Surgeons, Urologist
6 years of experience

Accepting new patients
Kips Bay
Manhattan Campus of the VA NY Harbor Healthcare System
423 E 23rd St
New York, NY 10010
212-686-7500
Locations and availability (7)

Education ?

Medical School Score Rankings
University of Nebraska (2004)
  • Currently 4 of 4 apples
Top 25%

Awards & Distinctions ?

Associations
American Urological Association

Affiliations ?

Dr. Mues is affiliated with 15 hospitals.

Hospital Affilations

Score

Rankings

  • NewYork-Presbyterian / Weill Cornell
    Urology
    525 E 68th St, New York, NY 10065
    • Currently 4 of 4 crosses
    Top 25%
  • New York Presbyterian Hospital / Columbia
    Urology
    630 W 168th St, New York, NY 10032
    • Currently 4 of 4 crosses
    Top 25%
  • Nyu Hospital For Joint Diseases
    301 E 17th St, New York, NY 10003
    • Currently 4 of 4 crosses
    Top 25%
  • Bellevue Hospital Center
    462 1st Ave, New York, NY 10016
    • Currently 3 of 4 crosses
    Top 50%
  • New York Presbyterian Hospital / The Allen Pavilion
    Urology
    5141 Broadway, New York, NY 10034
    • Currently 3 of 4 crosses
    Top 50%
  • NYU Hospitals Center
    Urology
    550 1st Ave, New York, NY 10016
    • Currently 2 of 4 crosses
  • Harlem Hospital Center
    506 Malcolm X Blvd, New York, NY 10037
    • Currently 2 of 4 crosses
  • Nyp-Columbia
  • NewYork-PresbyterianColumbia
  • Presbyterian Hospital
  • Stamford Hospital
  • New York Harbor Healthcare System
    423 E 23rd St, New York, NY 10010
  • Rusk Institute of Rehabilitation Medicine
    400 E 34th St, New York, NY 10016
  • Brooklyn Campus of the VA
    800 Poly Pl, Brooklyn, NY 11209
  • Tisch Hospital
    550 1st Ave, New York, NY 10016
  • Publications & Research

    Dr. Mues has contributed to 26 publications.
    Title Prospective Randomized Evaluation of Gel Mat Foot Pads in the Endoscopic Suite.
    Date February 2012
    Journal Journal of Endourology / Endourological Society
    Excerpt

    Several studies that compare open and laparoscopic procedures have demonstrated that the minimally invasive surgeon has greater musculoskeletal pain when compared with open surgeons. The purpose of our study was to demonstrate whether the use of the gel mat in the endoscopic setting offered any ergonomic benefit to the surgeon.

    Title Validating the Use of the Mimic Dv-trainer for Robotic Surgery Skill Acquisition Among Urology Residents.
    Date February 2012
    Journal Urology
    Excerpt

    To compare robotic surgery skill acquisition of residents trained with Mimic dVTrainer (MdVT) and da Vinci Surgical System (dVSS) console. No standardized curriculum currently exists for robotic surgical education. The MdVT is a compact hardware platform that closely reproduces the experience of the dVSS.

    Title Polyglyconate Unidirectional Barbed Suture for Posterior Reconstruction and Anastomosis During Robot-assisted Prostatectomy: Effect on Procedure Time, Efficacy, and Minimum 6-month Follow-up.
    Date January 2012
    Journal Journal of Endourology / Endourological Society
    Excerpt

    With widespread implementation of posterior rhabdosphincter reconstruction (RSR) followed by urethrovesical anastomosis (UVA), reconstruction has become a significant portion of robot-assisted laparoscopic prostatectomy (RALP). Successful anastomosis can be measured by time for reconstruction and the absence of urinary leak. We prospectively evaluated the experience of a single surgeon (KKB) in using the V-Loc™ wound closure device for the posterior RSR and UVA, and compared it with a standard reconstruction and anastomosis.

    Title Laparoscopic Ablation of Renal Neoplasms.
    Date June 2011
    Journal Journal of Endourology / Endourological Society
    Excerpt

    As a result of the widespread application of cross sectional imaging, there has been a significant rise in the incidence of small renal cortical neoplasms. The current standard of care in the management of these lesions is nephron-sparing extirpative surgery. In the last decade, however, image-guided or ablative therapies have garnered significant attention as nephron-sparing alternatives to partial nephrectomy. Although initially laparoscopic ablation was predominately intended for use as active treatment in those patients in whom more invasive therapy was contraindicated, as experience with laparoscopic ablation has become more robust, the indications for the procedure continue to evolve. The current article reviews the indications and contraindications, preoperative preparation, surgical technique, and postoperative follow-up for laparoscopic ablative procedures. Also discussed are techniques and patient selection criteria to avoid complications, as well as the management of complications that do occur.

