The authors presented a manuscript looking at outcomes between live robotic surgery and “standard” robotic cases, here, robot-assisted partial nephrectomy (RAPN). This is a timely manuscript given the increasing number of broadcast surgeries through meetings and courses in urology as well as other fields. The literature dealing with this issue is quite thin with just a few studies, mainly in the gastrointestinal and cardiovascular fields (as referenced by the authors). The study is well framed and the variables controlled as much as possible in this retrospective study. The first issue the article addresses is the concept that cases selected to be broadcast are carefully selected, thus not comparable to “everyday” practice. Table 1 demonstrates that the live broadcast group was quite similar to the standard group in important details, such as R.E.N.A.L. nephrometry score, body mass index (BMI), lesion size, sex ratio, etc. The “standard” cases were part of a consecutive series by the authors. So, whereas certainly some bias may exist in selecting these patients for live surgery, the groups seem comparable. It is also noted that all surgeons had performed over 100 RAPNs. What we do not know is when, in each surgeon's experience, that the live cases were performed. The number of cases to reach a comfort level high enough to do live surgery will likely be different for each surgeon, but knowing a “number” may be helpful for insight into the learning curve for this procedure. Live Robotic Surgery: Are Outcomes Compromised?UrologyVol. 80Issue 3PreviewTo determine the outcomes of patients undergoing robotic partial nephrectomy as a live broadcast surgery compared to a cohort treated without observers. Full-Text PDF ReplyUrologyVol. 80Issue 3PreviewWe thank Dr. Strup for his insightful comments. As discussed in the article, surgeon comfort with the proceedings surrounding a live surgical demonstration is paramount to its success. While obtaining this level of confidence may be a trait inherent to a given surgeon, it is certainly influenced by experience. In the present series, the average number of robot-assisted partial nephrectomies (RAPNs) performed before a live surgery was 51.3 cases. However, one must use caution when viewing any number as a surgical benchmark to be achieved before performing live surgery. Full-Text PDF