This year on June 19-20, the virtual ESU-ESUT Masterclass took place at the University Hospital of Patras, under the collaboration of the European School of Urology (ESU) and the EAU Section of Uro-Technology (ESUT). The expert technician team of ENDOGLOBE company support the live transmission of 4 surgeries from Patras and presentations from Greece Italy, France, Germany, Spain, United Kingdom to all over the world.

As already a tradition, leading experts of Europe shared their practical experiences, recent advancements, and hot-topics of the field of urolithiasis with around 48 delegates from all over the world in a 2-day intensive program. The faculty held interactive discussions on pathophysiology, diagnosis, and conservative treatment, highlighted the advantages, limitations, and potential threats of minimally invasive modalities and presented essential tips and tricks of their practiced techniques during live-presentations, pre-recorded and live-surgeries.

We all know that extraordinary times need extraordinary decisions. The current masterclass was unique in its nature being one of the first EAU meetings organized in a virtual format in the Covid-19 era. Although our initial plan was to house all the experts and attendees at our institution, we had to face and adopt a new reality. As a result, the whole program with interactive sessions and live-surgeries structured for in-person attendance was redesigned to virtual format in as little as 2 months. Thanks to our flexibility and continuous efforts of the faculty and organizing committee members as well as current advancements of technology, our project was successfully completed reaching the main goal: to share and deliver the knowledge.

Α central controlling office was structured at our institution moderating the whole process of live-sessions. The dedicated platform allowed to transmit the live-streaming signals with a minimal loss of quality and time. Before the masterclass itself, the platform was tested several times with the organizing committee members. This allowed the identification of potential issues and their timely management.

The first day of the masterclass encompassed mainly pre-recorded surgical video presentations and live-surgeries prepared and performed by renowned specialists. The pre-recorded videos included a mini-PNL performed by Prof. T. Knoll (Sindelfingen, DE); a supine endoscopic combined intrarenal surgery (ECIRS) with ultrasound guidance performed by Prof. C. Scoffone (Turin, IT); a supine ECIRS with fluoroscopic guidance Dr. E. Emmiliani (Barcelona, ES); a single-use ureteroscopic lithotripsy performed by Prof. B. Somani (Southampton, UK); a flexible ureteroscopic lithotripsy in a horseshoe kidney performed by Prof. O. Traxer (Paris, FR); a flexible ureteroscopic lithotripsy for upper ureteral stone performed by Dr. G. Bozzini (Milan, IT); and a bladder stone lithotripsy performed by Dr. I. Kyriazis (Athens, GR).

Particular attention was allocated to the broadcasting of live-surgeries. For obvious reasons, the latter was performed at the dedicated Endo-suite operating room at the University Hospital of Patras only by Greek specialists. With the help of several working cameras the participants had the possibility to capture all the aspects of surgeries, including endoscopic, radiologic, and outer pictures simultaneously on one screen.  The performed surgeries covered a prone percutaneous nephrolithotomy and an insertion of a filament ureteral stent by Dr. P. Kallidonis (Patras, GR), flexible ureteroscopic lithotripsy with high power laser by Dr. A. Ploumidis (Athens, GR), and a prone PNL with antegrade URS by Prof. Liatsikos (Patras, GR). Important to be mentioned, all pf the pre-recorded video presentations and live-surgeries were accompanied by pre-surgery set-up discussions facilitating in-depth understanding of essential materials for each surgical procedure.

The second day was dedicated more to the presentation of hot-topics, tips and tricks, complications, and troubleshooting. With the particular attempt to have interactive sessions, each presentation was followed by short discussion. All participants were free to ask questions either with a special button (raising hands) or writing the questions in a common chat area through-out the whole masterclass. The questions were addressed either by the presenter or by the moderators with additional discussion of important points. In the end of the masterclass panel experts shared their experiences with specific advice for the management of different particular cases.

Encouragingly for us, the feedback and evaluation of the ESU-ESUT virtual masterclass by the participants were very positive. Although the virtual format limited the social interaction of participants between each other and the faculty, it did not affect the delivery of the knowledge. Considering the advantages of the virtual events, such as greater participation of attendees, cost-reduction, eco-friendly and more convenient environment, and our positive experience with the organization of the current masterclass, I strongly believe that this kind of events will be more utilized in the near future.