Ziho Lee, MD, Author at Grand Rounds in Urology

Ziho Lee, MD

Northwestern University

Chicago, Illinois

Ziho Lee, MD, is the Chief of the Division of Trauma and Reconstructive Urology and an Associate Professor of Urology at Northwestern Medicine in Chicago, Illinois. Dr. Lee specializes in complex robotic reconstruction of the upper and lower urinary tracts, and he has helped develop novel techniques utilizing intraoperative fluorescence and ureteral substitution during robotic ureteral reconstruction.

Dr. Lee earned his medical degree from Thomas Jefferson University in Philadelphia, Pennsylvania. He then completed an internship in General Surgery and a residency in Urology at Temple University in Philadelphia, Pennsylvania, where he was Chief Resident. Dr. Lee completed his fellowship in Advanced Robotic Urologic Oncology and Reconstruction, also at Temple University. He then completed a secondary fellowship in Genitourinary Reconstructive Surgery and Trauma at the University of Washington and Harborview Medical Center in St. Louis, Washington.

Dr. Lee is the Chair of the Advances in Genitourinary Robotic Reconstruction Annual Meeting, and is a member of the Trauma and Urologic Reconstructive Network of Surgeons, Endourological Society, Society of Genitourinary Reconstructive Surgeons, and the American Urological Association. He has published 86 articles within his field, and serves as an Editorial Board Member for The Canadian Journal of Urology International.

Talks by Ziho Lee, MD

Reconstruction of Complex Upper and Mid Ureteral Strictures with Buccal Mucosa Graft Ureteroplasty

Ziho Lee, MD | Sep 2024

Ziho Lee, MD, focuses on using buccal mucosa grafts in ureteral reconstruction and highlights their value in complex cases. Buccal mucosa grafts offer a practical alternative when standard resection and anastomosis are not feasible.

In this 11-minute presentation, Dr. Lee describes onlay grafts, where the anterior surface of the ureter is slit and patched with the graft, and augmented anastomotic repairs for more severe cases with obliterated segments. He shares a short video of both techniques.
Dr. Lee emphasizes the importance of minimizing tissue manipulation and dissection, particularly in cases with fibrosis. Strategies like measuring defects with precision and securing grafts using Monocryl sutures are discussed for graft placement. He recommends using omental wrapping or attaching grafts to the psoas muscle to ensure stability and promote vascularization, especially in retroperitoneal cases.

Tips and Tricks for Robotic Ileal Ureter

Ziho Lee, MD | Sep 2024

Ziho Lee, MD, provides insights into robotic ileal ureter reconstruction, offering practical strategies for optimizing outcomes.

In this 10-minute presentation, Dr. Lee uses photos and procedure videos to outline an effective surgical strategy, starting with proximal ureter dissection to assess feasibility, followed by bowel harvest, bladder preparation, and distal anastomosis. Proper exposure is stressed as critical to ensure the best outcomes. Port placement strategies are discussed, including single setup configurations and rotating the robotic boom for upper tract access. Various tunneling techniques are detailed, including creating a mesenteric window to reduce strain and ensure smooth passage of the ileal segment.
The presentation concludes by emphasizing the importance of meticulous technique and thorough planning, especially for patients with complex histories, including prior pelvic radiation. While the indications for ileal ureter replacement are decreasing, it remains a vital tool for urologists. With careful patient selection and precise execution, surgical success rates can reach 90%, minimizing the need for future interventions.