What do you like most about the field of urology?
Urology offers the most compelling aspects of medicine. I love working with the patient population that we see in urology. Since the majority of patients I see are battling cancer (or have concerns regarding cancer), I take care of patients who are at their most vulnerable. These are folks who are often in the prime of their lives and are facing issues that impact the quality and quantity of their years to come. I consider it an incredible privilege that these people and their families put their trust in me to allay their fears, impact their lives and to, hopefully, cure their disease. Urology also offers me a unique opportunity to teach, to innovate, to write, to research and to utilize new technology to benefit my patients. Finally, the field of urology allows me to take care of the entire patient, not just the disease.
Surgical techniques are constantly evolving. What has changed most in urology over the past decade?
There has been an explosion of technology in urology. Minimally invasive techniques have greatly impacted the manner in which we care for patients with urologic malignancies and the speed in which patients recover from surgery. Whether through enhanced laparoscopic techniques, employment of robotic procedures to remove prostate, bladder or kidney cancers, or endoscopic devices to improve outcomes in the management of stone disease or voiding dysfunction, surgical techniques have evolved to the point that many urologic surgeries that once required extended in-patient stays are now performed on an outpatient basis.
What is robotic surgery, and is it the wave of the future?
Robotic surgery has become one of several methods we can use to essentially miniaturize a surgeon’s hands. It utilizes computer assistance to facilitate laparoscopic surgery. Surgery is performed through small ports (or openings) that are placed into the patient. Robotic surgery has been used at Virginia Mason since 2003, but was initially developed with the military in mind. Conceptually, a robotic system could be inserted in a patient on a battlefield, and a surgeon could operate the system remotely. What once required large, open incisions can now be accomplished through 7mm openings. In practice, however, the concept of a “remote” physician doesn’t work. The robot system doesn’t make clinical decisions nor does it make procedural judgments. The robotic system is simply a tool that a surgeon uses to enhance outcomes.
What’s one thing that few of your patients know about you?
Few of my patients know that I am an avid woodworker. When I’m away from work and not immersed in my family, you can find me searching for that perfect burl to turn into an interesting bowl, pen or rolling pin. As at work, I love new tools and technology. I find, however, that I’m outgrowing my home shop, which is bursting at the seams.