    Title Active Surveillance of Renal Cortical Neoplasms: a Contemporary Review.
    Date March 2011
    Journal Postgraduate Medicine
    Excerpt

    Over the past 2 decades, there has been a significant increase in the number of incidentally found small renal cortical neoplasms (RCNs). As more RCNs are being discovered in the elderly and infirmed patient populations, there has been a growing interest in the role of active surveillance (AS). Active surveillance is recommended for high surgical-risk patients and those with a reduced life expectancy. It is also an option for patients wishing to avoid surgery. We review the current literature on AS and highlight the natural history of disease, the important factors to evaluate during AS, and the contemporary role of biopsy.

    Title Contemporary Experience in the Management of Angiomyolipoma.
    Date February 2011
    Journal Journal of Endourology / Endourological Society
    Excerpt

    We review our single center experience in the management of renal angiomyolipoma (AML) in patients who were treated with active surveillance (AS) or invasive treatment protocols.

    Title Robotic Instrument Insulation Failure: Initial Report of a Potential Source of Patient Injury.
    Date January 2011
    Journal Urology
    Excerpt

    To report our experience with failures in the accessory tip covers that insulate the monopolar robotic cautery scissor instruments and the patient injuries that have resulted. Currently, there is no data in the literature regarding the failure rate of robotic instruments or their accessory components.

    Title Prospective Randomized Evaluation of Foot Gel Pads for Operating Room Staff Comfort During Laparoscopic Renal Surgery.
    Date January 2011
    Journal Urology
    Excerpt

    We evaluated the comfort level of our laparoscopy team during and after laparoscopic renal surgery, with or without the use of gel footpads.

    Title Prospective Randomized Single-blinded in Vitro and Ex Vivo Evaluation of New and Reprocessed Laparoscopic Trocars.
    Date December 2010
    Journal Journal of the American College of Surgeons
    Excerpt

    Reprocessing of single-use medical instruments has been proposed as a mechanism for managing the rising costs of health care. We compared the performance of new and reprocessed laparoscopic trocars.

    Title Comparison of Percutaneous and Laparoscopic Renal Cryoablation for Small (<3.0 Cm) Renal Masses.
    Date November 2010
    Journal Journal of Endourology / Endourological Society
    Excerpt

    We reviewed our experience with laparoscopic cryoablation (LCA) and percutaneous cryoablation (PCA) in the management of small renal tumors and compared clinical outcomes, short-term oncologic results, and patient complications.

    Title Endoscopic Management of Completely Excluded Calices: a Single Institution Experience.
    Date November 2010
    Journal Journal of Endourology / Endourological Society
    Excerpt

    Excluded calices refer to a single calix or multiple calices that are completely isolated from the collecting system. The etiology is a result of infection, malignancy, or inflammation that is secondary to endoscopic renal surgery. We report our experience with the endoscopic management of excluded calices.

    Title Image-guided Percutaneous Ablation of Renal Tumors: Outcomes, Technique, and Application in Urologic Practice.
    Date October 2010
    Journal Current Urology Reports
    Excerpt

    The recent increase in detection of small (<or=4 cm) renal cortical neoplasms has engendered changes in the management of these incidental renal tumors. There is increased interest in new forms of minimally invasive therapies, including focal renal mass ablation with cryotherapy and radiofrequency ablation (RFA). Percutaneous cryoablation (PCA) and percutaneous RFA are among the newest approaches to minimally invasive renal surgery offering excellent patient recovery, lower rates of procedure-related complications, and promising oncologic outcomes. Ablative techniques were once considered a treatment option only in highly selected cases. However, with excellent efficacy of ablative technologies having been demonstrated with intermediate-term follow-up, renal ablation has expanded to a larger patient population. Percutaneous renal ablative procedures are optimized when performed in a combined fashion, with urologists and interventional radiologists collaborating to optimize the chance of success of the ablation. This article reviews the recent advances in PCA and percutaneous RFA and offers suggestions for patient selection in contemporary urologic practice.

