About
448
Publications
88,129
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
3,936
Citations
Introduction
Professor and Chair of Robotic Surgery
School of Medicine
University of Hertfordshire
Consultant Urological and Robotic Surgeon
Associate Medical Director for Cancer Services and Cancer Lead
East and North Herts NHS Trust
International Professor of Urology and Robotic Surgery
Apollo Hospital Group India
Associate Member ESUI, EAU
website
www.nvasdevurology.com
https://researchprofiles.herts.ac.uk/portal/en/persons/nikhil-vasdev(9a105f10-065e-485e-b025-bcb5112e9ae9)/publications.html
Current institution
Additional affiliations
August 2014 - present
East and North Hertfordshire Teaching NHS Trust
Position
- Professor and Chair of Robotic Surgery / Consultant Urological and Robotic Surgery / Associate Medical Director - Cancer Services
August 2014 - March 2020
March 2016 - present
East and North Herts NHS Trust
Position
- Urology Medical Student Education Lead
Description
- Urology Medical Student Education Lead for medical students from the University of Cambridge and UCL Medical School
Publications
Publications (448)
Objectives
Multi-centre, multi-vendor validation of artificial intelligence (AI) software to detect clinically significant prostate cancer (PCa) using multiparametric magnetic resonance imaging (MRI) is lacking. We compared a new AI solution, validated on a separate dataset from different UK hospitals, to the original multidisciplinary team (MDT)-s...
Robotic technology has revolutionised minimally invasive urological surgery, enhancing precision and minimising surgical complications. Recent evidence suggests that utilising lower pneumoperitoneum pressures improves clinical outcomes but the comparative impact on post-operative pain remains uncertain. This systematic review analyses the literatur...
Introduction:
Focal therapy (FT) is a promising alternative to radical treatments for localized Prostate Cancer (PCa) in selected patients. However, it is not yet considered a standard treatment option, and there is currently no consensus on managing patients after FT. In this context, Prostate-Specific Membrane Antigen Positron Emission Tomograph...
Objectives
To compare 1‐year functional and 5‐year oncological outcomes of men undergoing robot‐assisted laparoscopic prostatectomy (RALP) with neurovascular structure‐adjacent frozen‐section examination (NeuroSAFE) with those in men undergoing RALP without NeuroSAFE (standard of care [SOC]).
Subjects and Methods
Men undergoing RALP in our centre...
Objectives: Perioperative blood transfusion (PBT) has been associated with worse survival after radical cystectomy (RC) in patients with muscle-invasive bladder cancer (MIBC). Here, we evaluated the association between PBT and survival after RC that was preceded by neoadjuvant chemotherapy (NAC). Methods: A retrospective analysis was performed on 9...
The formation of pneumoperitoneum involves the process of inflating the peritoneal cavity during laparoscopic and typically uses CO2 as the insufflation gas. This review aims to identify ideal gas mixtures for establishing the pneumoperitoneum with animal and human studies undertaken up to the writing of this review. A systematic search of PubMed,...
Purpose of Review
Our review delves into the progress across urological malignancies and discusses ongoing challenges and future directions in antibody–drug conjugate (ADC) development, emphasising their transformative potential in cancer care.
Recent Findings
ADCs have advanced from hematologic to solid tumours, notably in breast cancer, and are...
There is no shortage of references in popular culture to the prostate examination, with many a laugh built on the punchline of the finger up the bum. Interestingly, while cervical, breast, or bowel screening share barriers to uptake around the intimacy of the examination, 'ick-factor', or cultural taboos, they have never become comedy tropes-reflec...
Objective
to evaluate the role of urinary URO17® biomarker in the detection of urothelial tumors in haematuria patients and the detection of recurrence in non-muscle invasive bladder urothelial tumors.
Materials and methods
Our study was formed of two cohorts of patients, group I represents patients presenting with haematuria (n = 98), while group...
This study aims to review ophthalmic injuries sustained during of robotic-assisted laparoscopic prostatectomy (RALP). A search of Medline, Embase, Cochrane and grey literature was performed using methods registered a priori. Eligible studies were published 01/01/2010–01/05/2023 in English and reported ophthalmic complications in cohorts of > 100 me...
