The University of Tennessee Graduate School of Medicine, Knoxville

Dr. Wesley White Performs Live Surgery for AUA Attendees

Wesley White, MD, Assistant Professor of Urology, performed the first of six live remote surgeries that were broadcast from around the nation into the Orange County Convention Center during the American Urological Association’s Annual Meeting in May. With co-surgeons Ryan Pickens, MD, Urology Instructor; Robert Elder, MD, Obstetrics and Gynecology Professor; and Fareen Firoozi, MD, Director of the Center for Pelvic Health and Reconstructive Institute for Urology in New York, Dr. White performed a robotic sacrocolpopexy on a 62-year-old woman with stage 3 pelvic organ prolapse, which implies relaxation of the vagina in a fashion that causes pelvic pressure, vaginal bulging, and a resultant limitation of a woman’s lifestyle.

In treating pelvic organ prolapse, Dr. White said, “One paradigm that has worked very nicely for us is to take a multidisciplinary approach. We offer the gamut of options at The University of Tennessee Medical Center. This patient was no longer interested in observation or a pessary, and we thought she was not a good candidate for a native tissue transvaginal repair. Working as a Nurse Practitioner, she was hesitant to undergo a transvaginal repair with mesh augmentation. After weighing all of her options, she was interested in having a hysterectomy and sacrocolpopexy done.”

Dr. White said this operation is of great interest to urologists within and outside the United States. Many patients and physicians are reluctant to perform transvaginal repair with mesh due to recent controversies regarding its use. Sacrocolpopexy offers women the treatment option with the highest overall durability and success and largely avoids many of the mesh-related complications.

Leadership for AUA extended Dr. White the invitation to perform this live surgery after he moderated a live robotic sacrocolpopexy during the World Congress of Endourology in New Orleans. Other live surgeries during the AUA meeting were repair of pelvic organ prolapse through a transvaginal repair and 4 other robotic cases done for the treatment of urinary tract obstruction and genitourinary cancers.

Dr. White has now performed five live robotic and/or laparoscopic surgeries. He noted that while the pressure of performing live surgery can be intense, in the current era of robotics, it is by far one of the most popular ways of teaching surgical technique.