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Department of Urologic Surgery

Fellowship in Endourology & Laparoscopic Surgery

 

Overview

The Fellowship in Endourology and Laparoscopic Surgery provides specialized, comprehensive training in all aspects of Minimally Invasive Surgical Therapies (MIST), including robotic, laparoscopic and endourologic Urologic Surgery under the guidance of Drs. Duke Herrell and Nicole Miller.  The training includes all aspects of Urologic laparoscopic and minimally invasive surgeries. In addition, comprehensive training includes advanced Endourology of the lower and upper tracts, metabolic evaluation and medical management of stone disease. The fellowship is a 2 year program, including clinical and focused laboratory research.

Applicants must have completed an approved residency training program in Urology and must submit a letter of application along with a current curriculum vitae and supply a minimum of two letters of recommendation.

The clinical educational program includes 1 day per week of attending outpatient clinic with emphasis on evaluation and management of MIS patients including advanced MIS reconstructive laparoscopic Urology patients, laparoscopic /robotic/ and minimally invasive Urologic (ablative) Oncology, metabolic evaluation and medical management of stone disease patients, and evaluation and preparation of patients with upper and lower tract Endourologic disease. The fellow will have, approximately, 1-2 days per week for laboratory research activity and 2-3 days per week for clinical experience in robotic / laparoscopic and advanced endourologic Urology in the operating room.

The fellow will have graded surgical responsibility and will be responsible progressively for increased operative care of individual cases.  The fellow will also be responsible for preparation of teaching conferences for residents and staff.  The fellow will participate in teaching residents and medical students in the evaluation and management of endourologic and laparoscopic urology patients.

The education program provides clinical experience sufficient to develop clinical competence in advanced Endourology and laparoscopic Urology, as follows.

A. Fellows will meet the standard requirements for certification by the Endourological Society. Typically, fellows participate in, at least, 100 endourologic procedures during each fellowship year, including > 40 - 60 percutaneous renal procedures, > 60 flexible or rigid ureteroscopy procedures and typically > 150 laparoscopic and robotic urology procedures. The fellow will be expected to maintain an accurate and comprehensive operative log and will review this with the program director on a quarterly basis.

B. Experience in outpatient management of endourologic cases will be provided. The fellow will be familiar with extracorporeal shock wave lithotripsy for management of stone disease.

C. Vanderbilt University Medical Center provides state-of-the-art radiologic diagnosis through ultrasound, computerized tomography, MRI, and urodynamic equipment modalities of imaging. The fellow will learn to use these modalities in the evaluation and management of endourologic and MIS urologic patients.

D. The fellow will be taught percutaneous access to the kidney which is performed without radiologists. Both Dr. Miller and Herrell obtain > 95% of their own accesses. Fellows will also participate in a multidisciplinary team including Dr Herrell and Interventional Radiologists who perform CT guided ablations on a regular basis. The Urology team is an integral part of this approach and fellows are expected to become facile in hands on performance of RF and cryoablation.

E. Fellows will learn a variety of endoscopic techniques including advanced retrograde and percutaneous endoscopic urologic procedures. The fellow will acquire a basic knowledge of the metabolic aspects of stone disease and its medical management and prevention. Dr. Miller conducts extensive teaching on advanced metabolic and surgical treatment of stone disease. In addition, fellows will have the opportunity to learn Holmium laser enucleation of the prostate (HoLEP) for BPH under Dr. Miller's instruction.

F. Fellows will learn a variety of robotic and laparoscopic techniques including both pure laparoscopic and hand-assisted techniques for renal surgery. Transperitoneal and retroperitoneal approaches are utilized depending on diagnosis and patient factors.  Fellows are expected to become facile at laparoscopic suturing and reconstructive procedures. Robotic assisted laparoscopic prostatectomy is performed on a routine basis by both Drs. Joseph Smith and Herrell and the fellow will participate in many of these cases (>400/year at VUMC). Dr. Herrell also has an experience and fellows will be exposed to a variety of cutting edge techniques such as advanced robotic partial nephrectomy, laparoscopic donor nephrectomy, microlaparoscopic pyeloplasty and laparoscopic endoscopic single site surgery (single port).

G. Research projects are varied and include both basic science and clinical research opportunities. Fellows are expected to publish manuscripts and contribute to academia. Ongoing collaborative research is conducted through a variety of advanced collaborations including work with Vanderbilt University Departments of Biomedical Engineering, Biomechanical Engineering and Chemical Engineering.

H. To receive fellowship certification with the Endourologic Society, the fellow must:
1. Submit a case list for review to the Endourologic Society.
2. Submit an essay to the Annual Endourologic Essay Contest. This paper can be of a clinical nature, a review, or, preferably, a basic research project.
3. On satisfactory completion of the 2-year fellowship, the fellow will have a letter of endorsement from the director of the fellowship program sent to the Endourologic Society in support of his fellowship certificate.

Salary

The clinical status of the fellow will be at a PGY6 level for the state of Tennessee.

Application to the Program

If you are interested in applying for the Fellowship Program, please visit the Endourological Society's website, www.endourology.org to download and complete the application.  After completion, you should forward a paper copy of the application, along with your Curriculum Vitae, to the Society (their address can be found on their website), as well as to Vanderbilt at the following address:

S. Duke Herrell, M.D.
Vanderbilt Medical Center
A-1302 Medical Center North
Nashville, TN 37232-2765

In addition to the completed application, we also require three letters of recommendation, which may be mailed under separate cover, AND a recent passport-size photo.

All questions and or comments should be emailed to connie.smith@vanderbilt.edu.
 

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