Richard E. Link, MD, PhD, presented “Autosomal Dominant Polycystic Kidney Disease: Medical Considerations and Operative Magic Tricks” during the 23rd Annual Innovations in Urologic Practice on September 14, 2018 in Santa Fe, New Mexico.

How to cite: Link, Richard E. “Autosomal Dominant Polycystic Kidney Disease: Medical Considerations and Operative Magic Tricks” September 14, 2018. Accessed Dec 2024. https://grandroundsinurology.com/autosomal-dominant-polycystic-kidney-disease-medical-considerations-and-operative-magic-tricks/

Autosomal Dominant Polycystic Kidney Disease: Medical Considerations and Operative Magic Tricks – Summary:

Richard E. Link, MD, PhD, provides guidance for urologic surgeons in the management of autosomal dominant polycystic kidney disease (ADPKD).  He discusses relevant literature, patient selection, and the efficacy and safety of laparoscopic cyst decortication, as well as operative advice for handling massive kidneys during minimally invasive surgery.

Abstract:

ADPKD is the fourth most common cause of end stage renal disease globally. Along with progressive deterioration of renal function, ADPKD patients can develop a variety of symptoms. For example, hypertension, flank pain, cyst and urinary tract infections, nephrolithiasis, bleeding, and difficulty with eating can result from ADPKD. Native nephrectomy can also be a necessary adjunct to renal transplantation in a subset of cases.

This presentation reviews the contribution of the urologic surgeon to the management of ADPKD patients. Additionally, the discussion covers the spectrum of anatomic and symptomatic variation in ADPKD and how these factors influence surgical therapy in a patient-specific manner.

Today, the application of minimally invasive surgical techniques can be appropriate for the vast majority of operative scenarios with ADPKD kidneys. Limited literature supports the efficacy of laparoscopic cyst decortication to treat symptomatic ADPKD. This presentation provides guidance on patient selection and counseling for this procedure. It will also provide operative tips and tricks for handling massive kidneys during minimally invasive nephrectomy procedures to accelerate the learning curve.

About Innovations in Urologic Practice

Innovations in Urologic Practice (IUP) is an annual CME-accredited conference devoted to updating urologists on the rapidly changing healthcare environment. Topics focus on innovative diagnostic and treatment strategies, controversies, new and currently developing technologies, and challenges in today’s urologic practice. Dr. Link presented this lecture during the 23rd IUP in 2018. Please visit this page in order to learn more about future IUP meetings.

ABOUT THE AUTHOR

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Richard E. Link, MD, PhD, is a professor and board-certified and fellowship-trained urologist specializing in the treatment of urologic disease affecting the kidney, ureter, adrenal gland and prostate. Dr. Link holds the Carlton-Smith Endowed Chair in urologic education at the Baylor College of Medicine (BCM) in Houston, Texas and directs the BCM division of endourology and minimally invasive surgery. He serves as director of living donor procurement for several major kidney transplant programs in Houston, including Baylor St. Luke’s Medical Center, Texas Children’s Hospital, and the Houston Methodist Hospital. Dr. Link focuses on the use of laparoscopic, robotic-assisted, percutaneous, and endoscopic techniques to treat kidney and prostate tumors, benign prostatic hypertrophy, renal and ureteral obstruction, and urinary tract stones and has been an early pioneer in the development of laparoendoscopic single-site donor nephrectomy.

Dr. Link earned both his MD and PhD in molecular and cellular physiology at Stanford University in California and completed an internship and residency at BCM before completing a fellowship at The Johns Hopkins University School of Medicine in Baltimore, Maryland. Dr. Link also has a strong interest in applying single site robotic technology using the da Vinci SP platform to retroperitoneal and transvesical urologic surgery. He has published numerous papers and earned many awards, including the Fulbright and Jaworski LLP Faculty Excellence Award for Teaching and Evaluation at BCM.