Training Program Focus/Summary
*Fellowship: US Citizenship required
The Mission of the UC San Diego – Kaiser Permanente fellowship is to train the next generation of thought leaders in academic medicine. As such, the focus will be to provide a foundation of research inquiry and advanced surgical skills along with mentorship to support the fellow’s development into a junior faculty member.
The joint UC San Diego-Kaiser Permanente endourology/laparoscopic- robotic fellowship is Co-Directed by Dr. Roger Sur of UC San Diego and Dr. Marc Chuang of Kaiser Permanente San Diego.
The fellowship offers an opportunity to complete four major goals. Firstly, they will gain a complete surgical experience and mastery of both routine and complex kidney stone procedures, such as ureteroscopy and percutaneous nephrolithotomy, urinary diversion stone disease surgery, laparoscopic stone surgery (including DaVinci assisted) and on rare indications, open stone surgery (average 200 cases —100 PCNL, 100 URS, misc). Regarding percutaneous surgery, the fellow will gain mastery of gaining percutaneous access without the need for interventional radiology assistance. Ultrasound assisted percutaneous techniques is now routine technique. We have also begun a pure ultrasound-based PCNL (no fluoroscopy). Additionally, we have a focus on both prone and supine and MIP PCNL surgery. BPH surgery including HoLEP at Kaiser and UCSD (20-30 cases) is also a focus of the program. Benign pathology will also be treated including ureteral stricture and ureteropelvic junction obstruction. Nephron sparing endoscopic techniques will also be implemented for transitional cell carcinoma. Fellows will operate with Dr. Roger Sur, Dr. Manoj Monga, and Dr. Seth Bechis at UC San Diego.
Secondly, they will perform robotic assisted laparoscopic surgery(average 140 cases/year) with all fellowship trained Kaiser Permanente surgeons led by the Fellowship Co-director, Dr. Marc Chuang, who routinely performs a high volume of minimally invasive surgeries: robotic assisted laparoscopic radical prostatectomy, robotic assisted radical cystectomy, robotic partial and radical nephrectomy, robotic or laparoscopic pyeloplasty as well as open oncologic surgery. The robotic surgery will be performed at a new state-of-the-art hospital with the da Vinci Xi robotic system.
Thirdly, the fellows will participate in the metabolic clinic at UC San Diego Comprehensive Kidney Stone Center, which is a multi-disciplinary clinic incorporating dieticians, endocrinologists, and nephrology subspecialties. Dr. Sur is an Endourology Society fellowship trained urologist who has a complete understanding of metabolic derangements that underlie nephrolithiasis and the fellow will train directly under him during the clinic/outpatient phase of the fellowship. Fellows will understand how to identify risk factors in stone disease and offer patients strategies on prevention, where recurrence is 50% at 5-10 years without prevention.
Lastly, the fellowship will provide the fellow vast opportunities for Clinical,
Machine Learning, and Bioengineering research. There are numerous IRB approved clinical studies evaluating kidney stone disease from all different facets. The center also benefits from collaborations with Endourology Disease Group for Excellence (EDGE), Registry for Stones of Kidney and Ureter (ReSKU),and strong partnerships with both the Shu Chien-Gene Lay Bioengineering Department and UCSD Advanced Robotics Center Lab (ARCLab)— where opportunities for Endoscopic innovations and machine learning research can be performed, respectively.
The Schedule
