Week 2 -- Chih-Yun Hsia

This week I got the chance of observing surgeries in urology department. Beside my mentor Dr. Scherr, I also saw Dr. Tyagi preforming surgeries to fix female pelvic prolapse problem. The patients’ bladders and rectums fell into the vaginal cavity due to the change of integrity of the tissue in between. Before the surgery, we could clearly see the protrusion through the vagina. The surgeries were preformed through two openings of vagina, one for bladder and the other one for rectum.  Dr. Tyagi placed a piece of  biodegradable mesh through the vagina which will stimulate the tissue to grow to support the bladder/rectum on its normal place. However, Dr. Tyagi said that current mashes do not work so well permanently; she expected new material which serves better will come up soon.

Beside female pelvic prolapse, I also observed Dr. Scherr performing cystectomy.  Dr. Scherr first use da Vinci robotic system to remove the patient’s bladder, and then he created an Indiana pouch for bladder reconstruction. Dr. Scherr took a section of the patient’s right colon to serve as the pouch, and also a portion of the ileum which was brought out to the opening of the abdominal wall.  The ileoceca orifice helps the patient to be continent, which is the most significant advantage of Indiana pouch over other strategies. I was so amazed by this surgery since the whole process was really complicated and needed to be performed by well-experienced surgeons. 

In addition to the clinical side, I also had some progress on the research part. Dr. Scherr provided me two options: the update of bladder cancer database, and a project related to prostrate cancer biomarker. In the following week, my plan is to get the access to Epic system and update the data, and read more literature to have a better understanding of the project as well.