Grand Rounds for 1/24/2006

Kevin, MD hosts this weeks grand rounds:

Welcome to Grand Rounds, the weekly best the medical blogosphere has to offer, and a hello to all the new readers from WebMD. I’m honored to be hosting for the third time – it has come a long way since Kevin, M.D. last hosted way back in 2004.

Robotic Surgery Growth- Asia

Robotic general surgery guru will be in Dubai for Arab Health
Source: AME info
Dr. Susan Lim will be speaking in Dubai for Arab Health Conference

Dr. Lim, who
is the pioneer in Robotic general surgery both in Singapore and in Asia
since 2004 and to date is the leader in the field, believes most respected
hospitals in the world will be using robots to perform some of the most
complex surgeries without making large incisions.

Telling someone they have prostate cancer

One of the most difficult things that a urologist has to do is to tell his patient that he has cancer. I recently had a somewhat heated debate with my partner in robotic surgery.
Prostate cancer is the leading solid organ cancer in men and is diagnosed by a biopsy in the office. The reasons for a biopsy are given by the urologist when scheduling the procedure and the urologist is present for the biopsy.
I have had discussions with my partners about the two main ways of doing this for prostate cancer and there is a difference in opinion. The two ways are over the phone or face to face.

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The biggest operation on the oldest patient

Note: Our patient has given permission to use his story and name in our article and we are preparing a press release to give more details of this incredible story.
At 94 years old, the diagnosis of invasive bladder cancer is devastating. The treatment of choice for invasive bladder cancer is a radical cystoprostatectomy- the surgical removal of the bladder and prostate.
At 94 most urologists would tell the patient they are too old for surgery, but with Dr. Lefkon’s help I had performed this operation in a 90 year old woman and 94 year old man before and with Dr. Katz’s help had performed the operation in a 92 year old woman and a 96 year old woman.

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Medblog Grand Rounds 1/10/2006

This week’s Grand Rounds

I work in a large tertiary care center which is probably one of the
biggest and busiest hospitals in the world. There are doctors from all
sorts of subspecialties, nurses, supportive personnel and, of course,
thousands of patients who make this whole endeavor worthwhile.

This organization is glued together by the continuous effort of all these
thousands of people (30,000) who come to work and make a difference in
somebody’s life because it is part of what they do everyday.

Clinical cases hosted this years first grand rounds. This was my first entry into the grand rounds series.

Robotic Surgery Growth- The Czech Republic

The true robotic surgery pioneers were in Europe. Hospitals in Europe were buying robotic surgical systems in higher quantity than hospitals in the United States several years ago. The largest early series were from France. Recently most sales were going to hospitals in the United States.
From an article in The Prague Post, it seems that the future of robotic surgery is bright in The Czech Republic as well now. They have performed over 25 robotic procedures and other hospitals are considering purchasing the daVinci robotic system.

Should we do PSA Screening?

This is a frequently asked question and the answer will vary on who you ask.
PSA screening is recommended by the American Urologic Association . An excellent review of the original guidelines can be found at the American Family Physician website.
I came across a post on from a blog (retired doc\’s thoughts) by Dr. Gaulte. He summarizes that studies in the literature not only do not answer this question, but also are contradictory.

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