Extensive experience in urological surgery

During the Australian Urological Conference in Melbourne, Dr Raji Kooner spent time in the operating theatre at Epworth with Dr Simone Crivellaro and colleagues, focusing on single-port robotic surgical technique.

Dr Crivellaro is Director of Minimally Invasive Urology at UI Health and is recognised internationally for robotic-assisted surgery, including single-port robotic urology. These sessions support ongoing technique refinement as single-port robotic surgery continues to develop in urology.

Single-port robotic surgery is one approach within robotic urology. Suitability depends on the condition being treated, the patient's anatomy and history, and discussion of the available alternatives.

Dr Raji Kooner was presented with a certificate marking his 150th UroLift procedure. UroLift is one of several minimally invasive treatment options used for selected men with benign prostatic hyperplasia (BPH).

As with any BPH treatment, suitability depends on prostate anatomy, symptoms, goals of care, and discussion of the alternatives, including medication, iTind, Rezum, laser surgery and TURP.

These theatre images show Dr Raji Kooner with the team supporting iTind procedures, and with an Olympus Continuum iTind Physician Training Program certificate.

iTind is one of several treatment options for selected men with BPH. Treatment choice is individual and depends on prostate anatomy, symptom pattern, medical history and the patient's priorities.

From 11 to 13 April 2019, Dr Raji Kooner attended the 2019 ERUS in Asia Pacific Conference at Tungs' Taichung MetroHarbor Hospital in Taichung, Taiwan.

The meeting brought together urologists and robotic surgery teams for lectures, programme sessions and discussion of robotic surgical practice.

On 18 and 19 August 2018, Dr Raji Kooner was listed in the meeting programme as a speaker at the Taiwan Urological Association 2018 annual meeting at Taipei Veterans General Hospital.

The annual meeting marked the association's 40th anniversary and brought together urologists from Taiwan and the wider region for lectures, programme sessions and professional exchange.

Holmium laser platforms are used across several areas of urology, including stone surgery and selected prostate procedures. The images below show technology platforms encountered in theatre and at urology conference displays.

Technology is only one part of treatment selection. The appropriate approach depends on the condition being treated, anatomy, prior treatment, and the patient's goals and risks.

Dr Raji Kooner attended the EAU19 Annual Congress in Barcelona, Spain, from 15 to 19 March 2019. It is a major international meeting for urology education, research updates and professional exchange. He is pictured with world focal therapy leader Professor Mark Emberton, discussing advances in focal therapy for prostate cancer.

Conference attendance supports ongoing professional development and helps keep clinical discussions connected with international urology research and education.

From 29 September to 2 October 2024, Dr Raji Kooner attended the 66th American Society for Radiation Oncology (ASTRO) Annual Meeting at the Walter E. Washington Convention Center in Washington, DC.

For Dr Kooner's prostate cancer practice, attendance at meetings like ASTRO supports a multidisciplinary approach to treatment selection. Radiotherapy sits alongside active surveillance, robotic prostatectomy, hormone therapy and focal therapy as one of the main treatment families discussed with each patient, and staying current with advances in radiation oncology helps inform balanced advice on the trade-offs between modalities.

From 29 to 31 August 2024, Dr Raji Kooner attended the 24th Asia-Pacific Prostate Cancer Conference (APCC 2024) at the Melbourne Convention & Exhibition Centre. The conference theme was "Together in Discovery", with sessions running across four streams - clinical urology, translational science, nursing and allied health, and general practice.

APCC is the region's flagship multidisciplinary prostate cancer meeting, drawing urologists, radiation and medical oncologists, pathologists, nursing and allied health professionals, and primary care GPs from Australia, New Zealand, and the wider Asia-Pacific. Sessions cover the full prostate cancer pathway, from screening and diagnostics through to surgery, radiation, systemic therapy, and survivorship.

Attendance at meetings like APCC supports the multidisciplinary approach Dr Kooner takes to prostate cancer treatment selection, and to staying current with how the wider Australian prostate cancer community is evolving its practice.

On 14 and 15 June 2024, Dr Raji Kooner attended the Surgical Robotics and Innovation Summit 2024 at the Sydney Masonic Centre as an invited panelist. The meeting brings robotic surgeons together to share technique developments, present case material, and consider the wider direction of robotic surgery in current practice.

The image above is a photo of the opening keynote, presented by Prof Inderbir S. Gill (USC Institute of Urology, Los Angeles), an internationally recognised leader in robotic and laparoscopic urologic oncology. His keynote surveyed the evolution of urologic oncology over the period 2000-2024 across robotics, focal therapy, and artificial-intelligence tools. The slide title is the keynote speaker's framing of the field, not Dr Kooner's.

Invited panellist roles are by invitation from the conference programme committee; panellists contribute to a moderated discussion drawing on their own clinical practice rather than delivering a stand-alone lecture. Dr Kooner's contribution drew on his accumulated robotic-surgery experience in NSW practice (the 2,000 robotic surgical cases milestone is featured at the top of this page).

The image above is a still from the da Vinci surgeon-console feed during a recent robotic partial nephrectomy performed by Dr Raji Kooner. It captures the closure phase of the procedure, with multiple sutures placed across the kidney parenchyma over a haemostatic bolster after the tumour has been removed. The labels visible at the foot of the frame ("LARGE NEEDLE DRIVER", instrument numbers, 30-degree scope angle) are part of the standard da Vinci console interface that the surgeon sees in 3D during the operation.

