Chandra Shekhar Biyani

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Verified

Chandra verified their affiliation via an institutional email.

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• MBBS MS D Urol FRCS (Urology) FEBU MSc (Medical Simulation)
• Consultant at Leeds Teaching Hospitals NHS Trust

Introduction Simulation‐based training (SBT) has become an essential component of surgical education. However, the definitive evidence for dissrect patient outcomes remains inconsistent. This prompted us to conduct this systematic review and meta‐analysis to evaluate Kirkpatrick Level 4 evidence on whether SBT translates into clinical benefits and...

Purpose To perform a systematic review (SR) to examine the application of classification systems (CS) used to report intraoperative adverse events (iAEs) in urological surgery and to evaluate the crude incidence and type of iAEs. Materials and methods This review was published via PROSPERO (CRD42024549954) and conducted following the Preferred Rep...

Purpose To perform a systematic review (SR) to examine the application of classification systems (CS) used to report intraoperative adverse events (iAEs) in urological surgery and to evaluate the crude incidence and type of iAEs. Materials and Methods This review was published via PROSPERO (CRD42024549954) and conducted following the Preferred Repo...

Background and objective Radiation-induced cystitis (RIC) is an important consequence of pelvic radiotherapy that can cause high morbidity and, in extreme cases, mortality. The lack of a widely accepted classification system makes it difficult to compare treatment regimens. Our aim was to develop a new classification system covering the RIC spectru...

We aim to enhance the reporting of complications in surgical operations by establishing a classification for patient complexity. Current comorbidity assessment tools are insufficient due to their reliance on physiological parameters. The proposed patient surgical class category (PSCC) aims to address these limitations and enhance results by incorpo...

Non-technical skills (NTS) are crucial in healthcare, encompassing cognitive and social skills that support technical ability. Traditional NTS training is evolving with the emergence of artificial intelligence (AI) models that can intelligently converse with their users, known as large language models (LLMs). This study investigated the capabilitie...

While only a limited number of procedures have image guidance available during robotically guided surgery, they still require the surgeon to manually reference the obtained scans to their projected location on the tissue surface. While the surgeon may mark the boundaries on the organ surface via electrosurgery, the precise margin around the tumor i...

Background Over the last 2 decades, various education and training programmes have been launched by the European School of Urology (ESU) on behalf of the European Association of Urology (EAU) Education Office. These include e-learning platforms, in-person meetings, courses, podcasts, webinars, sub-specialisation meetings and the European Urology Re...

BACKGROUND: Urology is one of the most rapidly evolving and technologically advanced surgical specialties. However, training programs in Sub-Saharan Africa (SSA) face unique challenges. This study aimed to assess the current status of urology training in SSA and identify areas for improvement, providing crucial insights into the strengths and limit...

Background Urologic emergencies are common and complications from their management are high. Simulation‐based education (SBE) is a highly effective training method, allowing trainees to learn both technical and nontechnical skills in a safe environment. Training in the management of urological emergencies is limited in many healthcare settings, so...

Aim Entry into Higher Surgical Training is associated with new challenges to trainees’ clinical, technical, professional and inter-personal skills. A three-day modular “bootcamp” course was designed for new General Surgery ST3s transitioning from Core Surgical Training to bridge the gap and support areas of developmental need. Methods Four varied...

An innovative, practical hands-on interactive simulation-rich course aimed at senior urology trainees supporting the transition to a consultant role. It will reinforce your emergency urological skills and also provide training in often overlooked areas such as dealing with stress, effective leadership and the day-to-day challenges of consultant pra...

Aim To create an introductory course or “bootcamp” to assist new ST3s transition from working at core trainee to General Surgical Registrar level within a regional Health Education England system. Method Using previous expertise of “bootcamps” delivered in the region in similar specialities, a 3-day programme was designed to offer training in area...

Objectives: In recent years, consumer-grade immersive virtual reality (iVR) systems have gained increasing attention for their potential applications in surgical training. The relatively low cost and increasing quality of these systems make them an appealing alternative to specialist surgical simulators, but their efficacy in comparison to traditio...

Objectives To assess the feasibility of performance enhancement coaching (PEC) for newly appointed Urology registrars (ST3s), specifically: whether the concept appealed, and which areas beyond technical skills acquisition were felt to be most relevant or useful. Subjects and methods All delegates on the Urology Bootcamp 2023 were invited to take p...

