chla urology newsletter winter 2015
TRANSCRIPT
The Next Generation of Pediatric Urology
Children’s Hospital Los Angeles | Winter 2015
Pediatric Urology at Children’s Hospital Los Angeles
The Division of Pediatric Urology at Children's Hospital Los Angeles comprises one of the largest groups of fellowship-trained and board-certified pediatric urologists in the United States, offering care in 15 community locations. Our physicians provide comprehensive evaluation, diagnosis, treatment and follow-up care for infants, children, adolescents and young adults with congenital and acquired pediatric urology disorders
The Division is ranked among the top hospitals in the nation for urology care on the U.S. News & World Report Best Children's Hospitals List.
Our surgeons perform over 2,500 surgeries and see more than 19,000 patients annually.
Dear Colleagues and Friends,
I am excited to share with you this inaugural newsletter on behalf of the Division of Pediatric Urology at Children’s
Hospital Los Angeles. This past July a national search for a new Division Chief was completed, and I was honored and
proud to have been chosen for the position. Our previous Chief, Dr. Brian Hardy, was instrumental in transforming
pediatric urology care for the Children of Southern California. Although, we lost Dr. Hardy much too soon, his
uncompromising care of children will continue to reverberate for many generations to come. A short tribute to Dr. Hardy
accompanies this newsletter in honor of the man and his career. In addition, I am pleased to enclose information about
our group and some of the clinical and research programs of excellence we have to offer including the following:
Paul Kokorowski, MD is director of certainly one of the busiest minimally invasive and Robotic Surgical Programs on the West Coast and country. Nearly 300 Robotic Surgical Cases have been performed since inception of the Robotic Program in 2008, and the numbers keep rising every year, including partial and complete nephrectomies, pyeloplasties, ureteral reimplantations, urinary diversions, and now oncologic surgical procedures. We have also been exploring the role of single port surgical techniques in both conventional laparascopy and Robotics in the future.
Andy Chang, MD is director of our GU oncology program and works very closely with our renown oncology group, managing complex tumors of the GU tract that include Wilms tumor, rhabdomyosarcoma of the bladder and prostate, and testicular tumor. Dr. Chang is also actively investigating innovative nanotechnology technologies for novel delivery of treatment agents for tumors.
Dr. Steve Kim leads our Health Systems Innovation Program in Pediatric Urology. The major focus of the program is to track performance data in an effort to ensure the highest quality of care and safety for our patients. This is an extremely important component, recently added to our armamentarium as a division and critical as we continue to practice our specialty within the ever changing landscape of medicine.
The GOFARR Laboratory for Organ Regenerative Research and Cell Therapeutics under the leadership of our Director of Pediatric Urology Research, Laura Perin, PhD, continues to be a major component of basic science research within the Division. Research here focuses on novel regenerative medicine applications in the area of Kidney Disease and other organ abnormalities.
It is our commitment to provide only the very best in Pediatric Urology care and to make a difference. With both a strong clinical and research foundation, the future is certainly optimistic that we can continue on this positive trajectory. I look forward to sharing further exciting news with all of you in the years to come.
Sincerely,
Roger De Filippo, MD Chief, Division of Urology [email protected] 323-361-2247
Remembering Dr. Hardy
Brian E. Hardy, MD
March 29, 1942 - January 29, 2013
Dr. Brian Eric Hardy, Division Chief of Pediatric Urology at Children's Hospital Los Angeles (CHLA) and Associate Professor of Urology at the USC Keck School of Medicine, passed away peacefully at his home on January 29, 2013. Dr. Hardy was a brilliant and gifted surgeon who dedicated his career to improving the lives of children afflicted with urologic disorders. As a native of New Zealand, Dr. Hardy completed his undergraduate studies at Otago University in 1959 and obtained his medical degree from the Otago Medical School in 1964. Upon completing his surgical training at the Otago University Hospital Board, Dr. Hardy completed his urology residency at UCLA, served as Chief Resident in Urology at the Peter Bent Brigham Hospital, and completed a fellowship in pediatric urology at Harvard Children's Hospital Boston. After spending time at Toronto Hospital for Sick Children, Dr. Hardy was recruited to Children's Hospital Los Angeles and USC in 1984 to serve as the first full time Chief of Pediatric Urology. As Division Chief and co-director of the pediatric kidney transplant program at CHLA, he touched the lives of thousands of children by giving them the gift of life and restoring a sense of normalcy to their childhood. As a beloved teacher, mentor, colleague, and friend, he selflessly nurtured the careers of several generations of young urologists and successfully built the Children's Hospital Los Angeles Division of Pediatric Urology into one of the premier pediatric urology programs in the nation.
