With Safer Procedures, urological treatment Moves to the Rural Setting

July 23, 2019 – Yokne'am Illit, Israel

By G. Richard D. Batstone, MA, MB, BChir, MD (Cantab), FRCS (Urol), FRACS, FRCSC

Because of the risks and facility requirements for some common urological procedures, such as treatment of large kidney stones and benign prostatic hyperplasia (BPH), small hospitals in rural areas will often refer those cases to larger facilities. For the last 6 years, I’ve been following a different model. I perform kidney stone and BPH procedures 3 days a week at one base in Bangor, Maine, and then travel 85 miles 2 days a week to do surgery in Farmington, a rural town of about 8,000 residents. By treating patients locally, we reduce the impact on their lives and finances, and the rural hospital retains high-volume prostate and stone operations. As a surgeon, I enjoy operating at small hospitals, where the logistical and bureaucratic setup allows me to turn cases quickly and perform more surgeries per day.


I think this approach – taking surgeons to the patients – will be the model of the future. But this model relies on procedures being very safe, thus not requiring a high-level facility or the surgeon’s presence after surgery. In urology, the change is possible because of an advance in laser technology, utilized through flexible ureteroscopy, which dramatically shifts the safety profile for treating even the toughest kidney stone and BPH cases. It lets me safely operate and drive home the same day…

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Richard D. Batstone, MA, MB, BChir, MD (Cantab), FRCS (Urol), FRACS, FRCSC,
is an urologist at Northern Lights Urology in Bangor, Maine, and
Franklin Health Urology in Farmington, Maine.