Center of Excellence: Department of Urology, Guy's Hospital
City: London, United Kingdom
Director/ Urotour Coordinator: Prof. Prokar Dasgupta
Secretariat/ Organizational Support: Ms Erika Jones
Visit Dates: 30/10/2011-06/11/2011
Trainees: Αvakian Raffi, Athens
Kiratsas Christos, Athens
What the trainees said
Evaluation of the Center
Our welcoming to the Center of Excellence was very warm. We first met the General Director of the Hospital, who explained to us the main procedures and operation of the Center and how we could integrate ourselves to the daily program of the Department of Urology. All staff members were very friendly, hospitable and helpful in whatever we needed.
Description of the Center
The Guy’s Hospital Department of Urology that I had the chance to visit is probably one of the most popular ones in London and, as a consequence, one of the best in the United Kingdom. The Hospital has merged with St Thomas Hospital and has collaboration with King’s College Hospital, composing the largest health structure in the country. It is a Department with 2 Wings -1 for male and 1 for female patients- with 20-25 beds each, and 10 extra beds for one-day hospitalization in the Stone Clinic. The reception desk, patient wards, offices, outpatient clinics, operating theaters are brand new due to the recent renovation and, in general, all premises are extremely ergonomic and functional. The Director of the Department, Professor Prokar Dasgupta, has introduced a pilot program of a "one-day" procedure: once a week patients can proceed to the Center to have all necessary examination and screening tests conducted altogether on one day and almost always leave with the diagnosis for further treatment. The Surgery Unit operates on a daily basis (8:00 am - 17:00) and comporises 2 large operating theaters, 1 smaller septic one, 1 lithotripsy room and 2 fluoroscopy rooms for endourological interventions. These are more than enough for a medical staff of 7 Specialized Urologists and 6 Residents of Urology. Patient management is excellent and the schedule flows smoothly without any problems. The range of surgical procedures is wide covering almost the entire spectrum of Urology. The Department has a four-armed DaVinci with a double console for educational reasons -so that, while performed, all robotic urological interventions can be watched by both Residents and the other Specialized Urologists from a different room. The Department has also a Holmium Laser for Prostatectomies and other uses, Bipolar Endoscopic Diathermy, Extracorporeal Lithotripter, Laser Lithotripter, as well as full equipment for open procedures. In another space that is separate from the Department, there is a full Simulation Laboratory (sponsored by a known Surgical Instrument Company), where all physicians of the Department can practise and develop their skills in contemporarory and other techniques in their free time. The Laboratory has a DaVinci for educational/training use, an apparatus for training in Percutaneous Nephrostomies and PCNL, 4 Pelvic Trainers, Laparoscopic Virtual Simulator, Robotic Virtual Simulator and Virtual Simulator for Urethrocystoscopies and URS. The two last days of our stay coincided with the awarding of Professor Noel Clarke, who came from Manchester. We were very fortunate and thankful indeed as we were really impressed with his surgical competence, the round tables and debates that were organized on the occurrence of his awarding.
Evaluation of the Center
Our welcoming to Guy’s Hospital was very warm and indicative of the high professionalism ruling hospitals of abroad. Although the first day has mainly to do with informing and procedural issues without including clinical activities,still it was a very essential, useful and constructive process so that we could later on follow the activities of the program more easily. It should be pointed out that such formalities may seem to us as wasted time but, on the contrary, in foreign countries great emphasis is placed on the welcoming and informing of the new Physician, so that s/he feels at ease in the new and unfamiliar environment.
Description of the Center and its activities
It was obvious from the first moment that the Guy’s Hospital Department of Urology is one of the most advanced and professionally organized Centers, with facilities, infrastructure and equipment that are really impressive. We had the fortune and honor to watch Professor Dasgupta performing a Robotic Radical Prostatectomy in an operation room -with a double console, so that other surgeons can follow the procedure in 3D imaging and not simply through the screen watched by the Assistant and Scrub Nurse. This is surely a great advantage for the training of Urologists, for they have a full view of the surgical manipulations while at the same time participating actively through the second console under the supervision of a more experienced Consultant. The Simulation Lab of the Department was particularly impressive with a variety of simulators used by young Urologists to practise training in Robotic and Laparoscopic Surgery, Percutaneous Renal Puncture and Endoscopic Urology. Although time never seems enough in such cases, I must admit that Professor Dasgupta and his collaborators gave us the maximum possible time we could have. Also very special was our visit to the Lithiasis Department, a state-of-the art fully equipped Center to treat even the most complicated lithiasis cases in a combined way, without the unnecessary movement of the patient. Lastly, we had the opportunity to attend procedures in the exemplary operating theaters of London Clinic.
The most important event of that week was Professor Noel Clarke's visit. We had the opportunity to attend live surgery (through video) of a Partial Nephrectomy and Retroperitoneal Lymphnode Dissection, as well as a lecture on Professor Clarke's research conducted in his own Urology Department in Manchester. Professor Clarke's visit included also the 'Balloon Debate', where the youngest Urologists of the Department tried to present and support one form of therapy for a clinical prostate cancer case, using arguments in such an illustrative way that it seemed to be the most pleasant and effective way for one to plunge deep into the details of recent literature and assimilate mind the guidelines of the European Urology Society.
Another very didactic experience was attending the Outpatient Clinics, during which patients are referred straight away for the most common and necessary laboratory and imaging tests, and then go back to the Physician who had initially examined them for further instructions, saving in this way valuable time in the process of investigating their problem. Lastly, we had the honor to have dinner with Professors Dasgupta and Clarke, and the entire staff of the Urology Department. This pleasant evening showed to us that despite their great reputation and worldwide recognition, both Professors are particularly friendly and open -both in and out of the hospital setting- and create around them an exceptionally positive climate for all their collaborators.