Partial nephrectomy is a nephron-sparing kidney operation: only the kidney tumour and a margin of surrounding tissue are removed, leaving the rest of the kidney in place. In selected cases this approach is preferred over removing the whole kidney (radical nephrectomy), because preserving functioning kidney tissue helps protect long-term renal function. Whether partial or radical nephrectomy is appropriate for an individual patient depends on tumour size, location, kidney anatomy, the function of the other kidney, and patient comorbidities.

During the procedure Dr Kooner uses indocyanine-green (ICG) fluorescence imaging on the da Vinci system to map renal blood-flow patterns; the fluorescence view shown below highlights the perfusion of the kidney and surrounding tissue in real time, which can help guide tissue handling during dissection and reconstruction.

This still is shown for educational purposes and contains no patient-identifying information. Dr Kooner's robotic kidney work also includes robotic pyeloplasty and robotic adrenalectomy; the cumulative robotic-case figure is documented in the 2,000 robotic surgical cases card on this page.

The team photo above was taken at the conclusion of a recent NanoKnife focal-therapy case in the operating theatre. Dr Raji Kooner appears at the right of the frame, alongside the operating-theatre staff (anaesthetic, scrub and circulating roles) who support the procedure.

NanoKnife uses irreversible electroporation (IRE): short, controlled electrical pulses delivered through fine needle electrodes to ablate a defined target volume within the prostate, with the aim of preserving surrounding nerves and tissues. It is one of several options that may be considered for selected localised prostate cancers, alongside robotic prostatectomy, radiotherapy, active surveillance, and other focal approaches. Suitability depends on cancer characteristics on multiparametric MRI and biopsy, prostate anatomy, urinary and sexual function priorities, and patient preference, and is discussed in detail at consultation.

The image above shows Dr Kooner with a colleague beside the NanoKnife pulse generator outside the operating theatre. The site's NanoKnife page sets out how the procedure is delivered, who it may suit, what it does and does not treat, and the trade-offs against other treatment options.

We're proud to share that Olympus Australia & New Zealand has recognised Dr Raji Kooner for completing greater than 50 iTind procedures - the most in the Asia-Pacific region to date.

Boston Scientific, the manufacturer of the Rezum system, formally recognised Dr Raji Kooner for completing more than 200 Rezum water vapour therapy procedures for benign prostatic hyperplasia.

The Certificate of Achievement and glass award were presented at the Urology NSW rooms in June 2023, with Dr Kooner joined by members of the practice team and Boston Scientific representatives.

Learn more about Rezum · View certificate

Dr Raji Kooner completed a one-on-one laboratory training program on the new single port system. This advanced approach enables surgery through a single small incision, aiming to reduce discomfort, speed recovery, and improve cosmetic outcomes.

By bringing these techniques home, Dr Kooner continues to offer Australian patients access to leading-edge, minimally invasive prostate cancer care.

Dr Raji Kooner is one of the first surgeons in Australia to introduce the single port robotic system for prostate surgery. This advanced approach allows the procedure to be performed through a single small incision, with the aim of reducing discomfort, speeding recovery, and improving cosmetic outcomes.

Dr Kooner undertook specialised training in San Francisco, USA, working alongside internationally recognised experts in robotic surgery. By incorporating these techniques into his practice, he is able to offer patients access to the latest developments in minimally invasive prostate cancer treatment.

Mr. Langford, New South Wales' first robotic prostate surgery patient, reunites with Dr. Raji Kooner - his pioneering surgeon - years after their groundbreaking operation.

Dr Kooner has been implanting iTind since September 2022. He says: "The iTind is an important addition to our treatment portfolio, offering a less invasive treatment option with no major side effects."

The iTind procedure reshapes the anatomy of the prostatic urethra, gently creating a wider opening for urine to flow freely, without burning or cutting out tissue, and without leaving behind a permanent implant. It does not require overnight hospitalisation and preserves sexual and ejaculatory functions.

PSMA PET/CT is a new diagnostic imaging tool that assists in initial staging (determining the extent of prostate cancer), and also restaging of a recurrence. It is far more accurate than other imaging methods, improving the way in which prostate cancer is diagnosed and treated.

The improved visualisation of lymph nodes and bones allows physicians to develop a personalised, targeted treatment strategy.

Dr Kooner is one of the first in Australia to perform transperineal ultrasound-fusion guided biopsy into the prostate. This technology allows more accurate biopsy with fusion of MRI abnormalities onto ultrasounds used in theatre, allowing abnormalities to be targeted more accurately.

Dr Raji Kooner has now performed 2,000 robotic-assisted urological surgical cases across his urology practice. The milestone was marked with a presentation trophy in his Sydney consulting rooms.

This builds on a robotic-surgery practice that began when Dr Kooner performed the first robot-assisted radical prostatectomy in NSW and completed over 75% of the state's cases in the programme's first year (the 2011 Smeeth Archibald-finalist portrait, also shown in the featured news section on this page, captures that period). The 2,000-case figure spans robotic prostatectomy and other robotic urological procedures, including robotic pyeloplasty and robotic adrenalectomy.

Robotic-assisted surgery is one of several surgical approaches used in urology. For prostate cancer in particular, robotic prostatectomy sits alongside open and laparoscopic surgery, radiotherapy, focal therapy with NanoKnife, active surveillance and other options. The right approach for any individual patient depends on cancer characteristics, urinary and sexual function priorities, comorbidities and personal preference.

Procedure volume is one factor among several when considering surgical experience. Training, ongoing professional development, multidisciplinary team support and individual case complexity all matter as well, and they are factors Dr Kooner discusses with patients during consultation.