Technology at the Minimally Invasive Urology Institute
Irreversible Electroporation (NanoKnife)
Irreversible electroporation (IRE), also known as NanoKnife, is a minimally invasive, ablation therapy for prostate cancer that destroys targeted cancerous cells while preserving healthy, non-cancerous areas. NanoKnife may be used to treat an initial diagnosis of prostate cancer, or for cancer that recurs after radiation therapy.
Thulium Laser Enucleation
The Minimally Invasive Urology Institute is the only provider in Rhode Island offering laser enucleation of the prostate, a new surgical procedure for BPH that results in fewer complications and faster recovery times. Performed at The Miriam Hospital by urologist Samuel Eaton, MD, the procedure uses a surgical laser to remove tissue that is blocking urine flow.
GreenLight Laser Prostatectomy
Also known as photoselective vaporization of the prostate, the GreenLight procedure removes the excess prostate tissue that is constricting the urethra and blocking urine flow. The physician passes a cystoscope, a thin tube with a very small camera, into the urethra. A small fiber that transmits laser energy is then passed through the cystoscope.
Most patients can expect very rapid relief of their BPH symptoms—often within 24 hours of the GreenLight Laser prostatectomy.
Blue Light Cystoscopy
The Miriam Hospital is the only hospital in Rhode Island, and one of only three in New England, to offer blue light cystoscopy to diagnose and treat tumors in the bladder. Blue light cystoscopy is a minimally invasive procedure that enhances bladder cancer detection and diagnostic abilities.
Studies have shown that patients have better outcomes, shorter hospital stays, and fewer complications when they choose surgeons and hospitals that perform a large number of procedures each year.
The surgeons of the Minimally Invasive Urology Institute at The Miriam Hospital are among the most experienced in Southeastern New England in urologic surgeries.
Hexaminolevulinate hydrochloric acid (Cysview), an optical imaging agent, is instilled in the patient’s bladder about an hour before the blue light cystoscopy procedure. This agent binds to cancerous areas and highlights them, making them visible to the eye. During the procedure, the physician uses white light to examine the bladder and then switches to blue light. When the equipment is switched to blue light mode, additional hard-to-see tumors that may be present become more visible. These tumors stand out against the normal bladder tissue, making it easier for our team to identify and remove them.
A study published in the Journal of Urology shows that one or more additional cancer lesions were detected by blue light cystoscopy in 16.4 percent of patients compared to white light alone. Additionally, according to a 2009 study published in the Journal of European Urology, a reduced recurrence rate and prolonged recurrence-free survival rates for oncology patients have all been seen, resulting in better overall disease management.
Benefits of Blue light cystoscopy include:
- Better visibility of the tumor
- Increased chance of complete removal
- Decreased rates of tumor recurrence
Firefly Fluorescence Imaging
Firefly Fluorescence Imaging is a near-infrared form of imaging that allows us to map out the boundaries of the kidney, remove the diseased portion, and preserve as much of the healthy kidney as possible in surgery. Not only does Firefly Fluorescence Imaging allow for a maximization of kidney function, but it also allows us to better delineate renal tumors and tissue perfusion.
More than 80 percent of the kidney surgeries performed at the Minimally Invasive Urology Institute remove only the diseased part of the kidney.
MRI/Ultrasound Fusion-Guided Prostate Biopsy is one of the newest and more accurate technologies available to diagnosis and monitor prostate cancer. An MRI of the prostate is taken which shows superior, more detailed images of the prostate when compared to the typical transrectal ultrasound (TRUS) of the prostate. This allows cancerous areas in the prostate to be better visualized and evaluated.
MRI images of the prostate are fused or blended together with real-time ultrasound images using special computer software known as computer-aided detection (CAD). As the MRI images overlays the ultrasound images, the provider is then able to target the biopsy of the suspicious areas much more accurately than the standard TRUS biopsy. Both the MRI and Fusion-Guided Biopsy are outpatient tests.
In 2006, The Miriam Hospital received its first version of the daVinci robot and became the first in Rhode Island to use this technology. Since then, thousands of urologic procedures have been performed.
The daVinci surgical system is a sophisticated, minimally invasive approach that uses advanced technology to help our surgeons perform surgery with greater precision than conventional instrumentation allows. This 3D, high-definition, high-magnification system incorporates the best techniques of open surgery and applies them to a robot-assisted procedure.
The surgical robot’s innovative instrumentation gives our surgeons more precision, a better view, and enhanced dexterity, facilitating a minimally invasive approach that yields several benefits over open surgery.
Surgical Simulation Training (CREST)
The goal of the curriculum of robotic simulation and educational training (CREST) program is to enrich the resident learning experience in robotic surgery by providing a structured lesson plan that combines didactic review of procedural details/techniques with surgical skill videos and hands-on robotic training using the daVinci simulator to supplement practical operating room experience. Residents begin the CREST curriculum during the PGY-2 year. The daVinci robotic surgical simulator is an essential component of the CREST program. Residents of all training levels are expected to make use of the simulator (both individually and in organized, group settings) to practice their skills in preparation for operative cases as well as skill assessment sessions.
We offer UroLift treatment to men who have enlarged, non-cancerous prostate, known as benign prostatic hyperplasia (BPH). This procedure, performed in a minimally invasive manner, pulls and holds the enlarged prostate back using a suture, allowing the unobstructed passage of urine. This outpatient procedure does not involve any cutting, heating or removing of prostate tissue and does not cause sexual or ejaculatory dysfunction.
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