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Associate Professor Sree Appu

Associate Professor Sree Appu

Urologic Oncology & Robotics, MBBS (Hons) Melb, FRACS (Urology)

A/Prof Sree Appu has been the recent Clinical Head of Monash Medical Centre and Monash Cancer Centre. He has now completed his 7 years of leadership.

He is Director of Southern Urology Group and the first surgeon to pioneer robotic surgery for the group and amongst all Monash urologists.

Sree returned from North America after completing a formal Uro-Oncology fellowship and is amongst a select group of Australian urologists to train at a formally accredited centre of the International Society of UroOncology.

He operates at Cabrini Hospital Malvern and Brighton, The Valley Private, St John Of God Berwick and Epworth Freemasons East Melbourne.

He consults several times a week at his Bentleigh East rooms as well as Brighton, Mulgrave and Berwick.

A/Prof. Appu and his partners at Southern Urology provide 24 hour 7 days a week comprehensive on-call for their patients.

Background

A/Prof. Appu completed his high schooling at Geelong Grammar School and commenced Medicine at the University of Melbourne in 1991.

He graduated near the top of his year level and was awarded the Dean’s honours list for both medicine and surgery.

He subsequently undertook residency and general surgical training at the Royal Melbourne Hospital. In 2001 he was ranked first on the general surgical selection list. After his general surgical training, Sree commenced urology training on the Victorian Programme. Sree was awarded the Urological Society Travelling Fellowship in Oncology as the first Australian Uro-oncology Fellow at the University of Toronto

He is further trained and certified in major oncology and minimally invasive treatment of prostate cancer (brachytherapy, HiFU). He is one of a handful of highly trained robotic prostatectomy surgeons accredited at both Cabrini and Epworth Hospital networks.

Sree is also a prolific academic researcher and was appointed Clinical Adjunct Associate Professor in Urology by Monash University in 2012.

A/Prof Appu is fluent in Malay, Indonesian and Tamil. He has good working conversation ability in Hindi, Hokkien and Italian.

Special Interests

Urologic Oncology (Prostate, Kidney, Bladder and Testis Cancer) and Minimally Invasive Therapies. Robotic Da Vinci Prostatectomy

Information on Robotics for Patients

     

  • PRESENTATIONS

    1. Victorian Urology Section meeting 21st of October 2011 Lorne Victoria Australia. Photoselective Vaporisation of the Prostate (PVP) and Transurethral Resection of the Prostate (TURP) Have Similar Operative Times in Experienced Hands.

    2. World Endo Urology Meeting 2011 Kyoto Japan. Photoselective Vaporisation of the Prostate (PVP) and Transurethral Resection of the Prostate (TURP) Have Similar Operative Times in Experienced Hands.

    3. Asia Pacific Society of Uro-Oncology Conference 2011. Kuala Lumpur, Malaysia. Acute Penile Prosthesis Insertion in the Delayed Presentation of Ischaemic Priapism.

    4. Asia Pacific Society of Uro-Oncology Conference 2011. Kuala Lumpur, Malaysia. Congenital renal arteriovenous malformation is a rare cause of haematuria and ureteric obstruction. Accepted awaiting meeting

    5. Asia Pacific Society of Uro-Oncology Conference 2011. Kuala Lumpur, Malaysia. Renal carcinoma with inferior vena cava tumour thrombus: an Australian experience.

    6. Asia Pacific Society of Uro-Oncology Conference 2011. Kuala Lumpur, Malaysia. Does Radical Prostatectomy Increase the Risk of Inguinal Hernia?

    7. Victorian Urology Section meeting 21st of October 2011. Lorne Victoria Australia. Can Isolated adrenal trauma be managed conservatively?

    8. Royal Australasian College of Surgeons National Meeting Kuala Lumpur 2012. Flank Incision is a Safe and Effective Surgical Approach for Renal Carcinoma with Inferior Vena Cava Thrombus

    9. Royal Australasian College of Surgeons National Meeting Kuala Lumpur 2012 Hyperbaric Oxygen Therapy – An Effective Management Option for Radiation Induced Haemorrhagic Cystitis

    10. Royal Australasian College of Surgeons National Meeting Kuala Lumpur 2012 Comparison of operative times of photoselective vaporisation of the prostate (PVP) and transurethral resection of the prostate (TURP)

    11. Royal Australasian College of Surgeons National Meeting Kuala Lumpur 2012 Role of early penile prosthesis insertion in the management of delayed presentation of ischaemic priapism

    12. Royal Australasian College of Surgeons National Meeting Kuala Lumpur 2012 Renal Cell Carcinoma with malignant inferior vena cava extension

