The convergence of artificial intelligence and robotic surgery is redefining the management of genitourinary cancers by enhancing diagnostic accuracy, surgical precision, and training efficiency. This narrative review explores recent advancements in artificial intelligence applications across the cancer care continuum, with a focus on prostate, kidney, and bladder malignancies. Artificial intelligence tools, particularly those based on machine learning and deep learning, have demonstrated strong performance in analyzing imaging data, segmenting tumors, predicting pathological features, and supporting clinical decision-making. Intraoperatively, artificial intelligence enables skill assessment, personalized feedback, and real-time navigation by processing data from surgical videos and robotic system sensors. Augmented reality and intraoperative modeling further enhance visualization and margin control during complex procedures. The review also discusses emerging technologies such as single-port robotic platforms, which offer advantages in confined anatomical spaces and support less invasive approaches. Additionally, the growing field of telesurgery is addressed, highlighting its feasibility for complex urologic operations across vast distances. While many of these innovations are still in early stages of clinical validation, their integration into practice has the potential to improve oncologic and functional outcomes, expand access to expert care, and foster the development of next-generation surgical strategies in urologic oncology.
AIMS:Cavotricuspid isthmus (CTI) ablation is a cornerstone therapy for typical atrial flutter (AFl) and is commonly performed during atrial fibrillation (AF) ablation. In this multicentre randomized trial, we compared a lattice-tip catheter with an irrigated focal-tip catheter for radiofrequency CTI ablation (LINEAR study-ClinicalTrials.gov NCT07078760). METHODS AND RESULTS:Patients were randomized to a lattice-tip, dual-energy catheter (lattice-tip group) or to a standard 3.5-mm irrigated radiofrequency catheter (standard group) in two centres. In the lattice-tip group, only radiofrequency was utilized. The primary endpoint was the achievement and persistence of bidirectional CTI block after a 60-minute waiting period, confirmed by high-density electroanatomical mapping and adenosine testing. Secondary endpoints included the rate of first-pass block, the number of lesions, and the ablation time. Procedural complications were recorded. In total, 102 patients were randomized. The primary endpoint was achieved in significantly more patients in the lattice-tip as compared to the standard group (94.1% vs. 68.6%, P = 0.002). The lattice-tip catheter resulted in a significantly higher rate of first-pass block (90.2% vs. 60.8%, P = 0.001). CTI block required significantly shorter ablation time (41.3 ± 12.1 vs. 245.3 ± 91.3 s, P < 0.001) and a significantly lower number of lesions (8.3 ± 2.4 vs. 13.4 ± 4.5, P < 0.001) in the lattice-tip as compared to the standard group. No procedural complications were documented. CONCLUSION:The lattice tip catheter resulted in higher acute procedural success for radiofrequency CTI ablation compared to the standard irrigated focal-tip catheter. Future studies are needed to assess long-term efficacy and clinical outcomes.
Background Progressive aortic root dilation in patients with Fontan circulation requires vigilant monitoring to ensure timely surgical intervention. Case Summary A 41-year-old patient with Fontan circulation (tricuspid atresia, large ventricular septal defect, situs inversus totalis) presented on NYHA functional class II. Echocardiography and cardiac magnetic resonance imaging confirmed severe aortic regurgitation with 8.1-cm ascending aortic aneurysm and impaired function. He underwent a modified Bentall and bilateral Cabrol procedure using 30-mm tube graft, 27-mm mechanical valve, and coronary conduits. Despite a challenging postoperative course requiring temporary intra-aortic balloon pump, he recovered well with improved ventricular function. Discussion Aortic root dilation is a recognized late complication in single-ventricle physiology. This is the first report of surgical repair of a giant aortic aneurysm with severe regurgitation and impaired function in mirror-image Fontan anatomy. This case highlights how modified graft techniques overcome extreme surgical constraints. Take-Home Message A modified Bentall-Cabrol procedure can successfully repair giant aneurysms in Fontan anatomy.
Syringomatous adenoma of the nipple (SAN) is a rare benign tumor of the breast that can become a clinical and diagnostic challenge, as it can be misdiagnosed as invasive carcinoma due to its infiltrative nature. The treatment of choice is wide resection with clear margins. There are limited published cases of SAN. We present a case of SAN in a 42-year-old female patient, with regard to clinical manifestations, histopathologic and surgical findings, and differential diagnosis from other entities. A literature review of histologically confirmed cases of SAN revealed a total of 61 cases, including ours.
Intracardiac echocardiography (ICE) is an imaging technique that provides real-time, detailed visualization of intracardiac structures during various interventional procedures performed in the electrophysiology laboratory. Over the past decades, ICE has evolved beyond simply assisting with transseptal puncture, becoming an auxiliary tool in numerous aspects of cardiac interventions. This scientific statement offers a comprehensive, systematic overview of current applications of ICE across different clinical scenarios. The existing evidence regarding the benefits of ICE is primarily derived from observational studies, which complicates the formulation of definitive advice for its clinical use. Thus, this document aims to serve as a practical roadmap, emphasizing the key benefits of the technique. The document covers fundamental principles of ICE imaging, standardized views, its role in transseptal puncture, ablation of supraventricular and ventricular arrhythmias, reduction of procedural radiation, early detection and management of periprocedural complications, identification of infective endocarditis, and the role of ICE for endomyocardial biopsy and left atrial appendage occlusion procedures.
