European Urology Today: June/July 2023

very unusual for Western people, but it went well in the end. Visit to Osaka (12 to 14 April) It was time to leave Fukuoka. After a short domestic flight to Osaka Itami, Dr. Kentaro Takezawa picked us up at the subway station near Osaka University Hospital. We were immediately accompanied to a late lunch with Prof. Norio Nonomura, head of the department of urology, congress president of this year’s JUA meeting and incumbent JUA president. Despite the business of the entire staff in preparation for the meeting, we experienced tremendous hospitality. There was a well-planned programme in the hospital interspersed with exclusive lunches and dinners. The code word “gluten free” was considerately kept in mind with every restaurant visit. We stayed in a guesthouse conveniently located at a walking distance to the hospital, as the city centre of Osaka is a one-hour trip by subway. With some time left in the afternoon, we made the trip to the city centre to visit the famous Osaka Castle, and climb Umeda Sky Building (173m high) in the evening to enjoy a superb 360-degree view of the city. On our second day, Dr. Atsunari Kawashima gave us an impressive overview of the department’s latest translational research, which included the CCR8-targeted specific depletion of clonally expanded T(reg) cells in renal cell carcinoma, and the use of microbiome DNA derived from extracellular vesicles.

In Japan, instead of a medical oncologist, it is the urologists who apply systemic treatment to patients with metastasised urologic cancers. This provides urologists a unique opportunity to participate in clinical studies, tie with pharmaceutical companies, and generate funds for translational research. It was remarkable to see that every urologist is involved in translational research, and is able to exert urology so broadly. In addition, many urologists went to the United States or Canada for a fellowship before becoming staff member. At the clinic, Intuitive was present with a truck to show and let us experience the Da Vinci Single Port system™. On our last day at the Osaka University Hospital, we went to the OR. We saw another RARP, and a transurethral resection of the bladder (TURB). Four staff members, all with a different level of experience, were involved in a TUR of a bladder tumour at one of the ureteral orifices. We smiled because of a familiar scene taking place in front of us: urologists with wet feet and the OR nurse lugging a full bucket and applying swabs to the floor. It is the same in every country. Weekend off (14 to 16 April) Dr. Takezawa participated in the American Urology Association (AUA)-JUA Exchange last year, and insisted to bring his guests to Osaka’s bustling city centre by car on Friday afternoon. A convenient hotel next to Umeda, Osaka’s central station, was our base for the coming weekend. “It was remarkable to see that every urologist is involved in translational research, and is able to exert urology so broadly.” The Umeda station is not for the faint-hearted. It is incredibly crowded at rush hour and consists of two enormous multilevel buildings, where navigation does not work ( it wasn’t easy to find an exit).

Together with Prof. Eto and the urology staff members of the Kyushu University Hospital

The next day, Dr. Jun Teishima took us to the Kobe University Branch Hospital on Port Island. Minor surgeries are performed at this location, and there is a dry lab with another complete Hinotori system™. A training and education specialist was present, and we were lucky to be given the opportunity to do a virtual and practical training on the system all morning. In the afternoon we were taken for a tour of the OR, and experienced one patient undergoing MRI-fusion targeted prostate biopsies. It was a pleasure to meet Prof. Masato Fujisawa, head of the department of urology, president of Kobe University, and previous president of the JUA. In the evening, we joined him and the staff members for a delicious teppanyaki-style dinner with, of course, Kobe beef. Visit to JUA meeting in Kobe (19 to 22 April) The 110th Annual Meeting of the JUA (JUA2023) was held at the Kobe International Conference Center. After years of dealing with the COVID-19 pandemic, the excitement was high for the fully on-site meeting where participants rediscovered face-to-face contact.

Once you are in the right train, it only took 30 minutes to Kyoto (which has been the imperial capital of Japan for over 1000 years), or only 45 minutes to Nara (where emperor palaces and large Shinto shrines can be found). We visited both cities for a day. On Sunday evening, we moved to the city next door, Kobe. Visit to Kobe (16 to 19 April) In the morning, Dr. Tomoaki Terakawa of Kobe University Hospital picked us up. There were three simultaneous robot-assisted surgeries scheduled that day: radical prostatectomy, partial nephrectomy, and cystoprostatectomy with intracorporeal ileal conduit. We started in the OR where the RARP was performed using the first-ever Hinotori system™. This robot-assisted surgery system is developed in Japan and was proudly presented to us. We had not experienced this system before. We were allowed to witness the best parts of each surgery and stayed at the hospital until wound closure. We also spoke to the European representatives of Medicaroid, who were there in Kobe for the upcoming JUA meeting.

Introducing the first-ever Hinotori system™, which is developed in Japan

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European Urology Today June/July 2023


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