The aim of this article is to provide a literature review on the management of symptomatic physiological hydronephrosis in pregnancy and compare different modalities of intervention when needed. In this review, we conducted an electronic literature search of peer-reviewed journal articles. The PubMed, Research Gate, and Google Scholar databases wer...
Robotic-assisted radical cystectomy (RARC) is fast becoming the standard of care with comparable oncological outcomes to open surgery for patients with muscle-invasive bladder cancer. Ileal conduit is by far the most popular means of urinary diversion following a cystectomy. Use of stents is common practice to reduce uretero-enteric anastomosis-rel...
Objective:
To systematically evaluate cases of local anaesthetic systemic toxicity (LAST) in adult urological patients.
Methods:
A search of the Cochrane, Embase, and Medline databases as well as grey literature from 1 January 1974 to 1 February 2023 was performed using reported methods. Reporting followed the Preferred Reporting Items for Syste...
Testicular cancer is often overshadowed by other cancers despite being the most common cancer in men aged 15 to 34 years. This systematic review focuses on the potential of machine learning and deep learning techniques in the areas of testicular cancer imaging and histopathology, where artificial intelligence (AI) could assist in diagnosis, evaluat...
At presentation, approximately 25% of patients will have muscle-invasive bladder cancer (MIBC), and patients with non-MIBC may subsequently progress to MIBC. Prognosis is dependent on TNM stage (Table 12.1) and pelvic lymph node status. The disease requires a multi-disciplinary approach, encompassing surgeon, oncologist, radiologist, pathologist an...
Please confirm that an ethics committee approval has been applied for or granted
Not relevant (see information at the bottom of this page)
Application for ESRA Abstract Prizes
I don’t wish to apply for the ESRA Prizes
Background and Aims
Radical robotic prostatectomy is increasingly popular. Our aim was to evaluate the analgesic requirements post...
Zenith Annual Global webinar 7 Oct 2023 10-12 am
INTRODUCTION: Cisplatin-based neoadjuvant chemotherapy (NAC) is the standard of care for patients with muscle-invasive bladder cancer (MIBC) undergoing radical cystectomy (RC). Cisplatin, however, can induce renal toxicity. Furthermore, RC is an independent risk factor for renal injury, with decreases in estimated glomerular filtration rate (eGFR)...
![An overview of AI, ML and DL (image adapted with color changes from[1]).](publication/372014265/figure/fig1/AS:11431281177614005@1690552335095/An-overview-of-AI-ML-and-DL-image-adapted-with-color-changes-from1_Q320.jpg)
The advancement of computational abilities has taken us from the days of machines performing simple, one-dimensional tasks to themselves learning and applying knowns to unknowns. Artificial intelligence (AI) has become integral in daily life, yet there is vast room for application in surgery. Cancer research can divert attention from more prevalent...
Context:
Differences in recovery, oncological, and quality of life (QoL) outcomes between open radical cystectomy (ORC) and robot-assisted radical cystectomy (RARC) for patients with bladder cancer are unclear.
Objective:
This review aims to compare these outcomes within randomized trials of ORC and RARC in this context. The primary outcome was...
Introduction
Blue light cystoscopy with hexaminolevulinate (HAL) during transurethral resection of bladder cancer (TURBT) has been shown to improve detection, thereby reducing bladder cancer recurrence compared with white light cystoscopy.
Methods
Single‐centred UK (United Kingdom) study on 101 patients who underwent blue light cystoscopy between...
Background:
Little is known regarding functional outcomes after robot-assisted radical cystectomy (RARC) and intracorporeal neobladder (ICNB) reconstruction.
Objective:
To report on urinary continence (UC) and erectile function (EF) at 12 mo after RARC and ICNB reconstruction and investigate predictors of these outcomes.
Design, setting, and pa...
Background
Robotic cystectomy is the mainstay surgical intervention for treatment-refractory non-muscle-invasive and muscle-invasive bladder cancer. However, paralytic ileus complicates the post-operative recovery, and may be a consequence of an inflammatory response associated with transient gut ischaemia. We have therefore investigated clinical,...
Objectives
To evaluate the Versius Surgical System for robot-assisted prostatectomy in a preclinical cadaveric model using varying system setups, and collect surgeon feedback on the performance of the system and instruments, in line with IDEAL-D recommendations.
