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The Importance of Advances in Urological Surgery: From Open Surgery to Minimally Invasive Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: 23 September 2026 | Viewed by 1327

Special Issue Editor

Dr. Miguel Ángel Arrabal-Polo

E-Mail Website
Guest Editor
Department of Urology, San Cecilio Clinical University Hospital of Granada, Av. Dr. Jesús Candel Fabregas, s/n, 18014 Granada, Spain
Interests: laparoscopic urologic surgery; urological cancer; lithiasis

Special Issue Information

Dear Colleagues,

The evolution and continuous refinement of urological surgery represent one of the most compelling challenges in contemporary medicine. Today, minimally invasive techniques have redefined the standard of care, facilitating rapid patient recovery, significantly reducing morbidity, and consistently delivering superior clinical outcomes.

Over the past decade, robotic surgery has catalyzed a true revolution within our field. We have reached a point where urological surgery is becoming inseparable from robotic assistance; its application is no longer confined to oncology but has become essential in reconstructive surgery, endourology, and advanced minimally invasive procedures.

Parallel to these robotic advancements, the integration of artificial intelligence, advanced surgical control systems, image-guided surgery, and virtual reality is exponentially enhancing the precision and value of our interventions. The future of urology is intrinsically linked to the standardization of surgical techniques, AI-driven decision-making, and the rise of telesurgery—all aimed at minimizing risk and optimizing patient outcomes.

Dr. Miguel Ángel Arrabal-Polo
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • artificial intelligence
  • minimally invasive surgery
  • reconstructive surgical procedures
  • robotic surgical procedures
  • surgical oncology
  • telesurgery
  • virtual reality
  • results in urological surgery
  • laser in urology

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Published Papers (2 papers)

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Research

11 pages, 708 KB  
Article
Evaluation of Artificial Intelligence as a Decision-Support Tool in Urological Tumor Boards: A Study in Real Clinical Practice
by Javier De la Torre-Trillo, Yaiza Yáñez Castillo, Maria Teresa Melgarejo Segura, Elisa Carmona Sánchez, Alberto Zambudio Munuera, Juan Mora-Delgado and Alfonso López Luque
J. Clin. Med. 2026, 15(6), 2130; https://doi.org/10.3390/jcm15062130 - 11 Mar 2026
Viewed by 589
Abstract
Background/Objectives: Artificial intelligence (AI) tools, particularly large language models (LLMs) such as ChatGPT-4o, are gaining prominence in medicine. While their diagnostic capabilities have been explored across various oncologic domains, their role in clinical decision-making within multidisciplinary tumor boards (MTBs) remains largely unexamined [...] Read more.
Background/Objectives: Artificial intelligence (AI) tools, particularly large language models (LLMs) such as ChatGPT-4o, are gaining prominence in medicine. While their diagnostic capabilities have been explored across various oncologic domains, their role in clinical decision-making within multidisciplinary tumor boards (MTBs) remains largely unexamined in urologic oncology. This study evaluates the performance of ChatGPT-4o as a decision-support tool in a real-world MTB setting by comparing its recommendations with those of expert clinicians. Materials and Methods: A retrospective study was conducted using 98 anonymized clinical cases discussed by a urologic MTB between June 2024 and February 2025. An independent urologist entered the same cases into ChatGPT-4o using a standardized prompt replicating real-world presentation. Two certified urologists independently assessed the model’s responses. Agreement was analyzed overall and by tumor type, disease stage, clinical context, and treatment strategy. Results: ChatGPT-4o fully agreed with the MTB in 56.1% of cases, was correct but incomplete in 23.5%, and provided partially accurate but flawed recommendations in 18.4%. Overall concordance between ChatGPT-4o and the MTB yielded a Cohen’s kappa of 0.61, indicating moderate-to-good agreement. Discrepancies were most common in metastatic prostate cancer, often due to misclassification of tumor burden or errors in treatment sequencing. Highest agreement rates were observed in bladder and renal tumors, and in standardized therapeutic scenarios such as radiotherapy. Conclusions: ChatGPT-4o demonstrated moderate alignment with expert MTB decisions and performed best in well-defined clinical contexts. While it cannot replace multidisciplinary expertise, it may serve as a supportive tool to enhance access to standardized oncologic care. Full article
(This article belongs to the Special Issue The Importance of Advances in Urological Surgery: From Open Surgery to Minimally Invasive Surgery)
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9 pages, 311 KB  
Article
De-Intensification Strategies in Non-Muscle-Invasive Bladder Cancer: Outcomes and Cost Impact of In-Office Bladder Fulguration
by Maria Teresa Melgarejo Segura, Miguel Herraez Marcos, Maria Carmen Cano Garcia, Alberto Zambudio Munuera, Patricia Rodriguez Parras and Miguel Angel Arrabal Polo
J. Clin. Med. 2026, 15(5), 1939; https://doi.org/10.3390/jcm15051939 - 4 Mar 2026
Cited by 1 | Viewed by 546
Abstract
Background/Objectives: Non-muscle invasive bladder cancer (NMIBC) is characterized by high recurrence rates, requiring frequent diagnostic and therapeutic interventions. This study evaluates the feasibility, safety, oncological outcomes, and economic impact of implementing an in-office laser bladder tumor fulguration protocol. Methods: A descriptive, longitudinal study [...] Read more.
Background/Objectives: Non-muscle invasive bladder cancer (NMIBC) is characterized by high recurrence rates, requiring frequent diagnostic and therapeutic interventions. This study evaluates the feasibility, safety, oncological outcomes, and economic impact of implementing an in-office laser bladder tumor fulguration protocol. Methods: A descriptive, longitudinal study was conducted between 2020 and 2025 on 65 patients with recurrent NMIBC. Procedures were performed in an outpatient setting under local anesthesia using a flexible cystoscope and a Holmium:YAG (Ho:YAG) laser. The primary endpoint was recurrence-free survival. Secondary endpoints included complication rates (Clavien–Dindo) and a cost-analysis comparison with conventional transurethral resection of the bladder (TURBT). Results: The mean age was 69.4 years, with 89.2% of patients classified as ASA ≥ 2. After a median follow-up of 20.3 months, the recurrence rate was 33.8%, with 0% progression. Most procedures (95.4%) had no complications; only 4.6% presented Clavien–Dindo grade 1 events. Adjuvant mitomycin C was administered in 93.8% of cases. The cost analysis demonstrated substantial economic advantages, with costs reduced by 89.7% versus the 24 h admission model and 82.1% versus the day-surgery model according to regional health-system tariffs. Conclusions: In-office laser fulguration is a safe, effective, and economically sustainable alternative to traditional TURBT for selected low-risk recurrences. It optimizes hospital resources, minimizes anesthetic risk in comorbid patients, and maintains favorable oncological control. Full article
(This article belongs to the Special Issue The Importance of Advances in Urological Surgery: From Open Surgery to Minimally Invasive Surgery)
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