Description of Training
Fellowship Program in Endourology, Metabolic Stone Disease, Laparoscopic and Robotic Surgery at Duke University Medical Center begins on 15 August each year. David M. Albala, MD, heads the laparoscopic and robotic surgery program, while Glenn M. Preminger, MD oversees the endourology and stone disease program. Currently, the Fellowship Program is structured to explore both the medical and surgical aspects of nephrolithiasis and to investigate techniques which will facilitate minimally invasive surgery. The Fellowship is structured as a TWO YEAR PROGRAM only candidates who will agree to a two year commitment that will allow the Fellow to become proficient in clinical practice, basic and clinical research, and administrative capabilities will be considered.

Fellowship applicants must have core knowledge, skills and understanding of the basic medical sciences relevant to urinary tract stones, obstructive uropathy and other Urologic conditions which can be managed with endourologic techniques. The Fellowship will encompass a combination of clinical (75%) and laboratory (25%) training, with research opportunities in the bioeffects of shock wave lithotripsy, shock wave physics, advanced imaging technologies, robotic surgical techniques and virtual reality surgical simulation.

Duration of Training
During the Fellowship, one would work closely with Dr. Albala and Dr. Preminger concentrating on basic and clinical investigations in managing nephrolithiasis. We are currently involved in lithotripsy research including animal studies (bioeffects) as well as long-term clinical trials. In addition, the Fellow will participate in the Endourologic training program including basic endourology (percutaneous and ureteroscopic techniques) as well as basic and advanced laparoscopic and robotic procedures with specific emphasis on techniques that would further enhance minimally invasive surgery. These studies will include 3-dimensional video imaging and virtual reality surgical simulation.

Laboratory Facilities and Research Supervision
Full research facilities are available, including basic science bench-space for SWL bioeffects studies, The Duke Lithotripsy Laboratory in the Department of Engineering and two dedicated research lithotriptors for animal studies. The vivarium with full veterinary support is located immediately adjacent to the Medical Center and Department of Engineering.

All basic science research activities of the Fellowship will be performed at the Comprehensive Kidney Stone Center at Duke University Medical Center (DUMC). All animal projects will be performed at the DUMC Vivarium, a certified facility. The DUMC Vivarium veterinarians and technical-support staff will provide technical assistance.

NIH funding is currently in place to cover the costs of performing these studies. The Fellow will also have access to the two research lithotriptors, which are located within a 5 minute walk from the Medical Center. Pei Zhong, Ph.D., will act as the immediate supervisor for performance of the basic shock wave physics studies. High-speed photographic analysis, acoustic emission equipment and a cavitation detection system will all be available to perform shock wave physics studies.

Clinical Responsibilities
The Fellow will be responsible to make daily Rounds with the Endourology Resident at Duke University Medical Center. The Fellow will see patients in The Outpatient Clinic and participate in endoscopic, laparoscopic and robotic surgery. The Fellow will occasionally be required to take night call for Endourology patients.

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