Materials and Methods
Procedures were performed in cadaveric specimens by consultant u...
503
Background: Pts presenting with NMIBC carcinoma in situ (CIS) have a high risk of progression. FGFR inhibition may benefit CIS pts with FGFRalt who are unresponsive to first-line BCG, for whom treatment (tx) options, other than radical cystectomy, are limited. Erdafitinib (erda), an oral selective pan-FGFR tyrosine kinase inhibitor, is approved...
106
Background: Apalutamide plus androgen deprivation therapy(ADT) has been approved as a treatment option for castrate resistant non metastatic prostate cancer (nmCRPC) with a high risk of developing metastatic disease. It has also demonstrated benefit in patients with metastatic, castration-sensitive prostate (mHSPC) cancer, with improvement in o...
Urolithiasis is the most common cause of nonobstetric abdominal pain, resulting in 1.7 admissions per 1000 deliveries. Urolithiasis most commonly occurs in the second and third trimesters, with an incidence between 1:125 and 1:2000. Acute urinary system obstructions are challenging to manage in obstetric patients because they contribute to physiolo...
Purpose:
While the presence of residual disease at the time of radical cystectomy for bladder cancer is an established prognostic indicator, controversy remains regarding the importance of maximal transurethral resection prior to neoadjuvant chemotherapy. We characterized the influence of maximal transurethral resection on pathological and surviva...
Background:
We aimed to examine the global disease burden and trends of prostate cancer incidence and mortality by age, and their associations with gross domestic product (GDP), human development index (HDI), smoking, and alcohol drinking.
Materials and methods:
We retrieved the Global Cancer Observatory (GLOBOCAN) database for the incidence and...
Background
Surgical smoke refers to the plume produced by usage of energy-generating surgical equipment on tissues. This review aimed to assess the potential of this smoke to be a serious occupational hazard to theatre staff due to its composition, particularly during the COVID-19 pandemic.
Method
A search of Ovid MEDLINE, EMBASE, and PubMed datab...
Robotic surgery is a rapidly expanding field with technological advancements democratising access. This rapid growth necessitates similar growth in the training standards and programmes to ensure there are enough practitioners to utilise this new modality and that they do so safely. The purpose of surgical training is to improve the surgeon’s knowl...
Background
Surgical smoke refers to the plume produced by usage of energy-generating surgical equipment on tissues. This review aimed to assess the potential of this smoke to be a serious occupational hazard to theatre staff due to its composition, particularly during the COVID-19 pandemic.
Method
A search of Ovid MEDLINE, EMBASE, and PubMed dat...
Introduction and objectives:
With growing interest in the use of artificial intelligence (AI) to support diagnosis, we evaluate AI-based software designed to detect clinically significant prostate cancer (csPCa) in multi-parametric MRI, on a diverse dataset spanning two countries, multiple centres and scanners, and compare its performance to major...
Abstract
Objective
To describe and highlight the current use of immune checkpoint inhibitors (ICIs) in the muscle-invasive bladder cancer (MIBC) treatment landscape, particularly focusing on the perioperative setting. We provide a comprehensive review of key trials of the use of ICI in the perioperative setting, discussing trial outcomes and lim...
Introduction
The abandonment of traditional transrectal (TR) towards transperineal (TP) prostate biopsies, or TREXIT, is in vogue. Following our evaluation (Tamhankar et al. BJUI 2020; 126: 133-141) of nearly half a million prostate biopsies in the NHS over a decade (2008-2019), the reduced sepsis and emergency readmission rates with the TP approac...
Stromal tumour of uncertain malignant potential (STUMP) is exceedingly rare. Diagnosis and management of STUMP present a challenge to the urologist due to the absence of specific clinical findings and its unpredictable clinical course. Thus, radical resection is often recommended. Here, we present a case of a 64-year-old male, who presented with mi...
Background
Robotic cystectomy is the mainstay surgical intervention for treatment-refractory non-muscle-invasive and muscle-invasive bladder cancer. However, paralytic ileus complicates the post-operative recovery, and may be a consequence of an inflammatory response associated with transient gut ischaemia. We have therefore investigated clinical,...
