The Endourology Translational Research Lab is recognized as a premier research laboratory within the Endourology community. Our mission is to develop, rigorously evaluate, and refine urologic and surgical technology, techniques, and devices in order to improve knowledge
and advance endourological treatment. The laboratory is embedded within one of the busiest clinical endourology groups in the world, which facilitates our strategy for discovery and innovation, through:
- Thoughtful identification of substantial, meaningful clinical and surgical unmet needs (bedside-to-bench paradigm).
- Scientific discovery, directed development, early clinical testing, and implementation of novel technologies, devices, and innovative techniques (bench-to-bedside paradigm).
Areas of particular focus include:
Histotripsy: In collaboration with colleagues in Biomedical Engineering, we developed a new technique of tissue ablation called Histotripsy - non-invasive, non-thermal, mechanical focused ultrasound tissue ablation. By applying pulses of intense acoustic energy to a targeted volume, controlled cavitation (microbubble formation and collapse) can be produced. This leads to precise mechanical fractionation of targeted tissues with negligible thermal effects and immediate ultrasound imaging feedback. Our lab pioneered the development of histotripsy in pre-clinical models and facilitated the translation of Histotripsy for BPH and other urological applications. Furthermore, this research was foundational in establishing a start-up company, HistoSonics, Inc. in 2009.
Laser Lithotripsy: We are exploring new techniques utilizing high-power laser energy to more efficiently fragment and disintegrate kidney and ureteral stones. We are actively researching laser parameters and techniques to optimally and reliably produce smaller and more uniform fragments – stone dust. We are also working to understand the pathophysiologic response to elevated temperature and pressure during ureteroscopy with laser lithotripsy (URS LL) and to determine the etiology of pain and morbidity following URS LL. These findings will guide development of techniques that better control temperature and pressure during URS LL to minimize tissue injury, inflammation and potential long-term negative effects on kidney function. This research will improve clinical care by reducing post-operative pain, morbidity, and readmission rates for patients after URS LL. Additionally, efforts are underway to characterize laser-stone interactions with high-speed imaging and to develop new devices to facilitate clearance of stone debris. We have a strong collaboration with Prof. Adam Matzger, Professor in Chemistry, to understand structural stone factors that affect holmium laser fragmentation efficiency, and to develop improved stone models that can be used for urinary stone research.
Augmented Shockwave Lithotripsy: We are conducting research to enhance conventional shockwave lithotripsy (SWL). Together with Dr. Tim Hall in Biomedical Engineering we are applying low amplitude acoustic bursts between therapeutic lithotripsy pulses to alter the cavitation environment surrounding urinary stones. The resulting coalescence and clearing of residual nuclei and bubbles from the acoustic path improves efficiency of each lithotripsy pulse. Application of this technology for SWL has the potential to markedly improve stone fragmentation, increase stone free rates, and decrease surrounding tissue injury, thereby producing better outcomes for patients. As implementation of this technology can likely be accomplished without altering commercial SWL systems, diffusion of this technology is expected to be rapid, affording urologists and their patients, improved options for urinary stone treatment.
Surgical Device Development: We are developing devices to improve the efficiency of ureteroscopic stone surgery. These include ancillary instruments to stabilize the stone for laser lithotripsy, as facilitate the clearance of stone fragments.