Akhil A Saji, MD

Congratulations Dr Ahmed! Lasting impression is an understatement, my first console experience was on SP with you 5 years ago and countless teachings later we are following in your footsteps pioneering SP in the west. Learned from the absolute best and continue to do so. @SimplyUroMD @urorogerio @RoboticsUrology

@urorogerio @HUMCUrology @mdstifelman @asajimd You guys, @urorogerio and @asajimd, are among the very best. I’m incredibly proud to see you both pushing the envelope and advancing our field. Nothing is more rewarding than watching former trainees become outstanding surgeons and innovators. Deeply appreciate your kind words.

I’ve been fortunate to receive a few awards and scholarships throughout my life, but this one means the most. Honored to receive the Best Teacher Award from the finest—our @HUMCUrology residents. Despite everything on my plate, teaching remains closest to my heart. @mdstifelman

@RoupenMD OpenEvidence just partnered with Cedars-Sinai to try something like that but IMO the real issue here is who is actually paying the inference costs in these scenarios. For now seems like VC funding but eventually real revenue has to flow in and the moat is probably clinical data

I've seen multiple companies right now that are running AI coding agents in the background; however, I haven't seen any healthcare company that is running a clinical decision support tool in the background. Anthropic is talking about not prompting Claude anymore. In healthcare, we still prompt our AI, and the output depends on our prompt. If you miss a question then you miss an answer Even in AI, we're left behind.

SP left retro reimplant for distal ureteral stricture from hysterectomy. LAA offers amazing access to treat distal ureter strictures all while staying completely retro. Thanks to @RoboticsUrology for showing the possibilities with this approach! @SimplyUroMD @asajimd @MickeyBmickeyB

Benefits * Same day discharge capable * 360 vesicourethral anastomosis facilitates faster healing and minimal post-operative blood loss * Concomitant bladder stone removal or diverticular repair if needed * No concern for prolonged urethral ischemia from transurethral surgery * “Hostile” abdomen? No problem * IMO no size limitation

Plenty of HoLEP videos on X lately- lets show the other end of the spectrum. Heres an uncut (2x) ~400g SP transvesical simple prostatectomy. @urorogerio @SimplyUroMD @MickeyBmickeyB @RoboticsUrology

I didn't know that a simple tool that I built would have an impact like this! Last week, I built an AI tumor board, something to help me in my clinic to pull the most recent literature and approach a patient from multiple views, similar to what we do in a real-life tumor board, given the current clinical decision support tools lack that To my surprise, this tool is being used in second- and third-world countries and places where they don't have access to Doximity and OpenEvidence It's so satisfying to see that I'm able to help oncologists in other parts of the world! I am not sure how long I can sustain this, but feel free to share this, and I will keep paying the tokens' price for now. By the way, you don't need an account, and we don't save any data. This is a very simple user interface with a smart and simple backend if you are a developer would love your thoughts on the GitHub. …tumor-board-production.up.railway.app

Great work!! How are you paying for the Gemini pro token cost? If your post blows up you may end up with a large api bill. I would recommend a docker deployable link where people can insert their own api key for Gemini, ChatGPT or Claude. Would also recommend generation of a summary report that can be downloaded in PDF format

Onboard views from Starship and Super Heavy V3, which are equipped with upgraded cameras capable of streaming 4K video through every phase of flight via @Starlink

@DrDiGiorgio I wonder what their inference costs are like- this probably burns a tremendous amount of tokens. Who is paying?

This could actually be great. Right now we pay people to comb through a very fragmented medical record and piece together a cohesive picture. They often fail. This could change all that. I’m cautiously optimistic.

@lee_c_zhao @AmerUrol @YouTube Great video as always. Can you comment on arm positioning, instrument choice and role for cottonnoid? I saw you use that often

The SP pyeloplasty has come up several times #AUA2026 @AmerUrol Here is my technique of retro robotic pyeloplasty, Y-V flap for narrowed UPJ, 33 min uncut youtu.be/GbHA_5iP5oE?si… via @YouTube

@jdhdavis @KeithKow @OsinskiReflex @daviesbj Do you see higher UI with large gland RALPs? for GG1 and large gland we've been doing RASP with AS assuming genetic testing is reassuring

@KeithKow @OsinskiReflex @daviesbj Understood. The question is are you 100% dogmatic on the option or discuss multiple including radical. I’ve looked at my numbers and it’s 0.8 % of all Rarp and most upgraded. Robotic simple and Holep are not complication free which is the size range.

This is embarrsssing

There are enough training spots depending on what field you’re referring to. Only about 75% of residency slots are filled by US MD and DO students. The real underlying issue is incentivizing US students to go into fields that go under filled by US students. More American medical schools would just increase the percentage of seats filled by US students

@YounisJoseph Respectfully, I disagree. You can’t keep putting more people into a system that doesn’t have enough training spots.

Actually… you’re right we need more hospitals, and nurses but I think we desperately need more medical schools first. We’re undertraining US talent by a factor of 2 almost and importing the gap

Do you really believe we’ve reached the threshold where imaging utilization is at 100%? I don’t. There’s more volume to come. AI will make radiologists far more effective perhaps managers of agents that prelim read the scan and allow them to focus on the underlying clinical question.

Radiologists are the smartest doctors I know, but with all due respect, AI will hit them the most. Attended a lecture by a top gastro from AIG on how AI has been diagnosings CTs and MRCPs better than world renowned Radiologists. Mind blown

@TheAmolAvasare Putting out the fire quickly- appreciate it

For clarity, we're running a small test on ~2% of new prosumer signups. Existing Pro and Max subscribers aren't affected.

@DrSuneelDhand lol 😂

I personally think it may be a mistake to study medicine with what’s about to happen with AI. Especially in the United States with the insane levels of med school debt. My opinion only. These young students should know what they’re getting into and the big changes ahead

@fgomsan Well done!! 👏

HoLEP en bloc on a 500 cc prostate — complete unedited case. One of the largest in this series. Instrument reach, intravesical protrusion, massive morcellation: all the technical challenges of extreme anatomy in real time. 👉 youtube.com/watch?v=3GXSB5…

God sure blessed America

@MichaelMindrum Why rosuvastatin over others? Would you recommend another one for lower insulin resistance risk?

I’m 50 and feeling great. Running, eating well. I am low risk for CV events in the next 10 yrs but prefer to consider things over a 30+ yr horizon. I take a low dose of Rosuvastatin along with ezetemibe for primary prevention. I don’t fulfill a guideline based indication, but from my perspective the benefits exceed the potential risks and I’m willing to take it every day for 30+ years. Hope this helps.