    Title Active Surveillance for Larger (ct1bn0m0 and Ct2n0m0) Renal Cortical Neoplasms.
    Date October 2010
    Journal Urology
    Excerpt

    To report our experience with patients undergoing active surveillance (AS) with Stage T1bN0M0 and T2N0M0 tumors. AS is a reasonable option for selected patients with renal cortical neoplasms (RCNs). Most patients undergoing AS are high-risk surgical candidates with Stage T1a lesions. The natural history of larger (Stage cT1bN0M0 and cT2N0M0) RCNs remains undefined.

    Title Evaluation of 24 Holmium:yag Laser Optical Fibers for Flexible Ureteroscopy.
    Date June 2010
    Journal The Journal of Urology
    Excerpt

    Prior study has shown that holmium:YAG laser fiber performance differs among manufacturers. We determined the performance and threshold for failure of 24 commercially available holmium:YAG laser fibers.

    Title Small Renal Masses: Current Concepts Regarding the Natural History and Reflections on the American Urological Association Guidelines.
    Date March 2010
    Journal Current Opinion in Urology
    Excerpt

    Although surgical resection is the current standard for treatment of small (<4 cm) renal cortical neoplasms, active surveillance remains an option in selected patients depending on tumor characteristics and surgical risk. We review the natural history of small renal masses according to the current literature, and highlight issues regarding the recent guidelines for the management of T1 renal masses put forth by the American Urological Association.

    Title Quantification of Holmium:yttrium Aluminum Garnet Optical Tip Degradation.
    Date November 2009
    Journal Journal of Endourology / Endourological Society
    Excerpt

    Optical laser fibers are utilized to transmit energy to the surface of a stone during holmium:yttrium aluminum garnet (Ho:YAG) laser lithotripsy. During lithotripsy, fiber tip degradation (burn back) can occur. Fiber burn back may diminish fragmentation efficiency, increase operative time, and increase cost because of fiber replacement. We hypothesize that fiber tip degradation (burn back) varies among different commercially available Ho:YAG laser fibers.

    Title Clinical Experience and Sexual Function Outcome of Patients with Priapism Treated with Penile Cavernosal-dorsal Vein Shunt Using Saphenous Vein Graft.
    Date April 2009
    Journal Urology
    Excerpt

    To assess the outcome of new penile cavernosal-dorsal vein shunt using a saphenous vein graft. Traditional surgeries for priapism have high failure rate and subsequent impotence.

    Title Holmium:yttrium-aluminum-garnet Lithotripsy Proximal Fiber Failures from Laser and Fiber Mismatch.
    Date July 2008
    Journal Urology
    Excerpt

    OBJECTIVES: To document proximal fiber failures at the subminiature version A connector during holmium:yttrium-aluminum-garnet lithotripsy when fibers and lasers are mismatched. METHODS: Optical fibers supplied by Trimedyne were coupled to holmium:yttrium-aluminum-garnet lasers from Lumenis (VersaPulse 100 W), New Star (NS1500 12 W), and Dornier (Medilas H20) for an in vitro experiment. We reviewed the operating room laser log for our Lumenis VersaPulse 100 W laser for an in vivo experiment. The lasers were maintained with the rods aligned. The use of a different brand, small caliber (diameter less than 300 microm) and larger fibers and the number of proximal fiber failures were recorded. RESULTS: The in vitro experiment was stopped prematurely because the fiber failed on the New Star laser with an audible explosion sound and smoke emanating from the connector end. The fiber could not be extracted from the laser. The fiber at its connector end had melted and fused to the laser terminal. In vivo, 4% of all cases using the sub-300-microm fibers had connector end failures versus 0% of 365-microm fibers, and 0% of 550-microm fibers (P <0.001). Of 188 consecutive cases using the sub-300-microm fibers, 4 (13%) of 30 cases had connector end failures using the Trimedyne fiber versus 3 (2%) of 155 cases using the Lumenis fiber (P <0.01). CONCLUSIONS: The mismatch of small-caliber fibers with lasers runs the risk of fiber failure, energy reflected back at the laser, and laser damage. Urologists should familiarize themselves with the specifications of their holmium:yttrium-aluminum-garnet lasers and fibers to avoid expensive laser repairs.

    Title Current Status of Ablative Therapies for Renal Tumors.
    Date
    Journal Indian Journal of Urology : Iju : Journal of the Urological Society of India
    Excerpt

    The increase in detection of small (</= 4 cm) renal cortical neoplasms has made nephron-sparing surgery the new standard of care for T1a renal lesions. Advances in minimally invasive surgery have improved the surgical approach to these lesions to include laparoscopic partial nephrectomy and renal ablative therapies. In this review, we discuss the indications, outcomes, and potential complications of the commonly used ablative modalities in urologic practice. We will expand on renal cryoablation and review the mechanism of action, surgical approaches, and evidence based medicine using this modality.

