Thu May 23, 2013
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Urologic Fellowship Position
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Urologic Fellowship Position

Announcing a New Urologic Oncology Fellowship at UCLA

Contemporary Management of Prostate Cancer

Spring 2013

Mission Statement | To train thought leaders in conemporary and future diagnosis and management of prostate cancer by teaching techniques in imaging, targeted, biopsy, focal therapy, and minimally-invasive/robotic treatments.

 

Introduction

Prostate MRI-Ultrasound Imaging and Biopsy

(Journal of Urology Article 2013)

The UCLA Department of Urology is pleased to offer a 1-year fellowship for a graduate urologist who is interested in advanced training in targeted prostate biopsy alongside focal therapy research and minimally-invasive/robotic interventions for prostate cancer. The fellowship is a new component of the Institute of Urologic Oncology within the Urology Department on the Westwood campus.  Recent trends in targeting prostate tumors within the organ---from both a diagnostic and therapeutic standpoint---promise to change management of the disease in the near future.  This program would provide the fellow a cutting-edge opportunity to become a leader in novel technologies, such as MRI-guided fusion biopsies, focal therapies under the direction of Dr. Leonard Marks, and in minimally invasive and robotic surgery under the direction of Dr. Jim Hu
More about Dr. Marks and Dr. Hu

 

 

The Position

Robotic Surgery at UCLA

(European Urology Journal 2012)

A multi-disciplinary approach to focal management of prostate cancer has been pioneered at UCLA via cooperative efforts of the Departments of Urology, Radiology, Pathology, and Biomedical Engineering. A unique learning experience is assured via a large volume of clinical material, the inter-departmental support of this new work, and the multi-disciplinary expertise available. The Fellow would join a 15-person effort, from the four disciplines, working to bring prostate cancer diagnosis and treatment into the 21st century. The founding members of this team are shown here.

The Fellow would spend approximately 2/3 of his/her time performing procedures, either in the operating room or the procedure suite. OR time would be devoted almost exclusively to robotic surgery. The robotic surgery system entails the use of a master-slave laparoscopic robot. The physician's station encompasses controllers for each arm of the robot, as well as a viewing ocula port which provides a 3D image of the patient's internal environment. While the Da Vinci system has been in use for an established period of time, researchers at CASIT are working on many improvements, including tactile feedback addition to the controllers, which would allow the physician to feel how much pressure is being applied by the robotic arms to the tissues. The other 1/3 of the time would be spent in clinical care and research, which may be tailored to the Fellow's interests. The Fellow would be incorporated into an ongoing NIH-funded clinical research initiative, using technologies developed in part at UCLA, including a major focal therapy research program. Collaboration with engineering scientists at the UCLA Center for Advanced Surgical and Interventional Technology (CASIT) would be available. In the CASIT lab, surgeons have an opportunity to interact with biomedical engineers dedicated to urologic research, laying the fundamentals for new clinical interventions. Targeted prostate biopsy at UCLA is integrated with biomedical engineering at CASIT. Having completed the Fellowship, the individual would possess the technical skills, clinical expertise, and varied contacts needed to build a program of his/her own. 

 

Artemis Fusion Device: (a) Robarts prototype and (b) FDA-approved commercial model (Eigen)

Dr. Leonard Marks

 

Under Dr. Marks' leadership, more than 1000 targeted/tracking biopsies have been performed since inception of the program in 2009, making the UCLA program one of the largest in the world. An extensive online database has been built within the urology department, allowing the Fellow an opportunity to study and explore various aspects of targeted prostate biopsy, its role in active surveillance, and the correlations with whole mount prostatectomy specimens. A major multi-disciplinary research effort in focal therapy is in the formative stages.

 

 

 

Dr. Jim Hu

 

 

Dr. Hu has performed more than 1800 robotic-assisted surgeries, comprised of prostatectomies, cystectomies, partial nephrectomies, and reconstructive procedures. He has published numerous papers with accompanying videos and is known internationally regarding his surgical innovations in robotic surgery and health services research.

 

 

  

Dr. Dan Margolis

 

Dr. Dan Margolis is a leading authority on prostate MRI, having more than 10 years experience with interpreting such studies. Multi-parametric MRI is now performed at UCLA prior to most prostate biopsies; lesions are delineated by Dr. Margolis and his team; and targeted biopsies are performed in a special procedure unit in Clark Urology Center, where some 10,000 outpatient visits occur annually.

 

 

 

The fellowship exists under the auspices of the Institute of Urologic Oncology, with which it is wholly integrated. The Institute operates under the umbrella of the UCLA Department of Urology, which has for several decades ranked among the top urology departments in the U.S. The Urology Department is an integral part of UCLA Medical School, the new Ronald Reagan Hospital ("Best in the West"), and the larger university, which is ranked 13th best overall university in the world by Thomson Reuters.

The University of California is an Equal Opportunity/Affirmative Action Employer. UCLA assures equal employment opportunity for individuals from historically underrepresented minorities and women, for persons with disabilities, and for covered veterans. All qualified applicants are encouraged to apply.

 

For more specific information regarding the targeted biopsy project, please visit our Project Page.

