Insights from ERUS-EAUN24 Robotic Urology Nursing Meeting

In September we travelled with a delegation from the Antoni van Leeuwenhoek Hospital in Amsterdam to Bordeaux for the annual ERUS Meeting. On the first day, we attended the EAUN meeting, and we both had the opportunity to present during this 1-day meeting. The nurses’ programme held much promise and did not disappoint. It is always enriching to exchange experiences with colleagues from various countries. It was a pleasure to reconnect and get to know everyone better.

Ms. Van Tol presented on the role of advanced imaging in radical prostatectomies. Since urologists have mastered the technique of RARP, investigations have now been started on how this technique can be refined to obtain even greater precision. Ultimately, the aim is to lessen the positive margins even more and thus to have better oncological outcomes. Also, a lot can be gained when it comes to the preservation of continence and potency.

With the help of 3-D models, image guided navigation, fluorescence, tracers and drop-in probes, we aim to create a future where prostate cancer patients can receive tailor made care and be treated with even greater precision.

Training first assistants?
Ms. Remmé presented on the importance of training first assistants. At Antoni Van Leeuwenhoek Hospital, operating department practitioners function as first assistants in a variety of robotic surgeries across all surgical disciplines. Despite the complexity of laparoscopic procedures, there were, until recently, no official requirements for first assistants. This is also the case at other hospitals across the Netherlands.

The responsibilities of a first assistant have become more demanding, involving critical tasks. For example, placing a bulldog clamp on the kidney vein and artery during a partial nephrectomy, or managing the stapler in constructing a Bricker pouch. These are highly responsible tasks.

Following a serious incident involving a patient with a bowel perforation, we recognised the need to enhance the quality of surgery to improve patient outcomes. As a result, a comprehensive six-step training programme has been developed.
1. E-learning
2. Hands-on training
3. Laparoscopic box training
4. Training on the job
5. Yearly refresher course
6. Critical resource management training

Upon completion of this training, our colleagues are awarded a certificate. This certificate is recognised by the Dutch National Professional Association for Operating Department Practitioners.

Other presentations
Experts also covered the topic of non-surgical predictors in the recovery of erectile function following a RARP, as well as enhancing patient experiences by using videos to inform patients on their treatment. There was also time to reflect on the human factors in robotic surgery and how to train oneself to respond better at emergencies, as well as how work efficiently individually and as a team.

On the second day of the meeting, the nurses were offered a training at the Intuitive headquarters in Bordeaux. During the HOT training sessions, participants received a refresher of helpful tools and processes to aid in achieving an effective and efficient robotic service. They were introduced to a new educational augmented reality system which would help in the training and development of newly trained robotic users, and it did also serve as a refresher for trained robotic users. Most importantly, there was a session on ‘Advanced emergency simulation training for emergency scenarios’, which provided useful and practical information on how to implemented this within our own robotic theatres.

Overall, it was a successful ERUS programme, with an increase in the number of attendees, especially in the HOT training sessions. As we grow and develop as a group, we have also launched nursing poster presentations where teams are encouraged to embark on research and development within the world of robotic nursing.

We hope to see you next year in London for ERUS-EAUN25.