    Title Results of Kidney Tumor Cryoablation: Renal Function Preservation and Oncologic Efficacy.
    Date
    Journal World Journal of Urology
    Excerpt

    Changes in the management of minimally invasive oncologic renal surgery have introduced ablative therapies as the most recent advancement in minimally invasive technology.

    Title Intraoperative Evaluation of Renal Blood Flow During Laparoscopic Partial Nephrectomy with a Novel Doppler System.
    Date
    Journal Journal of Endourology / Endourological Society
    Excerpt

    Hemostasis remains a major challenge associated with laparoscopic renal surgery. We evaluated a cost-effective novel Doppler probe (DP) for assessment of vascular control during laparoscopic partial nephrectomy (LPN).

    Title Contemporary Experience with Laparoscopic Radical Nephrectomy.
    Date
    Journal Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
    Excerpt

    Abstract Introduction: We present our single-center contemporary experience with laparoscopic radical nephrectomy (LRN). LRN is an established minimally invasive approach comparable to open radical nephrectomy for the treatment of renal cortical neoplasms. Technical advancements and surgical experience with LRN mandate a re-evaluation of contemporary outcomes. Methods: Between June 2005 and July 2009, 74 patients underwent LRN for an enhancing renal mass. Six of these patients underwent a cytoreductive nephrectomy for metastatic renal cell carcinoma. Patient demographics, perioperative data, tumor characteristics, complication rates, and outcomes were retrospectively collected and analyzed from our prospectively established renal database. Results: The mean follow-up for patients undergoing nephrectomy without metastasis was 17.4 months (1-52 months). The mean estimated blood loss was 93 mL (0-600 mL) and the overall complication rate was 5.9%. Two patients developed metastatic disease after surgery, both of whom had high-stage (pT3a) tumors. No death was caused by renal cell carcinoma. In the cytoreductive cohort, the mean estimated blood loss was 592 mL (200-1200 mL). Four were high stage (pT3a/pT3b). The mean follow-up was 4.7 months (1-15 months), with an overall survival of 50%. Conclusions: With contemporary technology and increased laparoscopic surgical experience, LRN and, in selected cases, cytoreductive LRN can be performed safely and effectively for the majority of renal tumors. Experience has resulted in a reduction in operative time and blood loss complication rates. LRN remains the approach of choice for the management of renal cortical neoplasms not amenable to nephron-sparing surgery.

    Title Natural History of Renal Cortical Neoplasms During Active Surveillance With Follow-up Longer Than 5 Years.
    Date
    Journal Urology
    Excerpt

    OBJECTIVES: To present our experience with patients who elected active surveillance for renal cortical neoplasms (RCNs) with ≥5 years of follow-up. Few data are available regarding the long-term natural history of RCNs during surveillance. METHODS: We retrospectively reviewed our urologic oncology database and identified 44 patients with 51 RCNs who had received active surveillance for >5 years of follow-up. The patient and tumor characteristics and tumor growth rate and overall survival data were evaluated. RESULTS: The median patient age was 71.7 years (range 55-92), with 32 patients (72.7%) having a Charlson comorbidity index of ≥2. The median tumor size was 2.67 cm (range 0.9-8.6) at diagnosis. Biopsy was performed in 17 patients (38.6%). Of these 17 patients, clear cell renal cell carcinoma was diagnosed in 15 and papillary renal cell carcinoma in 2 patients. The median follow-up was 77.1 months (range 60-137), and the median growth rate was 0.15 cm/y. Of these patients, 2 (4.5%) required delayed intervention. One underwent laparoscopic radical nephrectomy because of a high tumor growth rate, and one elected to withdraw from active surveillance because of personal anxiety, despite having a stable tumor size for 72 months. The latter patient underwent laparoscopic renal cryoablation. Histopathologic examination revealed clear cell renal cell carcinoma in both cases. No metastases or cancer-related deaths occurred in our cohort; 1 patient died of cardiovascular disease. CONCLUSIONS: Most RCNs undergoing surveillance for >5 years grew slowly. The metastatic potential appeared minimal in patients who demonstrated low or absent tumor growth for a long period.