    13. Royal Australasian College of Surgeons National Meeting Kuala Lumpur 2012 Appropriate placement of ectopic ureteric stent

    14. Royal Australasian College of Surgeons National Meeting Kuala Lumpur 2012 Inguinal Hernia Risk Post-Radical Prostatectomy

    15. Royal Australasian College of Surgeons National Meeting Kuala Lumpur 2012 Pain prevents early activation of penile prostheses

    16. Royal Australasian College of Surgeons National Meeting Kuala Lumpur 2012. Adrenal trauma in the absence of significant intra-abdominal pathology

    17. Presentation at Urological Society of Australia Annual Scientific Meeting, Coolum 2001 Nephron Sparing Surgery: Techniques, Indications and Outcome. Finalist podium presentation for Cleveland Young Investigator Award, Royal Melbourne Hospital May 2001.

    18. Urological Society of Australia Annual Scientific Meeting, Coolum 2001. Comparison Of Olydiaxonal Sulphate and Polypropylene as Suspension Sutures for Pubovaginal Slings.

    19. Urological Society of Australia Annual Scientific Meeting Newcastle 2004. Is Pharmacological Castration Equivalent To Surgical Castration?

    20. Podium Presentation and Poster for SUO 2006, Bethesda Washington. Transurethral HiFU under MRI guidance: Demonstration in vivo. 2nd Place Young Investigator SUO Podium Award.

    21. Victorian Urology State Meeting 2003. Gastrointestinal Stromal Tumour of the Rectum presenting as Periprostatic Mass.

    22. Victorian Urology State Meeting 2003. CPA Monotherapy and Prevention of Clinical Flare in Metastatic Ca Prostate

    23. Victorian Urology Scientific Congress 2004. Role of Memokath in Spinal Patients.

    24. Victorian Urology Scientific Congress 2004. Technical Variations for Retropubic Prostatectomy Post Laparoscopic Mesh Hernia Repair.

    25. Podium Presentation Royal Melbourne Research Week 1997. Her2 and Herceptin: Role In Breast Cancer Management.

    26. Victorian Uro-Oncology Group (VUOG) Conference Melbourne 2008. Active Surveillance for Small Renal Masses:The North American Experience.

    27. Victorian Urology Scientific Congress 2010. Granulocytic Sarcoma of Urinary Bladder.

    28. Victorian Urology Scientific Congress 2010. Uncommon Urological Malignancies Involving the Inferior Vena Cava.

    29. Urological Society of Australia National Meeting Perth 2010. Are we providing enough urology teaching? A cross sectional survey.

    30. Victorian Urology Scientific Congress 2010. The Initial High Intensity Focused Ultrasound (HIFU) Prostate Cancer Experience.

    31. Victorian Urology Scientific Congress 2010. Self reported competence of urethral catherization in interns. Prostate Cancer Experience.

    32. Victorian Urology Scientific Congress 2010. Holmium Laser Enucleation of the Prostate: Comparison of Immediate Postoperative Outcomes in Patients With and Without Antithrombotic Therapy.

    33. Royal Australasian College of Surgeons National Meeting Kuala Lumpur 2012 Congenital renal arteriovenous malformation mimicking urolithiasis and urothelial cancer.

    34. Royal Australasian College of Surgeons National Meeting Kuala Lumpur 2012 Renal Cell Carcinoma with Inferior Vena Cava Tumour Thrombus: An Australian Tertiary Centre Experience

  • PUBLICATIONS

    1. Surgery illustrated-focus on details: Access sheath-aided percutaneous antegrade ureteroscopy; a novel approach to the ureter. Winter M, Lynch C, Appu S and Kourambas J. British Journal Of Urology International 2011 Aug: 108(4): 620-2.

    2. Age-related properties of the tumour vasculature in renal cell carcinoma. Meehan B, Appu S, St Croix B, Rak-Poznanska K, Klotz L, Rak J. BJU Int. 2011 Feb;107(3):416-24.

    3. Anal stenosis: use of an algorithm to provide a tension-free anoplasty. Duieb Z, Appu S, Hung K, Nguyen H. ANZ J Surg. 2010 May;80(5):337-40.

    4. Improved assessment of renal lesions in pregnancy with magnetic resonance imaging. Putra LG, Minor TX, Bolton DM, Appu S, Dowling CR, Neerhut GJ. Urology. 2009 Sep; 74(3):535-9. Epub 2009 Jul 14.

    5. Analysis of the spatial and temporal accuracy of heating in the prostate gland using transurethral ultrasound therapy and active MR temperature feedback. Chopra R, Tang K, