Dr. Ash Tewari is Professor and Chairman of Urology at the Icahn School of Medicine at Mount Sinai. He leads of team of professionals driven by a passion to provide unparalleled patient care.
Dr. Ash Tewari is one of the world’s leading researchers and surgeons in the field of prostate cancer. He specializes in robotic prostatectomy and has performed over 5,500 cases. Utilizing an array of innovative techniques, like robotic prostatectomy, that he has pioneered, published in prestigious peer reviewed medical journals, his treatment offers a cure for a majority of prostate cancer patients.
Dr. Tewari is the 2012 recipient of the American Urological Association Gold Cystoscope Award. He was the first to identify the nerves responsible for erectile function as a neural hammock. This increased understanding of the prostate anatomy aids in nerve-sparing prostate surgery techniques for robotic prostatectomy. As an active researcher, he is one of only a few robotic surgeons to be awarded a NIH R01 grant. This funding is for the investigation of real-time tissue identification during prostate cancer surgery.
ART™ Advanced Robotic Technique
The robotic prostate surgery approach used by Dr. Tewari is known as ART™ (Advanced Robotic Technique) prostatectomy, or ART™ for short. It is a highly successful approach to curing prostate cancer while minimizing side effects in select patients. Dr. Tewari and his team have developed and refined ART™ over the past decade based on the thousands of surgeries they have performed, their discoveries in prostate anatomy, and other leading-edge research. ART™ is highly individualized, reflecting a patient’s unique anatomy, cancer location and neural structure. Indeed, for Dr. Tewari, ART™ is truly an art. He routinely makes anatomical drawings of prostates on which he operates in order to map out a cancer’s spatial relationships to the fascia, muscles and nerves that surround the prostate. By drawing the anatomy of individual cases, he continues to fine tune ART ™ and improve cancer control while sparing nerves. He also uses the drawings as a teaching tool for students as well as his peers worldwide who are eager to learn his technique. The crux of the ART™ technique is the delicate removal of the prostate from the top of the nerve hammock with maximal clearance for preserving sexual and urinary function. Not only are nerves not handled, but oxygenation of the nerves is monitored during this phase of the technique so these preserved nerves are greater in number and also healthy and vascular.
Prostate cancer remains a major public health concern for men in the United States and the Western world, with about 200,000 men being diagnosed with prostate cancer and around 30,000 men dying from it in annually in the United States alone. In the last decade, use of serum prostate specific antigen (PSA) screening have led to more men being diagnosed earlier with prostate cancer that is curable and at times biologically confined to the prostate. A few of these men diagnosed with prostate cancer are found to have what is deemed to be low risk disease, defined as PSA 10ng/ml or less, biopsy Gleason score 6 or less, and clinical stage T2a or less. For these low risk low volume Gleason 6 patients, active surveillance (AS) is becoming an increasingly popular alternative to definitive treatment modalities such as radiation and surgery. It seeks to avoid the morbidity associated with overtreatment of indolent prostate cancer, and delay treatment for disease until it becomes clinically significant.
Personalized prediction of tumor response and cancer progression on prostate needle biopsy using quantitative biometric features
By fusing multiparametric MRI with real-time ultrasound, abnormal or suspicious areas seen on the MRI can be tracked and targeted during a prostate biopsy.
3Tesla Multiparametric MRI
3 Tesla Multiparametric Magnetic Resonance Imaging is a state of the art, non-invasive imaging modality that facilitates diagnosing, staging and pre-operative planning for prostate cancer.
Genetic screening can pick up mutations in an individual’s genetic code that may increase the risk of advanced prostate cancer.
The daVinci Surgical System is a sophisticated robotic platform designed to expand the surgeon’s capabilities.
NeuroSAFE allows the assessment of surgical margin for absence or presence of cancer intra-operatively.
Chair, Department of Urology
PROFESSOR AND SYSTEM CHAIR Pathology
PROFESSOR Genetics and Genomic Sciences
PROFESSOR Oncological Sciences
Matthew Galsky, MD
Director of Reconstructive Surgery, Female Urology and Voiding Dysfunction
Director of Male Reproductive Medicine
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