Robotic Fellowship in Europe

Robotic Fellowship in Europe

Advanced robotic training fellowship in Europe

Nick Brook will be in Belgium from April to Sept 2018

I will be undertaking a period of advanced robotic surgical training at Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium from April to September 2018, under the mentorship of Prof Alex Mottrie.

The OLV is a high-volume robotic surgery hospital with a large department of Urology. The hospital has been undertaking robotic surgery since 2001 and is closely aligned to the OLV Vattikuti Robotic Surgery Institute (ORSI). The urology department produces a large volume of clinical data on outcomes for robotic surgery and regularly reports on new techniques.

Advanced robotic skills to bring back to Adelaide

The aim of this outstanding and internationally recognised fellowship is to gain full competence in a range of advanced urological robotic-assisted techniques. The training is purely in robotic urology – five days of operating a week. I will return to Adelaide and be able to provide these advanced techniques to patients. The training serves three purposes. First, after six-months I will be fully trained in a range of urological robotic surgery. I will be able to bring these skills back to South Australia for service provision from October 2018. Second, the time will be invaluable in developing the skill set necessary to train our local urology registrars in robotic surgery. Since robotic surgery was introduced in SA in 2004, no registrars have been able to train in robotic surgery. It is vitally important for South Australian patients that doctors of the future are able to provide this kind of surgery. Third, the academic work and clinical outcomes data will open-up the possibility of international collaboration in this area for South Australia.

I undertook a period of fellowship training (2008-2009) with Prof David Nicol in Brisbane, and was appointed as a consultant Urologist in Adelaide in 2009, where I have been a urological surgeon with broad practice including benign and cancer work. I have a particular interest in urological cancer surgery and have been instrumental in developing urology cancer provision at the Royal Adelaide Hospital into a fully functioning multidisciplinary service. I have made a large contribution to the public service system by bringing innovative strategies and significant funding to the department.

I see a great number of benefits to this 6 month fellowship for the provision of service to the public and private hospital systems in Adelaide, and also for the development of our training registrars. I will be unpaid for this period, and will be leaving a young family in Adelaide for six-months. I believe this demonstrates my dedication to further training and professional development, and its importance for bringing high level robotic urology surgery skills to South Australia.

Categories: Updates


Urologist in Adelaide - Prostate Biopsy

Urologist in Adelaide - Prostate Biopsy

Urologist in Adelaide, Nick Brook using the Mona Lisa Biobot

Robotic prostate biopsy

In January 2017, Nick Brook organised for a 6 month free trial of the Biobot robotic biopsy system at the Royal Adelaide Hospital. This is the first such system in South Australia, and was only the third in use in Australia.

The system uses a patient's MRI scan and fuses this with a real-time ultrasound of the prostate to enable targeting of suspicious areas in the prostate.

Increased accuracy of diagnosis leads to increased confidence that the correct treatment can be chosen.

Software controls the robotic arm, to ensure that the needles are placed in the correct position for biopsy

The Advertiser story on the introduction of the Biobot to South Australia by Nick Brook can be found here

Categories: Updates


Nick Brook Urology Website online again

Nick Brook Urology Website online again

Adelaide Urologist Associate Professor Nick Brook has re-launched his urology practice website.

The website is relaunched

This was the most visited urology website in Adelaide, and has returned with updated patient information on urology conditions and procedures.

It highlights treatment options for prostate cancer, kidney stones, bladder stones, kidney cancer, vasectomy, vasectomy reversal and many others.

Optimised for mobile, tablet and desktop

You can view the website on your chosen device, for all the information you need on urology problems.

Categories: Updates


Prostate biopsy infection - antibiotic resistance

Prostate biopsy infection - antibiotic resistance

Infections associated with prostate biopsy have increased over time, and there is growing evidence of infections that are resistant to the antibiotics used to prevent infection.

Resistant infections after trans-rectal prostate biopsy (TRUS)

About 1-2% of patients who have a TRUS biopsy of the prostate will develop a febrile infection, which can be serious. Antibiotics (usually ciprofloxacin) are used before and after biopsy to keep this infection rate at 1-2%. However, there is increasing evidence that many of us carry bacteria in our gut (and rectum, where the needle is passed through to reach the prostate) that are resistant to ciprofloxacin.

A recent study from the Journal of Urology (Liss et al.) looked at 2673 men from 6 different medical centres undergoing biopsy and discovered cirpofloxacin-resistant bacteria in the rectum in 20.5% of men.

We know that some men are at increased risk of carrying such resistant bacteria (known as ESBL), and these include men who have been treated with ciprofloxacin in the prior six months, and those that have travelled to SE Asia or the Indian subcontinent in the recent past. The bacteria are harmless in the gut, but become dangerous if seeded into the prostate by biopsy.

How can the risk of infection be reduced?

One of the ways to reduce the risk of infection is to consider a transperineal biopsy instead of a transrectal biopsy. In transperineal biopsy, the needles for biopsy are not passed through the rectum, but instead through the skin of the perineum, and the infection risk is greatly reduced. A study from Jeremy Grummet in Melbourne demonstrated a reduction in serious infection, with a greater than 10x reduction in risk compared to transrectal biopsy.

You can read more about this study by following this link to an article by Jeremy Grummet.

Follow this link to read more about transperineal biopsy.

Categories: Updates, Prostate Cancer


Testosterone replacement statement by FDA

Testosterone replacement statement by FDA

A recent release from the U.S. Food and Drug Administration (FDA) has highlighted that caution is needed with the use of testosterone replacement treatments for men.

US FDA statement on Testosterone Replacement

Their advice suggests that replacement should only be used for men who have low testosterone levels caused by certain medical conditions such a primary hypogonadism (examples are failure of the testes to produce testosterone due to chemotherapy, genetic conditions, damage from infection), or disorders of the brain or pituitary gland that result in decreased testosterone.

Increasingly, testosterone replacement is being used to treat symptoms in men who have low testosterone for no other apparent reason other than due to ageing. The USFDFA state that the benefits and safety of testosterone replacement have not been established for this use.

Some studies suggest there may be an increased risk of cardiovascular problems (heart attack and stroke) with testosterone replacement, although not all studies have demonstrated this.

It is very important that you talk with your doctor about these risks, and the indications for starting testosterone replacement.

Categories: Updates, Other


Rapid Access Kidney Stone Service

Rapid Access Kidney Stone Service

Kidney stones are a common problem in Australia and can be very painful. Patients with severe pain may need to be seen urgently by a urologist. One option is to present to an emergency department, where the condition can be diagnosed with a consultation and CT scan, and then referral if necessary to a urologist.

From early 2015 we will be offering a rapid access stone assessment service based in the rooms at Calvary Hospital in North Adelaide. You will need a referral from your GP, and can then be seen the same day, with a CT scan organised at Radiology SA (in the same building as our office). CT usually needed to confirm the diagnosis, and show the size and location of the stone.

If necessary, you can be admitted directly to Calvary North Adelaide Hospital, and have the necessary treatment undertaken. Often, it is enough to be admitted with pain killing drugs, anti-inflammatories, and a tablet called an alpha-blocker – many kidney stones will pass on their own with this treatment and this may be sufficient to relieve your kidney stone pain. If the stone is larger or there are complications such as infection, you can have your surgery at the same time.

The aim of this rapid access kidney stone service is to shorten the time from presentation to definitive treatment.

Categories: Updates, Kidney Stones


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  • Nick Brook Urology
    Calvary North Adelaide Hospital
    89 Strangways Tce,
    North Adelaide,
    Adelaide SA 5006
  • 08 8267 1424
  • 08 8267 1370