Objective To develop and validate a low-cost, portable, and reusable simulation model for optical internal urethrotomy (OIU) training. Methods A 3D-printed low-cost simulation model for OIU was designed locally and the final model was evaluated by trainees and trainers at the urology boot camps (UK, Belgium, Portugal, Poland). Participants were...

Background Poor mental health in medical students is a global concern. Effective interventions are required, which are tailored towards the training-related stressors medical students experience. The Reboot coaching programme is an online, tailored intervention based on cognitive-behavioural principles. Aims To evaluate whether the Reboot coaching...

Background Surgical treatment of small renal tumours remain gold-standard for individuals who are suitable candidates. Over the last decade, minimally invasive surgery has provided significant advancements within the field of urological surgery. However, there is still a debate on which surgical modality is superior. This study aims to review the c...

Background Surgical site infections (SSI) complicate up to 40% of surgical procedures, leading to increased patient morbidity and mortality. Previous research identified disparities in SSI prevention guidelines and clinical practices across different institutions. The study aims to identify variations in SSI prevention practices within and between...

Background: Urological conditions are a cause of diminishing quality of life, hence affecting productivity. Despite the need for urological treatment, it was excluded from receiving priority in both United Nation and Lancet commission. Most of the surgeries in sub-Saharan Africa are open surgeries. The lack of basic endourology equipment and a sho...

Background The Essential Surgical Skills Course (ESSC) is a multi-specialty surgical stimulation embedded course that has been run successfully for five years, acting as an educational paradigm for bridging the gap between two levels of training. This report aims to describe the evolving process of designing and delivering a successful ‘hands-on’ c...

Purpose To present the seven-year experience of a multi-component and interactive module on female, neurological and urodynamic urology (FNUU) training at the UK National Urology Simulation Bootcamp Course (USBC) and demonstrate trainee satisfaction and competency progression. Methods During the week-long USBC, a four-hour module on FNUU was desig...

Background The Essential Surgical Skills Course (ESSC) is a multi-specialty induction “boot camp” style course that has been run successfully for five years. The aim of the current paper is to create an accurate guide for the replication of the course by other teams and assess the course's fitness for purpose, through the survey feedback provided b...

https://doi.org/10.1016/S2666-1683(23)00314-2

Background Minimally invasive (MI) surgery has revolutionised surgery, becoming the standard of care in many countries around the globe. Observed benefits over traditional open surgery include reduced pain, shorter hospital stay, and decreased recovery time. Gastrointestinal surgery in particular was an early adaptor to both laparoscopic and roboti...

Background: Standards for reporting surgical adverse events vary widely within the scientific literature. Failure to adequately capture adverse events hinders efforts to measure the safety of healthcare delivery and improve the quality of care. The aim of the present study is to assess the prevalence and typology of perioperative adverse event rep...

Background Urology trainees experience high burnout, and there is an urgent need for acceptable and effective interventions. The current study evaluated Reboot coaching workshops (Reboot‐C), a tailored intervention based on cognitive–behavioural principles, with urology trainees. Objective Our primary objective was to evaluate the acceptability of...

Introduction: The accurate assessment and grading of adverse events (AE) is essential to ensure comparisons between surgical procedures and outcomes. The current lack of a standardized severity grading system may limit our understanding of the true morbidity attributed to AEs in surgery. The aim of this study is to review the prevalence in which i...

The COVID-19 pandemic exposed the fragility of electivesurgical and anaesthesia services, resulting in millions ofoperations being cancelled across the world1. As healthsystems plan post-COVID recovery of elective surgicalservices, they should identify potential future external risksto surgical services2. Extreme weather events resulting fromclimat...

Background: Surgeons in the UK report high burnout levels. Burnout has been found to be associated with adverse patient outcomes but there are few studies that have examined this association in surgeons and even fewer which have examined this relationship over time. Purpose: The main aim was to examine the relationships between surgeon burnout a...

Background and aims: To obtain opinions from urology trainees and consultants regarding the need for, and structure of, a post-specialty training Urology Simulation Boot Camp (USBC) for consultant practice. Methods and results: A survey-based study was conducted, and 'Google Forms' were distributed electronically via social media. Urology specia...

