First time calling to the @sternshow - pretty cool getting to talk to @jonhein ! Maybe will get on soon and tell some good urology stories.

Packed room at our annual #SPARC event celebrating the successful #SP collaboration and productive #AUA26 with 17 abstracts presented from the group @CleClinicUro @drjkaouk

Guru @TheMobotMD talking single port complex partial nephrectomy @ #sparc2026

Great talk by @UABUroOnc on SP LAA for RCC #aua2026 #intuitivesurgical #roboticstheater

Imagine your surgeon preparing for your operation. They see you in pre-op, answer your questions, calm your fears, examine you, confirm the plan, and go get ready for the case. They review the imaging and think through the critical parts of the operation. Then a nurse interrupts them: “Doctor, your pre-op documentation isn’t good enough. You can’t just say you discussed the risks and benefits. You need a full H&P.” The surgeon points out that the H&P was already done in clinic. The note is right there in the chart. “No. That note is 31 days old. It has to be within 30 days. But it’s fine if you just copy and paste that old note.” Think about how insane that is. There is no new clinical information. There is no patient benefit. There is no improvement in safety or quality. The only thing being demanded is duplication. A pointless bureaucratic ritual to satisfy the machine. So now you have a frustrated surgeon, a delayed case, a bloated chart, and one more example of modern medicine confusing clerical box-checking with patient care. This is exactly what is wrong with the system. Endless note bloat. Pointless duplication. Administrative nonsense dressed up as professionalism. If there are no changes, there are no changes. Forcing a doctor to re-paste an unchanged H&P adds absolutely nothing for the patient. And the most insulting part is the tone. That smug, condescending “of course you have to do it this way” attitude, as if this is self-evidently necessary instead of obviously stupid. At this point, a lot of doctors would probably take a substantial pay cut to never touch a computer again. Cut the salary and use the savings to hire people to do the computer garbage. Epic. CDI queries. Coding queries. H&P updates. Order entry. Case booking. Inbox nonsense. All of it. Never touch Epic again. Never answer another coding query. Never update another unchanged H&P. Never place another order that a clerk or protocolized team could enter. Never do another ounce of hospital data-entry cosplay. Just let us be goddamn doctors instead of highly trained documentation technicians.

Another successful @RoboUro #NARUS2026 in the books. Great job to @Dr_Jen_Linehan on orchestrating a thoughtful meeting. Loved the live surgeries from @DrRonneyAbaza @RyanNelson762. Always practice changing techniques to take back home.

Incredible mentor! Thanks for all the Robo kidney inspiration. @RoboUro #NARUS2026

In one week, a first for me. GG3 prostate cancer in a 46 YO male and GG1 in a 36 YO male. Only one of which I am certain the treatment plan for. #UroSoMe @SUO_YUO

Surgery is a "wicked" environment: feedback is delayed, noisy, and often biased. My essay on why experience doesn't always equal mastery, and how to learn when the feedback loops are broken. leezhaomd.org/post/the-wicke… #MedTwitter #Surgery #MedEd

Just back from an amazing #TUM26. Performed an #SP NUT and learn a lot. #Robotics in a new phase of multiple options. Thanks to @PorpigliaF for setting this up.

And the very important SWOG Bright trial. Both allow for Neoadjuvant therapy prior to TMT! @HimanshuNagarMD @l_ballas thank you Todd. For GU 015 check out video: nrgoncology.org/patients/pat…

Never understood the fascination with Aqua. Too many complications. Subtotal or HOLEP with more reliable results with less side effects.

From the desk of Perry Xu, MD (@perryjxu): -Dr. Xu is seeing more patients post-aquablation with persistent gross hematuria and LUTS. -Here are some endoscopic images post-aquablation (6 months to a year ago). Most impressively, one patient had fused vessels across the aqua defect. Patients are very satisfied after salvage HoLEP! @EndourologyNm

Ah yes, all those greedy physicians. You mean the one’s whose median salary is 350K? And the hospital CEOs whose median salary is 1.1MM? “Better to remain silent and be thought a fool than to speak and remove all doubt.” Instead of proving yourself to be wholly retarded, you could just choose to not post.

(3) SP robots done by 1pm today. Many thanks given to the team @duponthospital

It somehow went OK. Thankfully they were all subtotals. If they were radicals, I would have cancelled within 10 seconds of being docked within the bladder.