Dr. George Koch

Do the Keith Rourke sliding T where, you know, you've you've like major incision and you say, oh, man, I outkick my coverage.

I cannot get the sutures down far enough.

Well, then you can just open it up, do like a sliding T and then close it back up.

So that was kind of always our backup plan.

I talk about it all the time with here and as he and I are deciding, you know, what case to do where and that kind of thing.

And I've never had to use it.

But that was always that's always my backup plan is we like that ventral ventral approach to you.

Do you think that there are techniques, you know, we're talking about your practice, but you're also, you know, as you mentioned, you've got a degree in clinical research.

I feel like whenever I want to catch up on what I've missed in urologic reconstructive research, I like look at what your group is doing to kind of guide the PubMed search.

You know, as far as the national trends go, do you feel like there are techniques that are becoming over or underused now?

nationally, you know, within like the GERS and reconstructive community?

It's a good question.

This, and this kind of gets to kind of your thoughts on your fellow and your fellow's case logs.

I, as I was thinking about kind of things that you and I could talk about with Stricture, I, when I was a fellow, I asked Dr. Wessels about his case logs and we actually like tried to, tried to find some, some documentation of what he did with Dr. McAninch and, you know, it was- Could we find him?

He didn't find it, but he kind of made some estimations for me.

And one of them was, you know, like buccal urethroplasty.

Yes, you know, we're finding non-transsecting techniques might, you know, we may not need as much buccal as we used to, but I would still argue, and I think you probably would too, that buccal urethroplasty is still like the workhorse of much of urethroplasty, you know, many urethroplasty techniques, I was going to say in the U.S., but I think worldwide it's pretty fair to say.

But it was interesting to hear, you know, I'm learning buccal urethroplasty from Dr. Wessels, who estimated that he had maybe done 10 to 15 during fellowship.

And that's because buccal urethroplasty was relatively new when he was in fellowship.

And I've never asked Dr. Wessels his age, and I won't.