Sinan Zeren, MD
Professor of Urology
Prof. Dr. Sinan Zeren participated in researches and clinical activities in the major urology centers in Los Angeles, and New York and practiced advanced endourologic surgery during his academic life in Adana Çukurova University. The city Adana is in the center of the southern torrid zone where stone diseases are more intensively encountered because of predisposing unfavourable climate, dietary habits, and socioeconomic conditions. He treated many complicated cases without the need for open surgery and shared his experiences with his colleagues in national and international scientific meetings where he had been invited as a lecturer, panelist or trainer and performed many live-surgeries which he had relayed from operating theaters.
Prof. Dr. Zeren who intensively performed percutaneous renal surgery for the management of renal stones, intrarenal stenoses, and urologic tumors from 1997 on, is now carrying on his operations together with his surgical team as a staff surgeon of Acıbadem Fulya Hospital from October 2010, and he is also continuing to share his expertise with his colleagues.
ENDOUROLOGIC OPERATIONS
In these operations visceral cavities are entered without making any incision or through 1 cm-incisions. They are performed using modern technologies with the aid of very thin, camera-mounted devices. They are usually employed for the management of urinary tract stones, stenoses, and tumors. They are ideal treatment modalities for prostatic enlargement.
Ureteroscopy : It is performed to observe any pathology inside ureter. The patients are discharged the same day.
Flexible ureterorenoscopy : This therapeutic intervention is performed using very thin flexible sophisticated instruments with a steerable tip. This intervention enables fragmentation, and elimination of moderate size stones using laser energy. The patients are usually discharged the same day.
Percutaneous Surgery : For relatively larger stones, percutaneous surgery is now considered as an ideal therapy. With manipulations inside a thin tube inserted through a nearly 1 cm- flank incision into the kidney, renal stones can be fragmented, and eliminated even rendering kidneys full of calculi completely stone-free. Through the same route, it is possible to treat intrarenal stenoses, and some renal tumors. Generally 2 days of hospital stay is adequate.
It must be emphasized that children (or infants), patients with one kidney or two problematic kidneys, elder patients, patients with very large stones, radiologically invisible (non-opaque) or hardly visible stones, those with a previous surgery on the same kidney or renal or bodily deformities, very obese persons, and individuals with concomitant medical problems should be treated by the staff having wide experience in this field and in medical centers equipped with high technology. Close follow-up after surgery is mandatory to complete the treatments with shorter hospital-stays.
Stone fragmentation with Laser / Pneumatic systems : Stones approached from inside the urinary tract can be fragmented by powerful lithotriptors under vision.
Shock wave lithotripsy (ESWL) : With the aid of sound waves sent from a source outside the body and focused on the stone, it may be possible to fragment stones inside the urinary tract. Careful, and targeted intervention is very important. The patients try to pass the stones fragmented into very small pieces after reasonable number of ESWL sessions. It should not be applied for the hard stones and stones larger than 2 cm in diameter in order to avoid extra unnecessary sessions. For pediatric cases general anesthesia is required.
Transurethral Resection (TUR) : TUR is a so-called closed treatment modality used for the surgical management of prostatic enlargement, and bladder cancer.
If performed with substantial experience under appropriate conditions, they are nearly perfect therapeutic modalities which can be applied for relatively larger prostates. Hospital stay usually lasts for approximately 2 days.
GreenLight XPS Laser (180 Watt) : This treatment modality which consists of evaporation of the prostate has been popularized recently. Patients can be discharged on the same day or one night stay may be recommended