Our Mission is to develop, rigorously evaluate, and refine urologic and surgical technology, techniques, and devices in order to improve knowledge and enhance patient care.
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. Dr. Roberts was awarded the 2014 Gold Cystoscope from the American Urological Association in recognition of these contributions and accomplishments. This prestigious award is presented annually to one urologist distinguished by outstanding contributions to the profession within ten years of completing residency training. Furthermore, this research was foundational in establishing a start-up company, HistoSonics, Inc. in 2009.
Augmented Shock Wave Lithotripsy: In collaboration with Tim Hall, PhD in Biomedical Engineering, we are conducting research to enhance conventional shockwave lithotripsy (SWL) by 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. This is a natural extension of our work on histotripsy and techniques for controlling cavitation processes. Application of this technology for SWL has the potential to markedly improve stone fragmentation, increase stone free rates, and decrease surrounding tissue injury. Although SWL is a noninvasive treatment modality, and is favored by patients in many cases, it has experienced a decreased pattern of utilization compared to ureteroscopy, largely a result of inferior stone free rates. Successful application of this research will improve SWL efficiency and lead to 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.
Laser Lithotripsy: Led by Khurshid Ghani, MD, and with support of extra-mural funding, we are exploring new techniques utilizing high power holmium laser energy to more efficiently fragment and disintegrate kidney and ureteral stones. Conventional techniques involve fragmentation and time consuming retrieval of fragments. However, very fine fragmentation (stone dusting) is achievable thus allowing spontaneous passage of sand like stone material (called dust) and very small fragments. We are actively researching laser parameters and techniques to optimally and reliably produce stone dusting across a heterogeneous spectrum of stone composition. Additionally, efforts are underway to characterize laser-stone interactions with high-speed imaging, evaluate thermal safety of these higher-power techniques, and development of new devices to facilitate clearance of stone debris. We also 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. Our findings will help us understand what aspects of macro and microstructural urinary stone detail are important for laser fragmentation.
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 well as a project with biomechanical engineering to create a new endoscope to aid with stone dusting. This project was awarded first prize at the 2018 national Biomedical Mechanical Engineering IDEA competition, and is currently supported by a Kickstarter Award from Fast Forward Medical Innovation.