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Urology Program at the Forefront at The Miriam Hospital


New advances in treatment and technology are now available in urology at The Miriam Hospital.

In the spring, the comprehensive Kidney Stone Center opened its doors as a multidisciplinary site to evaluate, diagnose and treat patients suffering from kidney stones. It is the only center of its kind in Rhode Island.

Gyan Pareek, MD, FACS, director of the Kidney Stone Center at The Miriam Hospital, says the center is a collaborative effort and brings together a team of nephrologists, urologists and dietitians, who will provide complete medical and dietary management of kidney stones.

Robotic Surgery Team 2013
From left to right, Dragan Golijanin, MD; Gyan Pareek, MD; Joseph Renzulli II, MD

“Our goal is to not only treat existing kidney stones but to also prevent new stones from forming. Because most kidney stones are a combination of genetics and dietary habits, tailored nutrition and dietary management are critical to providing the best treatment and follow-up care,” says Pareek. “We hope that our patient’s first kidney stone removal is also their last.”

Another new development in urology is the arrival of da Vinci Si, which is a high definition, advanced robotic system that assists surgeons performing urological procedures. It has provided the cutting edge technology needed in New England’s busiest center for robotic kidney surgery.

The precision, vision and control of the da Vinci Surgical System allows your surgeon to provide a precise, minimally invasive treatment for kidney surgery.

In 2006, The Miriam received its first version of the robot, da Vinci S, and became the first in Rhode Island to use this technology. Since that first procedure, a prostatectomy performed by Pareek and Joseph Renzulli, MD, 1,402 urologic procedures have been performed: 1,130 prostatectomies, 207 kidney

procedures and 62 cystectomies. The robotic system provides a minimally invasive approach to complex surgical procedures. For patients, less blood loss, quicker recovery and shorter hospital stays are all benefits of this technology.

The da Vinci Si has several new features that provide advanced clinical benefits and efficiency in the operating room. The new device has “Firefly” imaging, an enhanced, 3D, high definition vision of the operative field that allows surgeons to view real-time identification of the anatomy; a dual console, which enables a second surgeon or resident to provide assistance; and a skills simulator.

“This type of technology allows for better precision in the operating room and is both physician and patient friendly,” says Dragan Golijanin, MD, director of genitourinary oncology at Rhode Island Hospital and The Miriam Hospital. “The new instruments have attached suction that is excellent for organ preserving surgeries and minimal blood loss.”

“The new dual-console is also a benefit of the new robot that will be helpful to the other surgeons and the residents,” says Golijanin. “The second console will allow junior residents to be involved with robotic laparoscopic surgery earlier. The simulator will be used to help document their improvements, measure their skills, monitor patient procedures and record the time spent performing each procedure.”

Joseph Renzulli II, MD, notes that more enhancements are anticipated at The Miriam. “We will be adding blue light cystoscopy, an enhanced method for the detection of bladder cancer,” says Renzulli.

Learn more about the Kidney Stone Center at The Miriam Hospital.