Roger De Filippo, MD Steve Kim, MD, MSCE Andy Chang, MD Paul Kokorowski, MD, MPH
Nicole Freedman, NP Michelle Lagua, PA-C Valerie Gordon, RN Marissa Krupowicz, RN
Clinical Programs of Excellence
• Advanced Fetal Care (Institute for Maternal Fetal Health) • Bladder Exstrophy/Genitourinary Reconstruction • Pediatric Kidney Stone Center • LESS Surgery
• Robotic Surgery • GU Tumor/Oncology • Sexual Differentiation Disorders (Congenital Adrenal Hyperplasia (CAH) Clinic) • Spina Bifida • Voiding Improvement
Program Highlights
GU Tumor program/ Oncology
Dr. Andy Chang leads our effort in GU Oncology. Having trained in one of the nation’s leading urologic oncology training programs at the Keck School of Medicine, University of Southern California, our surgeons are very skilled in all forms of GU tumors and its complexities. Pediatric Urology at Children’s Hospital Los Angeles was the first to completely excise a Wilms tumor with level III thrombus involvement of the IVC, accompanied by active venoscopy, without the need for cardiac bypass. Looking forward, we are actively looking at the role for minimally invasive techniques for many of our oncology patients including renal sparing approaches for Wilms.
Disorders of Sex Development
A team of pediatric urologists, endocrinologists, psychologists and nurses provide specialized care at Children’s Hospital for disorders of sex differentiation, including androgen insensitivity syndrome, congenital adrenal hyperplasia and other disorders. Specialists work together to coordinate medical, surgical and psychological care for each child. On average between 12-15 complex genitoplasties are performed each year with a very large DSD population managed through our multispecialty clinic. We are presently applying for National Center of Excellence Designation by the CARES Foundation
Robotic Surgery Program
Children's Hospital Los Angeles is one of the first in the nation to move beyond traditional laparoscopic surgery to provide robotic-assisted laparoscopic surgery for children. Our surgeons have performed more than 200 robotic surgeries, making our Robotic Surgery Program one of the busiest centers in the United States.
We are the first hospital in Southern California to have a dedicated surgical robot for children, and are home to one of the few robots in the world being used to provide minimally-invasive surgery exclusively for kids.
The benefits of robotic surgery include:
Smaller incisions Shorter hospital stays Decreased postsurgery pain medication requirements Improved cosmetic appearance after surgery
About the Program
Children's Hospital Los Angeles uses the da Vinci Surgical System. Our surgeons are among a select few in the United States certified and actively promoted by Intuitive Surgical as pediatric robotic surgeons, having successfully completed the requisite number of surgeries using the required robotic system.
Basic Science Research
GOFAAR Laboratory for Organ Regenerative Research and Cell Therapeutics in Urology
Under the leadership of our Director of Pediatric Urology Research, Laura Perin, PhD, the Laboratory for Organ Regenerative Research and Cell Therapeutics in Urology focuses on new uses of stem cells and other techniques for organ regeneration and cell therapeutics.
Current projects include kidney organ replacement techniques with stem cells, as well as, new stem cell therapy studies for lung and heart disease, diabetes and kidney diseases. The goal is to search for potential applications that could be used to prevent these diseases and/or significantly delay the damage they cause.
Nanotechnology
Andy Chang, MD, and Travis Williams, PhD, of the USC Department of Chemistry are currently studying nanoparticles to create a catheter-free diagnosis of vesicoureteral reflux. Eliminating the need for catheterization would cause a significant shift in diagnosing this condition. Their research can also be used in drug delivery to treat cancers in a more exact manner.
This study is supported by foundations grants, including a Wright Foundation grant to explore the use of their technology in cancer, and USC Zumberge Interdisciplinary Research and Innovation funding.
Ongoing Clinical Investigations
Physician-scientists from the Division of Pediatric Urology at Children’s Hospital Los Angeles are actively involved in leading-edge pediatric urology research. Topics currently being investigated include:
Etiology of Human Cryptorchidism (Undescended Testes)
Victoria Cortessis, PhD, of the USC Department of Preventive Medicine and Children’s Hospital Los Angeles Division of Pediatric Urology, is investigating the genetic causes of a common condition, cryptorchidism (undescended testes).
Disorders of Sex Development Research
Urologists and Endocrinologists at Children’s Hospital Los Angeles are researching surgical quality outcomes for DSD patients. This includes incidents of adrenal rest tumor complications and a natural history study of Congenital Adrenal Hyperplasia (CAH) from infancy.
Clinical Research/Outcomes Research
Health Systems Innovation Program in Pediatric Urology
Recognizing the need for improving the quality of care provided to children and adolescents with pediatric urologic issues, the Clinical and Outcomes Research Program, directed by Steve Kim, MD, MSCE uses data to track performance and serve as a basis for continuous quality improvement to ensure that children receive the safest and most appropriate care for their condition.
Meeting the Future Challenges and Opportunities of Value-Based Healthcare Delivery
The healthcare delivery landscape is undergoing fundamental change as we begin to pivot away from a traditional fee-for-service based reimbursement schema to one increasingly focused on paying for value in the form of higher quality and lower costs.
To address these challenges, the Division of Pediatric Urology at the Children’s Hospital Los Angeles is undertaking efforts to create a comprehensive information technology and operational framework for addressing the challenges posed by value-based initiatives.
4650 Sunset Boulevard, MS #114 Los Angeles, CA 90027
UROLOGY UPDATE Winter 2015
Contact Us
Pediatric Urology
Children's Hospital Los Angeles
4650 Sunset Boulevard, MS #114
Los Angeles, CA 90027
323-361-2247