Robotic Surgery for Renal Cancer / Management of Urology (PDF)

presented her work as part of the Young Academic Urology Section at ERUS.




Professor Raj Persad, appointed in 1996, is a Consultant Urological Surgeon and Andrologist in Bristol. In his clinical role, he is one of the most experienced pelvic cancer surgeons in the UK and was one of the first in the UK to practice female neobladder reconstruction following cystectomy for invasive bladder cancer. He has subspecialised over many years in precise surgical techniques which improve both oncologic and functional outcomes. This includes techniques ranging from 1) the use of the Da Vinci Robot for performing Robot Assisted Laparoscopic Radical Prostatectomy, 2) High Intensity Focused Ultrasound for minimally invasive non-surgical treatment of prostate cancer and 3) Rectal Spacer and Fiducial Marker precision placement for optimizing the outcomes of Image Guided Radiotherapy for prostate cancer.



In the field of Diagnostics he has been one of the National Leads in developing the prostate pre-biopsy MRI pathway for patients with elevated PSA. This has optimized the accuracy of cancer diagnosis minimized clinical risk and sepsis associated with transrectal biopsy. He has developed to a fine art both cognitive transperineal biopsies of the prostate as well as Fusion Biopsy of the prostate.Professor Persad has been a National pioneer in minimally invasive techniques for the treatment of Symptomatic Benign Prostatic as an alternative to Transurethral Prostatectomy (TURP). These techniques include Urolift (prostatic urethral lift) procedure which he does under general or local anaesthetic depending on patient preference as well as REZUM, steam treatment of the prostate. He also treats BPH with Green Light Laser. All these techniques are offered by Professor Persad for BPH as well as traditional TURP if tablet therapy has failed or cannot be tolerated by the patient.



Professor Persad is also a National Authority in thetreatment of Erectile Dysfunction. He practices optimum medical therapies for all male patients and has a large cohort of patients who are diabetic or who have had prostatectomy and in need of erectile function restoration. If conservative therapy fails with erectogenic pharmacotherapy or use of medical devices he can offer the insertion of state of the art penile prosthetic devices. Professor Persad also treats deformity due to Peyronies across a range of severity, offering therapeutic injection in its early phases and various types of surgical correction if this fails according to patient needs.Professor Persad has a 25 year experience in the restoration of fertility through microsurgical reversal of vasectomy and has some of the best results nationally. He also for more complex cases offers epididymo-vasovasostomy. In combination with the Bristol Centre for Reproductive Medicine, he will soon be offering male infertility procedures such as micro-TESE (testicular extraction of sperm) in order to optimize assisted conception techniques.

Academically, Prof Persad is involved in an extensive range of research with the Universities of Bristol, Pittsburgh, London and Oxford. These include the detection of early bladder and prostate cancer and novel imaging and treatment strategies for these diseases. He formerly led a team of researchers engaged in improving strategies for treatment of advanced prostate cancer in areas of hormonal treatment and immunotherapy (BPCRN). He has been Principal Investigator, Chief Investigator, and Collaborator in many National and International studies sponsored by the MRC, EORTC, CRUK, and NCRN. He has been a recipient of £4.5m research grants from UK bodies as well as the NIH USA, and has published over 300 scientific articles and 7 books in the field of Urology.



Together with Scientists and Clinicians in Bristol he is part of the productive BRC (Biomed Research Centre), which has a number of far-reaching clinicaland scientific goals in the field of cancer and is Surgical Principle Investigator for the PreVent and Pre-Empt trials of lifestyle intervention in prostate cancer. He has an innovative research programme with Prof Chris Melhuish in Medical Robotics to enhance surgery and radiotherapy modalities with Robotic assistance.



In addition to his University and NHS Clinical commitments, he spends time visiting hospital units in the developing world (eg Tanzania), where he helps to train junior doctors and other healthcare professionals.





Dr. David M. Albala graduated with a geology degree from Lafayette College in Easton, Pennsylvania. He completed his medical school training at Michigan State University and went on to complete his surgical residency at the Dartmouth-Hitchcock Medical Center. Following this, Dr. Albala was an endourology fellow at Washington University Medical Center under the direction of Ralph V. Clayman. He practiced atLoyola University Medical Center in Chicago and rose from the ranks of Instructor to full Professor in Urology and Radiology in eight years. After 10 years, he became a tenured Professor at Duke University Medical Center in North Carolina. At Duke, he was Co-Director of the Endourology fellowship and Director for the Center of Minimally Invasive and Robotic Urological Surgery. He has over 180 publications in peer-reviewed journals and has authored five books in endourology and general urology. He is the Editor-in-Chief of the Journal of Robotic Surgery. He serves on the editorial board for Medical Reviews in Urology, Current Opinions in Urology and Urology Index and Reviews. He serves as a reviewer for eight surgical journals.



Presently he is Chief of Urology at Crouse Hospital in Syracuse, New York and a physician at Associated Medical Professionals (a group of 29 urologists). He is considered a national and international authority in laparoscopic and robotic urologicalsurgery and has been an active teacher in this area for over 20 years. His research and clinical interests have focused on robotic urological surgery. In addition, other clinical interests include minimally invasive treatment of benign prostatic hypertrophy (BPH) and the use of fibrin sealants in surgery. He has been a Visiting Professor at numerous institutions across the United States as well as overseas in countries such as India, China, Iceland, Germany, France, Japan, Brazil, Australia, and Singapore. In addition, he has done operative demonstrations in over 32 countries and 23 states. He has trained 16 fellows in endourology and advanced robotic surgery.

In addition, Dr. Albala is a past White House Fellow who acted as a special assistant to Federico Pena, Secretary of Transportation, on classified and unclassified public health related issues.