Background/aim:
The occurrence of germ cell tumour (GCT) in the elderly is rare, with scarce data available. The aim of this study was to understand the clinical outcomes of patients with GCT in patients aged > 45 years.
Materials and methods:
A retrospective study was conducted in a large tertiary cancer centre in north-west London. Between 1 J...
Purpose
The COVID-19 pandemic has led to competing strains on hospital resources and healthcare personnel. Patients with newly diagnosed invasive urothelial carcinomas of bladder (UCB) upper tract (UTUC) may experience delays to definitive radical cystectomy (RC) or radical nephro-ureterectomy (RNU) respectively. We evaluate the impact of delaying...
Purpose
Cisplatin-based chemotherapy followed by radical cystectomy (RC) is recommended in patients with muscle-invasive bladder cancer (MIBC). However, up to 50% of patients are cisplatin ineligible. The aim of this study was to compare clinical outcomes after ≥ 3 cycles of preoperative gemcitabine–carboplatin (gem–carbo) versus gemcitabine–cispla...
Aim
Assess the proportion of patients undergoing: (1) Preoperative assessment of the testicle, including serum tumour markers (STM) and testicular ultrasound (US), (2) Orchidectomy within 3 weeks of US diagnosis, and (3) Radiological staging (CT) within 3 weeks of surgery.
Method
Patients who had a radical inguinal orchidectomy for probable testic...
Objectives
To report the United Kingdom’s largest single centre experience of robotically assisted laparoscopic radical prostatectomies (RALP), using the neurovascular structure -adjacent frozen-section (NeuroSAFE) technique. We describe its’ efficacy on histopathological and functional outcomes, to be a reference to Units in their early stages of...
Context:
The management of locally advanced Muscle Invasive Bladder Cancer (MIBC) often necessitates neo-adjuvant chemotherapy (NAC) to downstage the disease prior to definitive radical cystectomy (RC) and pelvic lymph node dissection (PLND). The use of new imaging techniques, such as FDG-PET/CT, enables more accurate initial staging of bladder can...
An exploratory study was performed to determine the distribution of surgical smoke particulate matter (SSPM) and evacuation times within an AirSeal® System and a traditional insufflation access system in various simulated surgical scenarios. Identified trends showed statistical significance when setting the AirSeal® System to Low smoke evacuation t...
Robotic-assisted laparoscopic prostatectomy (RALP) has been linked to lower perioperative blood loss, lower transfusion rates, and shorter hospital stays. In addition, recent studies show that as compared to standard open prostatectomy surgery, there is less intraoperative blood loss. The authors report a unique case of anuric patients who have und...
Importance:
Robot-assisted radical cystectomy is being performed with increasing frequency, but it is unclear whether total intracorporeal surgery improves recovery compared with open radical cystectomy for bladder cancer.
Objectives:
To compare recovery and morbidity after robot-assisted radical cystectomy with intracorporeal reconstruction vs...
A man in his eighties presented to the Emergency Department with a 5-week history of lower abdominal and groin pain which had substantially affected his mobility. He practised intermittent self- catheterisation following radiotherapy for prostate cancer. Multiple suggestive features led to initial treatment for a urinary tract infection (UTI). Howe...
Background: Metastatic Urothelial Cancer (mUC) is known for its poor prognosis. Platinum based chemotherapy in the first line setting and immune checkpoint inhibition (ICI) therapy, especially PDL-1 inhibitors in the second line setting have revolutionised the treatment landscape. There exists a dearth of literature of real-world data on clinical t...
Introduction: Detection of lymph node status in bladder cancer significantly impacts clinical decisions regarding its management. There is a wide range of detection modalities for this task, including lymphoscintigraphy, computed tomography, magnetic resonance imaging, single-photon emission computed tomography, positron emission tomography, and fl...
Background: First-line chemotherapy for patients with cisplatin-ineligible metastatic urothelial carcinoma (mUC) is associated with short response duration and high toxicity. Pembrolizumab(PEM) and atezolizumab (ATZ) are associated with long-term, durable remissions as a first-line treatment of cisplatin-ineligible, PD-L1-positive patients with mUC...
The adoption of minimally invasive laparoscopic techniques has revolutionised urological practice. This necessitates a pneumoperitoneum (PNP) and the impact the PNP pressure has on post-operative outcomes is uncertain. During the current COVID-19 era guidance has suggested the utilisation of lower PNP pressures to mitigate the risk of intra-operati...
