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Doctor Profile |
Dr. Mark Passarella
Dr. Mark Passarella received his undergraduate degree from the University of Virginia and his medical degree from Georgetown. He completed his residency at Tulane in
New Orleans. He has been with Urological Associates since 2003. He and his wife, Lisa, have two children ages 5 and 2. He is interested in stone disease, oncology and minimally invasive
surgery/laparoscopy. In his spare time he enjoys skiing, boating and the outdoors.
Dr. Julian Fagerli
Dr. Julian Fagerli received his undergraduate degree from James Madison University and his medical degree from Eastern Virginia Medical in Norfolk, VA. After his internship at West
Virginia University in Morgantown, he completed a residency at the University of Pittsburgh. He’s been in private practice for eight years. He and his wife of 16 years, Nicole, have
two daughters: Anna, age 9 and Caroline, age 7. His clinical interests include oncology, stone
disease and infertility. When he’s not seeing patients he finds time for golf, hiking and fishing.
Perhaps the most impressive advance in the last several years is laparoscopy. Procedures that normally involve large incisions, long hospital stays, and extended recovery periods are rapidly becoming less and less common.
Stents, Scopes and Tape: The Continued "Miniaturization" of Urology
The minimally invasive trend continues unabated in urology. As one of the first specialties to embrace minimally invasive technology in the ongoing quest to provide the best possible patient care, urology has been at the forefront of innovation ever since. The first major advance was the debut of extracorporeal shock wave lithotripsy (ESWL) for stone disease in 1984. This was followed shortly by the laparoscopic revolution in the late 1990s and continues today with office-based treatment for benign prostatic hyperplasia and outpatient, minimal-access procedures for incontinence.
While ESWL revolutionized the treatment of stones, continued improvements in technology make open stone surgery a historical relic. Almost all stones today can be managed using minimally invasive surgery. ESWL continues to be the workhorse for the majority of stones, with perhaps 75 percent of all stones amenable to ESWL. However, even larger stones can be addressed endoscopically, virtually always as an outpatient procedure. Ureteroscopy in experienced hands has excellent success rates, even for large renal stones or those with complicated anatomy. Even the most complex stones can be removed using percutaneous approaches, or combinations of endoscopy/ESWL (see instrument above, left).
Perhaps the most impressive advance in the last several years is laparoscopy. Procedures that normally involve large incisions, long hospital stays, and extended recovery periods are rapidly becoming less and less common. Malignancy or the concern for malignancy is currently the most common reason for renal surgery. Nephrectomies are increasingly amenable to laparoscopic surgery, and the majority of surgical procedures involving ablative or reconstructive procedures in the kidney can now be done laparoscopically. As the use of CT scans increases, more and more lesions are being identified in the kidney. In fact, the majority of kidney cancers today are discovered incidentally during a CT scan for another reason. continued ...