Minimally Invasive Urology -- Endourology and Laparoscopy

Endourology is the use of a small telescope to gain access to the urinary system. This minimally invasive technique allows our Doctors to visualize the inside of the bladder, ureter and kidney, without making a surgical incision. In this manner, the presence of a stone, polyp, or tumor not otherwise seen in the urinary tract can be determined. We have found that in many patients, it is preferable that treatment be performed endoscopically. This can be accomplished at our center through the use of specially adapted lithotriptor and laser probes. We currently have an active program for the evaluation and treatment of upper urinary tract stones and tumors, which many patients have found helpful.

Laparoscopy is performed by passing a telescope through the abdominal wall, usually at the umbilicus, to directly visualize the inside of the abdomen and pelvis. Though primarily diagnostic in adults and children, interventional laparoscopy is evolving. For example, lymphadenectomy (removal of lymph nodes) for the staging of urologic malignancy may be performed through this technique, avoiding an incision and prolonged hospitalization. Laparoscopy is also helpful in the diagnosis and treatment of some children with undescended testicle(s). Our approach to additional laparoscopic techniques is in evolution and we would be happy to talk with you regarding this.

Addresses

CAB 4100

The Cancer Institute of New Jersey

Phone

(732) 235-7775 CAB 4100
(732) 235-8185 CINJ

Participating Physicians

• Robert E Weiss, MD; Associate Professor
• Joseph G Barone, MD; Associate Professor
• Isaac Yi Kim, MD, PhD; Assistant Professor
• Murali K. Ankem, M.D.; Assistant Professor

Program Description

Faculty members of the Division of Urology are committed in developing innovative and less invasive treatments that can lead to safer and faster recovery for patients with urologic disorders. The Minimally Invasive Surgery Program at Robert Wood Johnson University Hospital offers a wide array of treatments and procedures using latest technologies and instrumentation in the field of urologic surgery.

Laparoscopy

Laparoscopic surgery allows removal or reconstruction of various genitourinary organs through tiny incisions in the body. By avoiding large incisions, which are typically required in traditional "open" surgery, patient benefits include less intraoperative blood loss, improved cosmesis, less postoperative discomfort, shorter hospitalization and faster overall convalescence. Currently, most kidney and adrenal tumors can be safely removed through a laparoscopic approach.

As an alterative to standard laparoscopic renal procedures such as radical nephrectomy, we are one of the handful programs in the country that offers renal cryoablation for kidney tumors. Laparoscopic renal cryoablation allows complete destruction of renal cancers by freezing the cancer cells to less than -20° Celsius and is available for select patients with small renal tumors. Early clinical results indicate that renal cryoablation is associated with less perioperative complications and improved renal function compared to other laparoscopic or open renal procedures.

Robotic Surgery

Recent advancements in robotic technology have led to the use of the daVinci Robotic System (Intuitive Surical Inc.) in the management of localized prostate cancer. The daVinci Robotic System is compatible with any laparoscopic access/ports and affords safe removal of the cancerous prostate gland through a very small incision. Its main advantages over standard laparoscopy include excellent 3-D magnified visualization and greater dexterity to the surgeon, potentially translating into more precise dissection and preservation of the sphincter tissue and neurovascular bundles, which are responsible for urinary continence and erectile function, respectively. Currently, We are one of only two academic institutions that offer an active daVinci prostatectomy program in the state of New Jersey.

Endoscopic and Percutaneous Surgery

With the use of endoscopes, urologic surgeons can easily navigate throughout the urinary tract with minimal morbidity. Specialized tools including KTP and holmium lasers can fit through these scopes allowing safe and effective managements of common benign urologic conditions such as benign prostatic hyperplasia and kidney stones. By avoiding an open incision and significant blood loss, most cases are treated as an outpatient basis. In select cases of very large kidney stones, a single small skin incision is made just over the kidney through which a scope is introduced for direct stone fragmentation.

The Greenlight PVP laser vaporization of the prostate is one of the newest innovations in which a benign prostate gland is ablated in a bloodless fashion. Unlike the traditional TURP (transurethral resection of the prostate), a continuous KTP green laser beam affords vaporization and coagulation of prostate tissue simultaneously thus leading to minimal postoperative bleeding and a same day discharge.

Special Treatments or Services

• Robotic (daVinci) assisted laparoscopic prostatectomy
• Robotic (daVinci) assisted laparoscopic dismembered pyeloplasty
• Laparoscopic nephrectomy and nephreoureterectomy
• Laparoscopic partial nephrectomy
• Laparoscopic renal cryoablation
• Laparoscopic adrenalectomy
• Laparoscopic RPLND
• The Greenlight laser vaporization of the prostate for BPH
• Percutaneous nephrostolithotomy
• Ureteroscopy with holmium laser lithotripsy and tissue ablation

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