Purpose To investigate and assess outcomes, complications, and functional results amongst different modifications of endoscopic enucleation of the prostate (EEP). Methods We conducted a systematic review and meta-analysis according to the PRISMA checklist. We searched the Medline, Cochrane, and Embase databases. We included only randomised-control...

Background and aims Urinary bladder recurrences (UBRs) after radical nephroureterectomy (RNUx) are a known challenge in patients with upper-tract urothelial cancers (UTUCs). We aim to assess factors associated with UBR and clonal-relatedness with resected UTUC. Methods Patients who underwent RNUx for UTUC between 1998 and 2015 in five institutions...

Introduction: There are several endoscopic enucleation procedures (EEP) using different energy sources: holmium laser enucleation of the prostate (HoLEP), thulium laser enucleation of the prostate (ThuLEP), Greenlight® (GreenVEP) and diode (DiLEP) lasers, and plasma kinetic enucleation of the prostate (PKEP). The comparative outcomes among these E...

Autonomous robotic Ultrasound (US) scanning has been the subject of research for more than 2 decades. However, little work has been done to apply this concept into a minimally invasive setting, in which accurate force sensing is generally not available and robot kinematics are unreliable due to the tendon-driven, compliant robot structure. As a res...

Understand the importance of feedbackIdentify the key requirements for delivering good feedbackExplore the pros and cons of different feedback modelsUnderstand some of the barriers to effective feedback, and relate these to your own practice. Understand the importance of feedback Identify the key requirements for delivering good feedback Explore th...

Aim Achieve an international consensus on how to recover lost training opportunities. The results of this study will help inform future EAES guidelines about the recovery of surgical training before and after the pandemic. Background A global survey conducted by our team demonstrated significant disruption in surgical training during the COVID-19...

Background and Aims Poor well-being affects the performance of all kinds of workers, including surgeons. This study aimed to answer two questions: (1) how does burnout affect surgeons personally, and what is their burnout experience like? (2) How does burnout affect the care that surgeons provide in the United Kingdom (UK)? Method This study condu...

Aim Stents are widely used in the management of ureteric strictures but require changes every 6–12 months and stent related symptoms are commonly reported. AlliumTM ureteric stents are large calibre, metallic stents that aim to reduce the incidence of stent-related complications, with an indwelling time up to three years. These were introduced with...

Objectives To develop a nomogram that could predict spontaneous stone passage (SSP) in patients presenting with acute ureteric colic who are suitable for conservative management. Patients and Methods A 2517 patient dataset was utilised from an international multicentre cohort study (MIMIC, A Multi-centre Cohort Study Evaluating the role of Inflamma...

Surgical outcomes are traditionally reported using postoperative metrics. Routine data collection of postoperative complications and histological outcomes are widely used as surrogate markers of surgical quality. Although these measures can provide an overall account of surgical outcomes, they may not reliably reflect surgical skill and or competen...

Background Stone disease is a common complication of horseshoe kidneys (HSK). There are currently limited studies that examine the relationship between HSK anatomy and stone formation. We aim to determine if there is such an association by measuring the isthmus size and renal angulation in both stone and non-stone forming HSK using computed tomogra...

Acquisition of surgical skills by simulation has become the foundation of modern surgical training. As the training opportunities in modern surgical skills centers are limited due to cost and availability; many low-cost, easily available and sustainable alternatives for simulation of surgical training have been developed. This is a reappraisal of l...

This book provides a detailed overview of a range of simulation models that have been developed which are applicable to urology. Chapters feature critical analysis of techniques including synthetic bench top models, computer-assisted virtual reality and box simulators. Furthermore, details of best practice, the latest innovations and guidance on ho...

Introduction Nomograms, used to predict the risk and success of treatment of urinary tract stones, are being used in paediatric clinical practice. However, no studies have determined the best prediction model. This study aimed to identify the most robust nomogram(s) for predicting clinically relevant outcomes in urinary stone disease in paediatric...

Percutaneous nephrostomy insertion is a technique performed by an interventional radiologist or a urologist for an acutely or long-standing obstructed urinary tract. Mastering the technique involves overcoming a steep learning curve. Various methods of training have been developed over the years to facilitate learning. These vary from simple physic...

