Zeyad R. Schwen

Objectives: To determine the diagnostic performance of ex vivo fluorescence confocal microscopy (FCM) for prostate cancer detection in magnetic resonance imaging (MRI)‐targeted biopsy specimens using final histopathology as the reference standard, and to quantify workflow component times relevant to same‐day implementation. Patients and Methods: In this single‐centre prospective observational study, men undergoing MRI‐targeted transperineal prostate biopsy were enrolled. Targeted biopsy cores were imaged ex vivo using a Histolog® FCM scanner (SamanTree Medical SA, Lausanne, Switzerland) after rapid acridine orange immersion and prior to routine histopathological processing. Two board‐certified genitourinary pathologists independently reviewed FCM images in a blinded fashion and classified each specimen as positive or negative for prostate cancer and clinically significant cancer (CSC), defined as International Society of Urological Pathology Grade Group (GG) ≥2. Diagnostic performance was calculated against final histopathology. Workflow feasibility was assessed by measuring specimen preparation, scanning, and interpretation times. Interobserver agreement and exploratory discordance analyses were performed. Results: A total of 50 MRI‐targeted biopsy specimens from 44 patients were analysed, of which 33 (66%) contained prostate cancer and 17 (52%) met criteria for CSC. For cancer detection, Reader 1 achieved 87.9% sensitivity and 94.1% specificity, and Reader 2 achieved 97.0% sensitivity and 76.5% specificity, with overall accuracy of 90% for both readers. Interobserver agreement for cancer detection was 88% ( κ = 0.74), and for CSC was 86% ( κ = 0.61). Mean specimen preparation and interpretation times were ~2 min each, with standardised scanning time of 50 s, enabling complete FCM assessment in Ex vivo FCM provides rapid, accurate, and reproducible assessment of MRI‐targeted prostate biopsy specimens for cancer detection within clinically feasible timeframes. These findings support FCM as a same‐day diagnostic adjunct and justify prospective trials evaluating real‐time implementation during targeted biopsy.

The Central European Journal of Urology is an open access quarterly-issued journal, which provides a forum for the presentation of original clinical, experimental and other research studies...

Objective: To describe the surgical technique for the single-port (SP) transperitoneal donor nephrectomy (DN) through a modified Pfannenstiel incision using the Da Vinci SP ^® surgical system (Intuitive Surgical, Sunnyvale, CA) on a cadaver. Patients and Methods: In a male cadaver, the SP surgical system was used to perform transperitoneal DN. A 3-cm modified Pfannenstiel incision was made. Through the incision GelPOINT mini (Applied Medical, Rancho Santa Margarita, CA) was inserted. The floating docking technique was used. Through the gel port, the dedicated 25-mm multichannel port and a 12-mm assistant port were introduced. The surgical steps for DN were performed in the following order: (1) mobilization of the colon, (2) identification of psoas muscle, ureter, and the gonadal vein, (3) hilum dissection, (4) perirenal dissection, (5) stapling the renal artery and renal vein, and (6) removal of the kidney through the enlarged incision. Results: Transperitoneal SP DN was completed without any complications or capsulotomy. Additional ports were not needed. The total operative time was 63 minutes and 54 seconds. A good-quality kidney was harvested. Renal artery length was 4 cm. Conclusion: We demonstrated the feasibility of SP transperitoneal DN through modified Pfannenstiel incision, using the novel SP robotic platform. Further assessment is necessary in a clinical setting.