Kevan Sternberg

@peepeeDoctor Our manuscript from nearly a decade ago reporting overestimation of stone size by US @vpstonefree @KevSternbergUro - pubmed.ncbi.nlm.nih.gov/27289025/

@cedrickchiu @JenAngerMD Sorry I missed it but heard you did great! Keep up the good work!

Great time at #neaua24! Thank you to my mentors @JenAngerMD & @KevSternbergUro for helping me with these projects.

@SPuro88 @CanesDavid Seems about right to me from my experience, let me get right on that… Thanks for the share!

@CanesDavid @KevSternbergUro urine trouble!

Wow. Dues shaming. #neaua24

@AshleyVAlford @bostonsci @UMassUrology Looking good team!

Thanks to @bostonsci for hosting our residents for a session on prosthetics in their mobile cadaver lab! @UMassUrology

@peepeeDoctor @BJUICompass @amy_krambeck @NaeemBhojani7 @MattBultitude Journal club!

@KevSternbergUro @BJUICompass @amy_krambeck @NaeemBhojani7 @MattBultitude I rarely fail access now. The ureter is different. And this review shows the data

Hot off the press @BJUICompass - preop alpha blockers for URS - just do it ! bjui-journals.onlinelibrary.wiley.com/doi/10.1002/bc… @amy_krambeck @NaeemBhojani7

@peepeeDoctor @BJUICompass @amy_krambeck @NaeemBhojani7 @MattBultitude I’ve never done it consistently to give a fair opinion. My sense is that this can’t make a difference, just as I don’t think it helps with stone passage. However, I’m up to try when my friends and experts think something works!

@KevSternbergUro @BJUICompass @amy_krambeck @NaeemBhojani7 @MattBultitude Game on ! I love it. I do it. It works

Walked into robotic cases and wow, the memories... I have wracked my brain to think of anything in the world i’d rather do LESS than be a resident bedside assisting. Always wrong, always too slow, the target of all the stress in the room. Attendings don’t forget your past.

@Nick_sDean @DrIgorSorokin @amy_krambeck I agree that the UAS will require a bit of a learning curve. For pcnl, I can’t think of a reason that I would need to return to standard. So maneuverable and easy to use. I use now for every case

@DrIgorSorokin @amy_krambeck @KevSternbergUro I trialed this for URS, but have heard similar positive experiences for m-pcnl

First trial of vacuum-sheath from ClearPetra. I found it a bit clunky to maneuver, but it did what it promised. Excited to try it on a matrix stone.

@VeenaGraffMD @alextatem @clavelluro @kjdelay1 @JonBeilan @drchadb @APSForg Thanks for also reminding me why I couldn’t stomach anesthesia!

@KevSternbergUro @alextatem @clavelluro @kjdelay1 @JonBeilan @drchadb See this too - @APSForg presents some cases and pics of this. Anecdotally, several colleagues have witnessed the same but now not seeing as much since having patients stop based on recent ASA consensus. apsf.org/article/are-se…

Just had my first case cancel because a patient didn’t stop his Ozempic. Has this happened to anyone else? @clavelluro @kjdelay1 @JonBeilan

Thanks!

@miurologa Should the second pic should be labeled supine PCNL? ECIRS can be done in either position- I do it all the time in prone split-leg. ECIRS does not equal supine but agree with doing what is best for the surgeon and most the patient

The discussion is not whether prone or supine #PCNL is better, do what you do best and make the best decision for your patients. I am grateful to have learned the two techniques from the best, that It gives me the versatility to be able to choose the one I consider best. 🙌 @2fabiosepulveda @VicentiniUro @RalphVClayman Dr Fernández-De Castro Adolfo Serrano #PatientCare #pcnl #ecirs

@EndoLuminalEndo @peepeeDoctor @caseydauw @VUMCurology @JEndourology @endouroacademy @MantuGuptaMD Yes but surprising it is still such a prominent discussion- a non-opioid approach with NSAIDs and adjuncts has been well established for years- even in the U.S.!

