Cancers of the Urinary Tract
Dr David Merrilees specialises in advanced diagnosis and minimally invasive treatment for prostate, kidney, and testicular cancers, offering personalised care with a focus on robotic and laparoscopic surgery.
Prostate Cancer
David has special interest in the diagnosis and treatment of localized and oligometastatic (low volume spread) prostate cancer. He offers diagnositic services for a raised PSA with MRI, PET scan and transperineal prostate biopsy.
The investigation pathway has become more streamlined with MRI before bioposy for men with a raised PSA and subsequent biopsy only if needed. A PET PSMA scan (special CT scan) is a very useful test that can help with a dificult to diagnose prostate cancer. PET is also useful for risk stratification of low risk prostate cancer. The major role for a PET is staging the spread of a high risk prostate cancer and management of PSA recurrence after curative treatment.
Men with localized prostate cancer are encouraged to carefully consider curative treatments - surgical based or radiation based - and take into consideration cancer factors, patient factors and comorbidities befreo making a decision on your preferred option.
David offers Robotic radical prostatectomy or laparoscopic radcal prostatetomy - if you need open radical prostatectomy (which is still a good option in some circumstances) David will refer you to a colleague or he rarely performs this proceedure currently .
The investigation pathway has become more streamlined with MRI before bioposy for men with a raised PSA and subsequent biopsy only if needed. A PET PSMA scan (special CT scan) is a very useful test that can help with a dificult to diagnose prostate cancer. PET is also useful for risk stratification of low risk prostate cancer. The major role for a PET is staging the spread of a high risk prostate cancer and management of PSA recurrence after curative treatment.
Men with localized prostate cancer are encouraged to carefully consider curative treatments - surgical based or radiation based - and take into consideration cancer factors, patient factors and comorbidities befreo making a decision on your preferred option.
David offers Robotic radical prostatectomy or laparoscopic radcal prostatetomy - if you need open radical prostatectomy (which is still a good option in some circumstances) David will refer you to a colleague or he rarely performs this proceedure currently .
Kidney Cancer
David has a very large volume experience in laparoscopic nephrectomy and lap partial nephrectomy for Renal cell carcinoma - these minimally invaisve options improve the post operative recovery from surgery in the upper abdomen - less post op pain, faster recovery and less bleeding.
Many kidney cancers are diagnosed incidentally during scans for other reasons. For small kidney masses a biopsy may be required to find out wither the growth is indeed a cancer. There are a number of non cancerous benign kidney lumps that need not require surgery and can safely be watched with serial scans.
Many kidney cancers are diagnosed incidentally during scans for other reasons. For small kidney masses a biopsy may be required to find out wither the growth is indeed a cancer. There are a number of non cancerous benign kidney lumps that need not require surgery and can safely be watched with serial scans.
Testicular Cancer
One of Davids areas of interest is Retroperitoneal surgery for advanced testicular cancer. This surgery is often required if there has been spread of testicular cancer to the lymph nodes around the aorta and vena cava (main blood vessels).
Primarily in New Zealand this surgery is post chemotherapy and is done with Open surgery but David has recently successfully completed his first full bilateral laparoscopic retroperitoneal lymph node dissections and in time will offer this and robotic surgery to a wider group of patients - currently for select patients only with low volume disease.
Primarily in New Zealand this surgery is post chemotherapy and is done with Open surgery but David has recently successfully completed his first full bilateral laparoscopic retroperitoneal lymph node dissections and in time will offer this and robotic surgery to a wider group of patients - currently for select patients only with low volume disease.