Description of Surgical Anatomy on Neurovascular bundle with reference to Radical Prostatectomy (Robotic / Laparoscopic / Open)
Robotic Assisted Laparoscopic Prostatectomy (RALP) has revolutionised the surgical management of localised Prostate Cancer in the modern era. The surgeon is provided with greater precision, more versatile dexterity and an immersive three-dimensional visual field. The impressive hardware facilitates, for example, the dissection of the peri-prostatic...
Background
Pathological involvement of seminal vesical poses a treatment dilemma following robotic prostatectomy. Margin status plays an important role in deciding further management. A wide range of treatment options are available including active monitoring, adjuvant radiotherapy, salvage radiotherapy and occasionally androgen deprivation therap...
MIBC Treating complications�“Metabolic” - Belgium Association of Urology
Purpose
To assess the association of patient age with response to preoperative chemotherapy in patients with muscle-invasive bladder cancer (MIBC).
Materials and methods
We analyzed data from 1105 patients with MIBC. Patients age was evaluated as continuous variable and stratified in quartiles. Pathologic objective response (pOR; ypT0-Ta-Tis-T1N0)...
Background
This study aimed to determine the impact of pulmonary complications on death after surgery both before and during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic.
Methods
This was a patient-level, comparative analysis of two, international prospective cohort studies: one before the pandemic (January–October 201...
A book describing our story over the last 20 months – in recognition of their continued work and dedication throughout the pandemic at the East and North Herts NHS Trust
Background: The efficacy of intravesical chemotherapy maintenance for patients with non-muscle invasive bladder cancer (NMIBC) is inferior compared to intravesical bacillus Calmette–Guerin (BCG). How intravesical chemohyperthermia (CHT) compares with BCG is under investigation.
Objective: To compare the oncological outcomes and safety profile betwe...
Background
Metastatic Urothelial Cancer (mUC) is known for its poor prognosis. Platinum based chemotherapy in the first line setting and immune checkpoint inhibition (ICI) therapy, especially PDL-1 inhibitors in the second line setting have revolutionised the treatment landscape. There exists a dearth of literature of real-world data on clinical t...
Keynote Address
“Urinary biomarkers in bladder cancer – current status and future directions” - Mr N Vasdev
Aim
A comprehensive review of the literature on the current and future applications of artificial intelligence (AI) in the context of urological oncology.
Method
Four key areas of urological oncology were identified, and a comprehensive literature review was carried out in each area looking at the current and future applications of AI. These four...
Introduction
Traditional intravesical chemotherapy instillations under room temperature post trans-urethral resection (TUR) of non-muscle invasive bladder cancer (NMIBC) have lower efficacies than maintenance BCG installations. Intravesical chemo-hyperthermia (CHT) at higher temperatures is developed to improve the efficacy of chemotherapy instilla...
Aim: This is a narrative review with an aim to summarise and describe urinary biomarkers in the surveillance of non-muscle-invasive bladder cancer (NMIBC). It provides a summary of FDA-approved protein biomarkers along with emerging ones which utilise genetic, epigenetic and exosomal markers. We discuss the current limitations of the available assa...
The aim of the Scot BC Quality OPS clinical project is to create a reliable prospective data set for evaluating real-world effectiveness and efficiency consequent to standardisation and monitoring of bladder cancer treatment (through the national Quality Performance Indicator programme) and streamlined surveillance in Scotland. Several work package...
Purpose:
To investigate the pathologic response rates and survival associated with 3 versus 4 cycles of cisplatin-based NAC in patients with cT2-4N0M0 MIBC.
Material and methods:
In this cohort study we analyzed clinical data of 828 patients treated with NAC and RC between 2000 and 2020. A total of 384 and 444 patients were treated with 3 and 4...
External factors, such as the coronavirus disease 2019 (COVID-19), can lead to cancellations and backlogs of cancer surgeries. The effects of these delays are unclear. This study summarised the evidence surrounding expectant management, delay radical prostatectomy (RP), and neoadjuvant hormone therapy (NHT) compared to immediate RP. MEDLINE and EMB...
