Conferences Spotlight Miller School’s Leadership in Urologic Oncology and Robotic Surgery

Three times in one week, the Miller School’s Dipen J. Parekh, M.D., demonstrated breakthrough robotic surgical techniques for treating urological cancers to audiences of urologists from around the world. Parekh, professor and Chair of Urology and Director of Robotic Surgery, was using the University of Miami Hospital’s brand new da Vinci Xi system. The procedures, all of which were performed at UMH, were broadcast live and in 3-D, with Parekh describing each step as he performed it and fielding questions from the audiences.

The first procedure, a robotic partial nephrectomy, took place on May 17 during the American Urological Association’s annual meeting. Parekh’s audience — thousands of urologists from more than 100 countries — was nearly 250 miles away, seated in the Chapin Theater at the Orange County Convention Center in Orlando.

“The invitation to perform a live robotic surgery on the largest possible stage — the AUA annual meeting — is the ultimate honor,” said Parekh. “It is testimony to our reputation as one of the premier robotic urologic surgical centers in the world.” The Department of Urology, he noted, performs the largest number of robotic surgical procedures for urologic cancers in South Florida.

Parekh performed another robotic partial nephrectomy and a robotic prostatectomy on May 22 and 23, during “Urologic Oncology & Robotic Surgery on the Beach.” That conference, which attracted 200 urologists from 17 countries, was held at the Eden Roc Hotel on Miami Beach immediately following the AUA meeting, and was organized by Parekh with Mark L. Gonzalgo, M.D., Ph.D., and Murugesan Manoharan, M.D., also of the Department of Urology.

The minimally invasive procedures were performed through four small punctures in the patient’s abdomen. The magnification and 3-D imagery presented each step in impressive detail as tools on the robot’s arms responded to movements of Parekh’s hands at the console. Each of the complex procedures was completed in one hour.

“This conference spotlights our leadership in the field of urologic oncology,” said Parekh, who helped UMH become the first academic medical center in the world to use the da Vinci Xi. “A lot of people are interested in robotics, and the technology is constantly changing, so it is important to have conferences like this one.”

Gonzalgo demonstrated a robotic prostatectomy and a robotic cystectomy using the hospital’s older da Vinci Si system. The two prostatectomies not only showed the same procedure using different model robots, but also different surgical techniques in the timing of nerve release.

Manoharan, Sanoj Punnen, M.D., and other faculty members gave lectures or assisted with conference organization. Outside presenters, surgeons widely respected in the field of urology, discussed their own robotic procedures, some with accompanying videos.

The attendees were impressed. “I’m enjoying the conference very much,” said Jeffrey Nalesnik, M.D., a surgeon who heads up the urological robotics practice at San Joaquin Community Hospital in California. “I like the live surgery, and how the conference is presenting state of the art in surgical treatment of the major urological cancers. This was also my first experience with the da Vinci Xi.”

Kwan Joong Joo, M.D., Ph.D., professor of urology at the Sungkyunkwan University School of Medicine in Seoul, Korea, had an eye-opening preview of his practice’s future. “I have never performed any robotic surgery, and I begin training in June,” he said. “These presentations make me very excited.”

A sizable Brazilian contingent attended the conference because robotic surgery is still in its infancy in that country. The numbers tell the story.

“There are 3,000 robots in the U.S. and only 12 in all of Brazil,” said Carlos Corradi, M.D., president of the Brazilian Society of Urologists. “And they are only in three cities — Sao Paolo, Rio de Janeiro and Porto Alegre. That doesn’t give us much opportunity for training.”

The solution — and one of the reasons for the large number of Brazilians at the conference — is a new mini-fellowship exchange program that will bring the country’s urologists to the Miller School for special training. The point person for the exchange program will be Andre Berger, M.D., a Brazilian native who is currently a urologic oncologist at the University of Southern California, and who will be moving to Miami to join the Miller School in July.

“There is already a strong partnership between the Miller School and the Brazilian medical community, and Dr. Parekh is highly respected there,” said Berger, who travels back and forth between the U.S. and Brazil every month. “We plan to have additional meetings between urologists from the two countries to discuss the latest advances in robotics, and we hope to begin the training later this year.”

“We are proud to be the preferred academic urology and robotic surgical program for our colleagues in Latin America and the Caribbean,” said Parekh. “We look forward to educating and collaborating with urologists from all over the world.”

The conference had 32 exhibitors, one of which was da Vinci, so the attendees were given an opportunity to get a feel for the Xi’s controls. The exhibitors were also pleased with the conference turnout.

“We have had a lot of interest in our UroNav fusion biopsy system,” said Mike Washam, an account manager at Invivo, demonstrating the company’s portable unit, which combines targeted MRI and ultrasound technology for non-invasive prostate biopsy. “We are about to install one at University of Miami Hospital, and it will be the first unit available for treating patients in South Florida.”

Ted Daley, senior engineer at Trumpf Medical Systems, agreed. “The new material presented at this conference attracted some high-profile attendees,” he said. “We make specialty operating tables for the da Vinci systems, and the surgeons who spoke with us were very interested and very engaged.”

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