teaching
and learning robotic surgery and in the second part a step by step approach to radical
prostatectomy trying to give the participant a schematic approach to the procedure.

One of the highlights of the symposium was a talk introducing the concept of modular
training, as developed by Dr. Jens Uwe Stolzenburg for Laparoscopic Prostatectomy, into
training in robotic surgery . If one adopts this training model for robotic prostatectomy, once
a surgeon reaches a medium level of experience they are able to execute the majority of the
procedure with only the most difficult steps performed by the senior surgeon. This allows a
higher practice volume for the learner so facilitating rapid progression to the more difficult
steps of the procedure. In comparison conventional training usually comprises the "senior"
surgeon letting the "junior" performing as much of the procedure as they can from the start.
This model unfortunately means that the trainee will miss out on performing the easy steps of
the surgery that comes after a difficult one. Use of the Da Vinci Si dual console may allow the
easier introduction of modular training into training centres that has to date has been hard to
achieve.

The meeting was concluded by the video and oral presentations made by junior urologists.
The prize for the best video and the best oral presentation was an Intuitive Surgical sponsored
fully funded one month robotic fellowship at a European training center of the winners

choice. The video prize was won by Dr. Giovannalbero Pini (Heilborn - Germany) who
presented a video on robotic ureteral reimplantation. The best poster presentation was
awarded to Dr. Fabrizio Gallo (Savona, Italy) for his presentation on RALP: the “real”
learning curve. Both of last year’s winners will present reports on their fellowship experiences
during the 2011 Junior ERUS meeting.

Looking towards the future, Junior ERUS have great ambitions.. We are keen to promote and
sponsor training projects and fellowships in addition to offering help and support to junior
urologist working in the field of robotic surgery. We hope to attract young urologists from
across Europe, to attend our next Junior ERUS symposium which is part of the 11th ERUS
congress in Hamburg, Germany.

The Junior-ERUS Board has produced a preliminary program for the meeting. The half day
meeting will focus on the key issues regarding training, including covering all the steps that
a surgeon needs to become a console surgeon. The existing and suggested training methods
outside of the operating room will be reviewed as well as a discussion on the important role
of the table side surgeon. The principles of the surgical console will be explained followed
by a step by step explanation of the RALP with a really basic approach. The aim is to give a
schematic overview including key anatomic landmarks that help make the procedure easier
for beginners.

We will once again have a golden presentation session during our meeting. This year we
will be offering a number of prizes for the best videos and posters including; a fully funded
one month fellowship in robotic surgery, one free registration for the 2012 ERUS and one
free registration for an ERUS Masterclass. The topics of the videos and posters are limited
to aspects of lab training, patient positioning, bedside assisting or elementary tips & tricks
for the beginning console surgeon. As the focus of the meeting is junior surgeons; only
experiences presented by juniors and made by juniors will be accepted. In order to allow
residents that do not have a robot in their unit to participate and to have the opportunity to
win the fellowship, we will accept experiences on training outside the operating room with
dry or wet labs, simulators in open, robotics and laparoscopic surgery. If none of the received
abstracts are considered to be of sufficient quality the prizes will not be assigned. The
abstracts will be evaluated by the Junior ERUS board, and the golden ones will be showed
during the junior ERUS session. The participants within the session will vote directly for the
winner. All abstracts, videos and posters, considered to be of interest for presentation at the
ERUS meeting will be published in the abstract book in European Urology Supplement.

In conclusion we would like to invite you to join Junior ERUS at our next meeting in
Hamburg. You can find all the information about the ERUS congress on our website
www.erus2011.com.
Junior ERUS board

Announcement