    Title Independent Diagnostic and Post-treatment Prognostic Models for Prostate Cancer Demonstrate Significant Correlation with Disease Progression End Points.
    Date
    Journal Journal of Endourology / Endourological Society
    Excerpt

    Abstract Background and Purpose: A major advance in the standard practice of tissue-based pathology is the new discipline of systems pathology (SP) that uses computational modeling to combine clinical, pathologic, and molecular measurements to predict biologic activity. Recently, a SP-based prostate cancer (PCa) predictive model for both preoperative (Px+) and postoperative (Px) prostatectomy has been developed. The purpose of this study is to calculate the percent agreement and the concordance between the Px+ and Px end points. Patients and Methods: Fifty-three patients underwent robot-assisted prostatectomy for PCa, and had Px+ and Px testing performed. Data were collected on Px+ end points and Px end points along with pathologic specimen results. The percent agreement and the degree of correlation between the Px+ and Px end points were then calculated. Results: The percent agreement (PA) between Px+ end points and Px end points ranged from 77% to 87%. The PA between a high Px+ favorable pathology (FP) classification and dominant Gleason score ≤3 and Gleason sum ≤6 was 71.7% and 37.4%, respectively. On univariate analysis, Px+ disease progression (DP) score significantly correlated with Px prostate-specific antigen recurrence (PSAR) score (P<0.001), while Px+ DP probability significantly correlated with PxPSAR probability (P<0.001). Px+ FP probability significantly correlated with postprostatectomy dominant Gleason grade ≤3 (P<0.001) and Gleason sum (P<0.001). Conclusion: The PA between Px+ and Px testing end points for radical prostatectomy patients was very good. Furthermore, there was a direct correlation between most Px+ and Px end points. While the Px+FP classification and Gleason sum demonstrated a poor PA, Px+FP score still maintained a direct correlation to prostatectomy Gleason sum.

    Title Post-percutaneous Nephrolithotomy Systemic Inflammatory Response: a Prospective Analysis of Preoperative Urine, Renal Pelvic Urine and Stone Cultures.
    Date
    Journal The Journal of Urology
    Excerpt

    Prior studies suggest that renal pelvic urine culture is a more accurate predictor of urosepsis. We prospectively determined the correlation between preoperative bladder urine cultures, intraoperative renal pelvis cultures and stone cultures in patients undergoing percutaneous nephrolithotomy. We also examined post-procedure risk factors for systemic inflammatory response syndrome.

    Title Nonischemic Laparoscopic Partial Nephrectomy Using a Novel Wet Monopolar Device in a Porcine Model.
    Date
    Journal Journal of Endourology / Endourological Society
    Excerpt

    Abstract Background and Purpose: Laparoscopic partial nephrectomy (LPN) is the minimally invasive standard of care for the management of a cT(1a) renal mass. We evaluated a novel saline enhanced electrosurgical resection (SEER) device for performance of a nonischemic LPN. Materials and Methods: Six pigs were used in a nonsurvival pilot study. Energy penetration was characterized by applying the SEER to the lower pole of each kidney for 30 seconds, 1 minute, and 3 minutes using pure cutting energy at 100W and a drip rate of 1 drip per second. Energy testing was performed with the hilum clamped in six kidneys and without clamping in six kidneys. Subsequently, a nonischemic upper pole LPN was performed with the SEER device, and the kidneys were harvested. The areas of necrosis were sectioned and stained with hematoxylin and eosin. Depth of necrosis was visualized grossly and microscopically for each time point. We also recorded time to perform LPN, estimated blood loss (EBL), and subjective severity of bleeding. Results: The average operative time was 15.4 minutes. The mean EBL was 44.2 mL with nine (75%) cases classified as minimal, 2 (17%) moderate, and 1 (8%) severe bleeding. The mean depth of necrosis on the kidney remnants was 2.97 mm. The mean depth of necrosis for unclamped kidneys at 30 seconds, 1 minute, and 3 minutes was 0.38 mm, 0.88 mm, and 1.27 mm, respectively. The mean depths for the clamped kidneys were 2.73mm, 3.23mm, and 8.68mm respectively. Depth of necrosis was significantly higher in the clamped kidneys at 3 minutes (P=0.0035). Conclusions: In the porcine model, the SEER transected parenchyma and collecting system with low resection times and minimal blood loss. Use of coagulation during resection is the main advantage of a monopolar resection compared with cold scissors. Testing performed for 3 minutes during hilar clamping demonstrated a significantly deeper level of necrosis.


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