Category Archives: Miscellaneous

Profitability

I agree that the reimbursement for a radical prostatectomy should be more than it is, but that is true for nearly everything we do these days at the hospital. You are paid a little more for the code for a laparoscopic prostatectomy (the code for a dVP) than for an open radical and with experience you can do a dVP in about the time it takes many urologists to do an open (2-3 hours). Granted some folks can do an open in 90 minutes, but, given the lower positive margin rates with the da Vinci and slightly better potency and continence rates, I don’t see how anyone can continue to justify doing opens.

daVinci S travelling to NJ train stations this week

trainevent.jpg
Newark Beth Israel is bringing the daVinci S robot to 3 train stations in NJ this week from 7AM to 10AM.
Commuters will have a chance to see and possibly test-drive the newest robot.
I will be in Newark on Wednesday morning with the intuitive surgical team.
Tuesday, December 5
Secaucus Junction
26 County Road
Secaucus, NJ
Wednesday, December 6
Newark Penn Station
1 Gateway Center Raymond Blvd.
Newark, NJ
Thursday, December 7
Hoboken Train Station
40 Hudson Place
Hoboken, NJ

A single dose of prophylactic antibiotics may be enough

ScienceDaily: Single Dose Of Antibiotics Before Surgery Sufficient To Help Prevent Infection: “Single Dose Of Antibiotics Before Surgery Sufficient To Help Prevent Infection
A single dose of antibiotics prior to surgery appears to prevent infections occurring at the surgical site as effectively as a 24-hour dosing regimen, and with reduced antibiotic costs, according to an article in the November issue of Archives of Surgery, one of the JAMA/Archives journals.”

I have been using 3 total doses on antibiotics for most of my robotic kidney and prostate operations. I will need to review this study and may switch to a single dose for prevention of infection. I have not had a single wound or deep infection in almost 250 robotic operations. I have seen urinary tract infections that I think is the result of the catheter and 2 men developed testicle infections 2-3 weeks after robotic prostatectomy.

Congratulations to the Newark Beth Israel Cardiovascular team

Newark Beth Israel Medical Center Named One of Nation’s 100 Top Providers of Cardiovascular Care: Financial News – Yahoo! Finance: “Newark Beth Israel Medical Center Named One of Nation’s 100 Top Providers of Cardiovascular Care
Monday November 20, 9:00 am ET
NEWARK, N.J., Nov. 20 /PRNewswire/ — Recognized for outstanding outcomes in adult cardiac care, the Saint Barnabas Heart Center at Newark Beth Israel Medical Center has been named among the nation’s 100 top hospitals for cardiovascular performance by Solucient”
A full list can be found on the Solucient website.

Muscle breakdown after robotic kidney surgery

I recently had a patient who had muscle breakdown (rhabdomyolysis) of a buttock muscle after a robotic removal of part of a kidney for tumor.
I found a nice review of this problem on urotoday’s site that had an article from the BJU. The urologist that wrote the article were from the Department of Urology, Aberdeen Royal Infirmary in Aberdeen, UK.
My patient was overweight, but not morbidly obese. I performed the robotic partial nephrectomy in a similar lateral position that the authors show. He needed 1 course of dialysis when his kidneys were not working well. The rhabdomyolysis led to significantly kidney problems since our surgery is done by temporarily stopping the blood supply to the kidney which leads to short term kidney malfunction in that kidney. He also had kidney problems to start with.
I had performed over 40 robotic kidney surgeries in this positioning and over 150 laparoscopic ones prior to having this problem. There have also been reports of rhabdomyolysis after open surgery, but this rare complication should always be remembered even in experienced hands.

Firefighters may be at higher risk of developing prostate cancer

Firefighters at High Risk for Cancer – Forbes.com: “‘For testicular cancer there is a 100 percent increase in risk, for multiple myeloma there is a 50 percent increased risk, for non-Hodgkin’s lymphoma it’s a 50 percent increased risk, and for prostate cancer it’s a 28 percent increased risk, compared with non-firefighters,’ he said.”

da Vinci robot makes top 10 list of all time robots

SoulCast – The 50 Best Robots Ever: “08. DA VINCI SURGICAL SYSTEM
In the future, you’ll beg to be operated on by a machine. Credit Intuitive Surgical’s 2000 robot, a fusion of arms, cameras, and instruments that allows doctors to slice into patients remotely. Procedures done with the da Vinci are more precise than when humans wield the scalpel – research shows there’s less blood loss and quicker recovery.”

Surgeon hand pain during laparoscopic kidney removal

UroToday – Hand Pain during Hand-Assisted Laparoscopic Nephrectomy- An Ischemic Event?
One of my reasons for telling visiting urologists that I prefer robotic kidney surgery to laparoscopy is how much better I feel physically during a robotic vs. a laparoscopic surgery.
This abstract discusses the pain encountered by urologists during hand assist nephrectomies. I agree there is pain, but I notice it more if the hand port is relatively tight. The tighter it is, the more pain I have.
Regardless of the reason for the pain, I think most of us would agree that doing robotic kidney surgery in a comfortable fashion that the da Vinci provides may be better than operating with an ischemic, painful hand.

Associates in Urology looking to add a second robotic surgeon

New Jersey
Urologist with interest in Robotics

 

Associates in Urology, a 9
urologist group located in West Orange, NJ, is seeking a BC/BE urologist for a
position on a partnership tract.   The applicant should have a strong interest
in minimally invasive urology including robotics.  Fellowship or residency
training in robotics and laparoscopy is preferred.

This is a unique opportunity to join a dynamic
group concerned primarily with patient care. Our physicians focus on appropriate
and high quality patient care and have subspecialties in infertility, female
urology, oncology, and minimally invasive and robotic surgery. 

Our practice is one of the busiest robotic
practices in the northeast.  We are searching for a physician who can work well
with others and can become the second high volume robotic surgeon in our group. 
We perform the majority of the robotic adult urology at Newark Beth Israel
Medical Center in Newark, NJ and are responsible for the robotic training course
for urologists at the hospital.  The group also has a strong presence at Saint
Barnabas Medical Center in Livingston, NJ and is well respected in the New
Jersey. 

Our office is located in West Orange, NJ,
about 30 minutes from NYC. The practice website is

www.njurology.com
.

Call Dr. Dominic Savatta or
our office manager, Leslie Davis at 973-325-6100 to inquire about practice
details. You may send your CV to

dsavatta@njurology.com

for consideration or to ask questions.

 

Associates in Urology, LLC

741 Northfield Avenue, Suite 206

West Orange, NJ 07052

Phone: 973-325-6100

Fax: 973-325-1616

Website: www.njurology.com