 

Recent Publications Derived from Targeted Biopsy Research

  1. Sonn, G.A., et al. "Targeted biopsy in the detection of prostate cancer using an office based magnetic resonance ultrasound fusion device". The Journal of Urology 189: 86, 2013
  2. Marks, L.S., et al. "MRI-ultrasound fusion for guidance of targeted prostate biopsy". Current Opinion in Urology, 2013 
  3. Natarajan, S., et al. "Clinical application of a 3D ultrasound-guided prostate biopsy system". Urologic Oncology 29: 334, 2011

 Recent Publications Derived from Targeted Biopsy Research

  1. Carter, S., et al. "Anatomic and technical considerations for optimizing recovery of sexual function during robotic-assisted radical prostatectomy". Current Opinion 23: 1, January 2013
  2. Yu, H., et al. "The Current Status of Robotic Oncologic Surgery". CA: A Cancer Journal for Clinicians 00: 0, 2012
  3. Alemozaffar M., et al. "Technical Refinement and Learning Curve for Attenuating Neurapraxia During Robotic-Assisted Radical Prostatectomy to Improve Sexual Function". European Urology doi:10.1016/j.eururo.2012.02.053, 2012
  4. Friedlander, D.F., "Stepwise Description and Outcomes of Bladder Neck Sparing During Robot-Assisted Laparoscopic Radical Prostatectomy". The Journal of Urology 188, November 2012
  5. Kowalczyk, K.J., et al. "Effect of minimizing tension during robotic-assisted laparoscopic radical prostatectomy on urinary function recovery". World Journal of Urology doi:10.1007/s00345-012-0973-3, November 2012
  6. Kowalczyk, K.J., et al. "Robotic-assisted laparoscopic radical prostatectomy after aborted retropubic radical prostatectomy". Journal of Robotic Surgery, doi:10.1007/s11701-012-0377-9, August 2012
  7. Kowalczyk, K.J., et al. "Partial Clamping of the Renal Artery During Robot-Assisted Laparoscopic Partial Nephrectomy: Technique and Initial Outcomes". Journal of Endourology 26:5, May 2012
  8. Yu, H., et al. "Use, Costs and Comparative Effectiveness of Robotic Assisted, Laparoscopic and Open Urological Surgery". The Journal of Urology 187, April 2012
  9. Yu, H., et al. "Comparative Analysis of Outcomes and Costs Following Open Radical Cystectomy Versus Robot-Assisted Laparoscopic Radical Cystectomy: Results From the US Nationwide Inpatient Sample". European Urology 61, March 2012
  10. Hu, J.C., et al. "Letter to the Editor: Challenges of Interpreting and Improving Radical Prostatectomy Outcomes: Technique, Technology, Training, and Tactical Reporting". European Urology 59, 2011
  11. Kowalczyk, K.J., et al. "Stepwise Approach for Nerve Sparing Without Countertraction During Robot-Assisted Radical Prostatectomy: Technique and Outcomes". European Urology 60, May 2011
  12. Lei, Y., et al. "Athermal Division and Selective Suture Ligation of the Dorsal Vein Complex During Robot-Assisted Laparoscopic Radical Prostatectomy: Description of Technique and Outcomes". European Urology doi:10.1016/j.eururo.2010.08.043, September 2010
  13. Williams, S.B., et al. "Randomized Controlled Trial of Barbed Polyglyconate Versus Polyglactin Suture for Robot-Assisted Laparoscopic Prostatectomy Anastomosis: Technique and Outcomes". European Urology 58, August 2010
  14. Freire, M.P., et al. "Anatomic Bladder Neck Preservation During Robotic-Assisted Laparoscopic Radical Prostatectomy: Description of Technique and Outcomes". European Urology 56, September 2009
  15. Berry, A.M., et al. "Robotic Urethrovesical Anastomosis: Combining Running and Interrupted Sutures". Journal of Endourology 22:9, September 2008
  16. Berry, A., et al. "Landmarks for Consistent Nerve Sparing during Robotic-Assisted Laparoscopic Radical Prostatectomy". Journal of Endourology 22:8, August 2008

Interested applicants should directly contact:
Dr. Jim Hu (jchu@mednet.ucla.edu) or
Dr. Leonard Marks (lmarks@mednet.ucla.edu) for more information.

Applications are now being accepted for a position to start July, 2013 (or sooner).

Other members of this team and their roles are shown below:

 

Shyam Natarajan, PhD
CASIT Post-Doctoral Fellow
Department of Biomedical Engineering
Research: MRI/TRUS Fusion, Embedded Systems, Signal Processing 
shyam@ucla.edu

 

Steven Raman, MD
Department of Radiology
Research: Interpretation of MRI
sraman@mednet.ucla.edu

 


Malu Macairan
Department of Urology
Research coordination
mmacairan@mednet.ucla.edu

  Jiaoti Huang, MD, PhD
Department of Pathology
Research: Whole mount histology
jiaotihuang@mednet.ucla.edu
 

Aaron Fenster, PhD
Robarts Research Institute,
University of Western Ontario,
London, Ontario, CA
Advisor / Collaborator: Ultrasound, Artemis usage, & MRI Fusion
afenster@imaging.robarts.ca

  Jelle Barentsz, MD
Department of Radiology
Radboud University, Nijmegen, NL
Advisor/Collaborator: MRI
j.barentsz@rad.umcn.nl