Background Poor wellbeing affects the performance of all types of workers. Surgeons are particularly at risk of suffering from burnout, but minimal qualitative research has examined the causes of burnout and potential solutions in this group. Understanding this could inform the development of future burnout interventions. Purpose This study aimed...

Background The coronavirus pandemic has had an indisputable impact on surgical training. The qualitative effect on the perceived confidence and capability of trainees has been widely reported. In order to fully delineate the scope of the problem, quantitative data is also required. Methods This cross-sectional study collected compared data on the...

Examination of the scrotum is an essential skill for emergency, surgical and general practice (GP) clinicians. However, the examination poses a number of challenges due to its intimate nature and wide range of potential pathologies, resulting in many UK trainees feeling uncomfortable and underconfident in this skill. This article aims to address th...

Background Intraoperative adverse events (iAEs) are surgical and anesthesiologic complications. Despite the availability of grading criteria, iAEs are infrequently reported in the surgical literature and in cases for which iAEs are reported, these events are described with significant heterogeneity. Objective To develop Intraoperative Complication...

The Royal College of Physicians and Surgeons of Glasgow is a community of health professionals working together to develop and improve patient care. The College is dedicated to supporting its members through education, training and continuing professional development. Furthermore, the College is committed to good global citizenship and has supporte...

Although penoscrotal and catheterization procedures are basic skills, it is very important for students and residents to master these skills in a learner-centered environment. Multiple training models are available for simulation training.KeywordsSimulationTrainingVasectomyVasovasostomyCircumcisionParaphimosisPriapismPeyronie'sPenile fractureCathet...

Developing and implementing a simulation program is a complex, multi-phase, and demanding process. The necessity for the implementation science in healthcare simulation is now broadly acknowledged, so educators in leadership positions have a responsibility to minimise “trial-and-error” approach and ensure the implementation of evidence-based simula...

Simulation-based training nowadays constitutes a large part of the procedural learning curve and can be acquired using training models. Procedural training simulators imitate some aspect of human anatomy or surgical step, facilitating a learning activity through simulation of characteristics of that anatomy or step. Applying surgical simulators off...

Simulation for teaching and training in functional urology, especially female urology, is an understudied but growing field. Anatomical training and training on anatomical landmarks for pelvic floor surgery have benefited from several simulation tools such as 3D models, virtual reality and 3D printing. The variable nature of the female pelvic floor...

Intraoperative adverse events (iAEs) are under-reported, have poorly standardized nomenclature, and are plagued by barriers to reporting and cultural acceptance. Not surprisingly, although surgeons are willing to report iAEs, they often under-report these events, especially those of lower severity, owing to perceived clinical insignificance¹. Attem...

Surgical training has undergone a paradigm shift as the acquisition phase of surgical skills has transitioned from the operating theatre to the simulation lab. Several factors have led to this shift; including reduced operative volumes, the need for competence-based curricula and ethical concerns in relation to patient safety. Yorkshire and Humber...

Background Previous systematic reviews have found high burnout in healthcare professionals is associated with poorer patient care. However, no review or meta-analysis has investigated this association in surgeons specifically. The present study addressed this gap, by examining the association between surgeon burnout and 1) patient safety and 2) sur...

Background The growth of “bootcamp style” simulation training in surgical practice has been exponential over the last decade. Developing and delivering a surgical bootcamp requires a significant investment. This systematic review aims to identify the key components that allow for a successful and rewarding surgical bootcamp course to be implemented...

Background: The Performance Improvement score (Pi-score) has been proven to be reliable to measure performance improvement during E-BLUS hands-on training sessions. Our study is aimed to adapt and test the score to EST s1 (Endoscopic Stone Treatment step 1) protocol, in consideration of its worldwide adoption for practical training. Methods: The Pi...

Background The SARS-Cov-2 pandemic had a profound impact on surgical services, potentially causing a detrimental impact on training opportunities. The aim of this global survey was to assess the impact of the COVID-19 crisis on surgical training and develop a framework for recovery. Methods A cross-sectional, web-based survey was conducted. This w...

