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URO-ONCOLOGY

Urological oncology has made dramatic advancements over the past five years concerning diagnostics, operative approach, instrumentation and pharmaceutical products. Dr Zargar offers the latest in diagnostics and therapeutics to patients with testicular, bladder, kidney and prostate cancer. 

Diagnostic Imaging

The MRI machinery and techniques have progressed significantly over the past five years. This is particularly the case for prostate imaging where previously precise imaging methods were not available. Dr Zargar has a longstanding interest in this field and has published few manuscripts concerning the role of MRI in diagnosis of prostate cancer. He continues to be involved with research concerning MRI and prostate cancer. For patients with elevated PSA, he selectively offers prostate MRI imaging and real time MRI imaging for sampling specific areas of concern within the prostate gland.

Other imaging techniques include position emission topography (PET scan) which in combination with newer prostate cancer markers (PSMA) offer more advanced imaging however their true value is still to be determined.

The newer imaging techniques in combination with advanced 3D printing systems also allows for tissue and tumor reconstruction allowing for better conceptualization and planning of the surgical procedures. This has been particularly of value in complex kidney tumors where kidney preserving surgery is contemplated. Dr Zargar will discuss this with you if this is something that will aid in your treatment or something that you might be interested in. 

Genomics

With the recent advances in whole genome sequencing and specific identification of genes involved in various aspects of urological cancer, many commercial multiplex gene panel tests have become available for clinical practice. Various urine and tissue gene panels are available for patients with kidney, bladder and prostate cancer.  Such developments have and will allow for patients tailored specific treatment strategies and are another armament in development of precision personal medicine.Depending on your clinical scenario, Dr Zargar will discuss these with you as additional tools in helping tailoring the best  care plan for your condition. 

Pharmaceutical

Multiple novel agents, immunotherapy and targeted agents have been developed or are in latest phases of development for patients with urological malignancies. Dr Zargar works closely with the other members of multidisciplinary team and will offer you best therapy based on the latest available evidence or access to clinical trials based on the context of your clinical condition. 

Surgery

Surgery still plays a primary role in the diagnosis and treatment of the majority of urological cancers. Doctor Zargar performs a wide range of oncological procedures. In the majority of the cases, the surgery is performed in a minimally invasive fashion and with the aid of robotic technology 

• Prostate cancer

  • prostate biopsy, robotic prostatectomy, robotic salvage lymph node dissection
    

• Urothelial cancer

  • Bladder cancer

    • Cystoscopy, endoscopic tumour resection, robotic radical cystectomy, and urinary diversion (ileal conduit and neobladder)

  • Kidney

    • Pyeloscopy, endoscopic laser resection, robotic nephroureterectomy
      

• Kidney cancer

  • Robotic partial nephrectomy, laparoscopic radical nephrectomy, open nephrectomy
    

• Testicular and penile cancer

  • orchidectomy, retroperitoneal lymph node dissection, partial and radical penectomy

How can we help you further? Please feel welcome to contact Dr Zargar's office on 1300 ZARGAR  or submit an online enquiry.

ROBOTIC SURGERY

Robotic-assisted surgery is enabling surgeons to perform complex minimally invasive surgery with more precision, offering patients improved outcomes. Robotic and laparoscopic surgery is an attractive option for patients because it offers:

• Reduced length of hospital stay and expedited healing

• Less postoperative pain and less need for pain medication

• Quicker return to normal activity and work

• Smaller incisions and diminished scarring
  

A/Prof Zargar performs a wide range of robotic surgical procedures including:

• Robotic prostatectomy

• Robotic simple prostatectomy

• Robotic radical cystectomy and intra-corporeal urinary diversion

• Robotic partial nephrectomy

• Robotic adrenalectomy

• Robotic nephro-ureterectomy

• Robotic ureteric surgery including pyeloplasty, ureteric re-implantation

Robotic Prostatectomy

This method of surgery has become the preferred surgical approach for men with clinically significant, localised prostate cancer. The 3D magnified view, precise, wristed movements provided by the robotic platform allow for preservation of the continence mechanism as well as the nerves for erectile function thus maintaining excellent quality of life after surgery. With minimal pain after the procedure, patients are generally able to return home the day after the surgery.

The robotic approach alone per se does not guarantee success with regard to cancer control or functional outcomes. In fact all the published studies have demonstrated that in trained experienced hands excellent outcomes can be achieved regardless of the modality of surgery. With extensive international training and high volume experience, Dr. Zargar will discuss the best surgical options with you and will assist you in deciding the best method of care for your prostate cancer.

Robotic Partial Nephrectomy

Kidney tumours are often diagnosed incidentally and are often small at the time of diagnosis. Removing the tumor alone instead of the entire kidney when technically feasible allows for preservation of kidney function. Robotic partial nephrectomy is a great method for treating small renal tumors and some selected larger tumors. As well as safely removing the mass and preserving kidney the benefits of minimally invasive approach will mean reduction in pain, faster recovery and earlier return to normal function for the patients. Dr. Zargar was trained for this procedure at the Cleveland Clinic, which is one of the world’s leading institutions for this technique. As well as the technical expertise Dr. Zargar is an expert in the filed of renal preserving surgery with over 50 publications in the peer reviewed journals on this topic. Read more about this procedure here.

Robotic Radical Cystectomy and Intracorporeal Urinary Diversion

Robotic cystectomy for bladder cancer is a technically complex procedure encompassing removal of the urinary bladder and the adjacent organs (prostate in men, uterus/cervix in women). This is followed by removal of the lymph nodes where cancer cells can spread to, and finally the formation of new path for urine excretion, called urinary diversion. This can be in a bag on the abdominal wall (ileal conduit) or a new reservoir made from intestine (Neobladder).

The treatment of patients with bladder cancer is not only about the surgery; it involves the appropriate use of upfront chemotherapy (neoadjuvant chemotherapy), nutritional assessment, and modified peri-operative care as part of our enhanced recovery pathway in the framework of the multi-disciplinary team. Dr. Zargar has extensive experience in all aspects of care for patients with bladder cancer and will provide you with ample information about the best care pathway.

How can we help you further? Please feel welcome to contact Dr Zargar's office on 1300 ZARGAR or submit an online enquiry.

GENERAL UROLOGY

General urology is a specialized field of medicine dedicated to diagnosing and treating conditions impacting the urinary tract in both men and women and addressing issues within the male reproductive system. This encompasses a spectrum of concerns, such as lower urinary tract symptoms, urinary incontinence, kidney stones, erectile dysfunction, and prostate problems.
A/Prof Zargar and his team offer medical and surgical therapy for various general urological conditions. 

• Kidney stones

• Lower urinary tract symptoms

• Blood in the urine

• Evaluation of elevated Prostatic Specific Antigen (PSA)

• Benign prostatic hyperplasia (BPH)

• Penile and scrotal conditions