This much more an issue on 🇺🇸 side of world Endourology than 🇬🇧 and 🇪🇺 I think but still a really important message. @peepeeDoctor @caseydauw and team done a lot of work in this domain I recall… @VUMCurology @JEndourology @endouroacademy @MantuGuptaMD

Nice article re pain relief after stone surgery and in ureteric colic, and particularly the possibility of an opioid free approach… @kvnkoo @emiliani_e @sproietti81 @jleow @kmoretry @DrDAgarwal @roger_sur @Joseph_HM_Wong 👇🏽👇🏽👇🏽👇🏽

@squarrier Nice place for a gathering! It’s where I got married!

Family holiday gathering!

@SPuro88 @jfishman61 Agree 100%. I learned from a friend that a phone call to the other urologist also goes a long way. “Hey, I saw your pt and agreed with your recs”. Thanks @vpstonefree (@DartmouthUro friends can tell him so since I don’t think he ever goes on this app 😂)

@jfishman61 Agree with this. I think it’s professional courtesy to tell the patient “I agree with Dr. X’s plan and I wouldn’t do anything different. Feel free to go back to them or if you wish to remain with me, that’s fine as well.” I often find the second opinions don’t make that clear.

Every now & then a pt will come in for an office visit, disagree with my recommendations, refuse to follow up and say they’re going elsewhere for a second opinion. Often, the second option makes the exact same recommendations. Should the second opinion doc send pt back or keep?

@Uro_Dima Absolutely not. I will discuss stones and work up /prevention strategies if appropriate. We need to move past the days where urology is only about prostate cancer- but that will not happen ever for many reasons… caveat would be if the pt does not have a PCP

Healthy 55 yo M sees you for a kidney stone. No labs available and negative family history. Do you bring up prostate cancer screening?

@ryansteinbergmd @EndoLuminalEndo @DrIgorSorokin Agree! It’s hard to change practice patterns and consider different approaches. “That’s how I trained in fellowship” can be a negative mindset- even when we train from the best. Also a reason I promote social media as education when used appropriately

@KevSternbergUro @EndoLuminalEndo @DrIgorSorokin Wish I could ❤️ this >1x (& not bc they scrub out). Change and compromise are HARD but is so 🔑 when building a great team. Thanks for sharing the outcome. This has been a great 🧵 to see others thoughts & perspectives on something I never would considered

Mini PCNL - and indeed Endourology in general: it’s all about the team!!! #SvenLahme

@DrDAgarwal @DrIgorSorokin @amy_krambeck @noahcanvasser @urowhite1 @BodoKnudsen @jaimelandmanuci @caseydauw @nkavoussi @dmarchalik @squarrier @aaronlaymd @jifriedlander @DrJohnMDiBi @NakadaSteve @ryansteinbergmd The question was “at a teaching hospital” so you and @BEkidneystone bring up the important point re:teaching the case. I think my compromise may work as I can teach the access w/o distraction and then less is needed for the stone tx so can continue to teach well.

@DrIgorSorokin @amy_krambeck @noahcanvasser @urowhite1 @BodoKnudsen @jaimelandmanuci @caseydauw @nkavoussi @dmarchalik @squarrier @aaronlaymd @jifriedlander @DrJohnMDiBi @NakadaSteve @ryansteinbergmd IMO: Without a tech manning the back-table and handing us what we need, the residents can’t focus on what I am doing to learn or I can’t teach as well if I am also working the back-table.

In a teaching hospital do you have a scrub tech scrub in for PCNL? @amy_krambeck @noahcanvasser @urowhite1 @BodoKnudsen @jaimelandmanuci @caseydauw @nkavoussi @dmarchalik @squarrier @aaronlaymd @jifriedlander @DrJohnMDiBi @NakadaSteve @ryansteinbergmd

@ryansteinbergmd @EndoLuminalEndo @DrIgorSorokin Closing the loop - I came up w/a compromise that may work for me in my current situation- have a scrub for access and when start the stone work, un scrub to help w/fluids/equipment. N of 1 day= good. Ability to adapt is not easy and comes with time…

@KevSternbergUro @EndoLuminalEndo Teams are always best as they know the case flow & equip needs. But, in a teaching setting, if you are scrubbed in with a trainee for URS or PCNL, what do you need a scrub nurse for? Aren’t they better utilized to help the circulating RN get/open items? @DrIgorSorokin