Objective To design and assess a novel penile fracture simulation model for teaching penile fracture repair. Methods We used a validated circumcision simulator to create a model. Foreskin for a circumcision was divided into two halves. A transverse slit (“simulated fracture”) was created on one part of the first half of the foreskin (mimicking “tu...

The introduction of laparoscopic surgery has several advantages including shorter hospital stay, less pain, and smaller scars. This new surgical technique, however, provoked a paradigm shift in training modality. It was a difficult task to acquire these complex surgical skills in demanding and constantly changing operating room settings due to the...

Objectives The objective of our study was to study trainees’ feedback and rating of models for training transurethral resection of bladder lesions (TURBT) and prostate (TURP) during simulation. Methods The study was performed during the ‘‘Transurethral resection (TUR) module” at the boot camp held in 2019. Prior to the course, all trainees were re...

Surgical disciplines are popular and training places are competitive to obtain, but trainees report higher levels of burnout than either their non-surgical peers or attending or consultant surgeons. In this review, we critically summarise evidence on trends and changes in burnout over the past decade, contributors to surgical trainee burnout, the p...

The operative and non-technical skills exposure of urology trainees has reduced due to a number of factors, including the European Working Time Directive, and the COVID-19 pandemic. Simulation-based education (SBE) is an innovative addition to clinical experience which can begin to address the skills-based learning deficiency in order to help train...

Objective: To design and assess a novel penile fracture simulation model for teaching penile fracture repair. Methods: We used a validated circumcision simulator to create a model. Foreskin for a circumcision was divided into two halves. A transverse slit ("simulated fracture") was created on one part of the first half of the foreskin (mimicking...

Objective To develop an assessment instrument that can be used as a comprehensive feedback record to convey to a trainer the non-technical aspects of skill acquisition and training. Methods The instrument was developed across three rounds. In Round 1, 6 endourological consultants undertook a modified Delphi process. Round 2 included 10 trainers wh...

Background The COVID-19 pandemic represents the greatest biopsychosocial emergency the world has faced for a century. The pandemic has changed how individuals live and work, and in particular, frontline healthcare professionals have been exposed to alarming levels of stress. Objective The aim of this study was to understand the professional and pe...

Background: The SARS-CoV-2 pandemic had a profound impact on surgical services, potentially having a detrimental impact on training opportunities. The aim of this global survey was to assess the impact of the COVID-19 crisis on surgical training and to develop a framework for recovery. Methods: A cross-sectional, web-based survey was conducted....

Background Ischaemic priapism is a urological emergency. Early treatment is required to prevent irreversible loss of erectile function. Corporal aspiration is the first step in management. Currently, there are no satisfactory training models to develop skills in a controlled environment. We have therefore developed a novel training model to teach t...

Background The SARS-CoV-2 pandemic had a profound impact on surgical services, potentially having a detrimental impact on training opportunities. The aim of this global survey was to assess the impact of the COVID-19 crisis on surgical training and to develop a framework for recovery. Methods A cross-sectional, web-based survey was conducted. This...

Background: Ischaemic priapism is a urological emergency with early treatment required to prevent irreversible loss of erectile function. Corporal aspiration is the first step in management. Currently, there are no satisfactory training models to develop skills in a controlled environment. We have therefore developed a novel training model to teac...

In surgical robotics, the ability to achieve high levels of autonomy is often limited by the complexity of the surgical scene. Autonomous interaction with soft tissues requires machines able to examine and understand the endoscopic video streams in real-time and identify the features of interest. In this work, we show the first example of spatio-te...

Objective To determine and analyse the temporal changes in oncological nephrectomy practice and training opportunities using data obtained from the UK British Association of Urological Surgeons nephrectomy register from 2008 to 2017. Patient and Methods All nephrectomies within the dataset for this time period were analysed (n = 54 251). Cases wer...

Background Urolithiasis has a significant impact on patients’ health-related quality of life (HRQoL). Objective To develop a core patient-reported outcome measure (PROM) using modern psychometric methods to quantify the impact of urolithiasis and different treatments. Design, setting, and participants Adult patients with urinary calculi, attendin...

Cystinuria is the most common cause of inherited stone disease and is caused by the failure of absorption of filtered dibasic amino acids including cystine in the proximal tubules. It is associated with a very high recurrence rate in affected patients, with the potential for significant morbidity in such patients due to the need for repeated surgic...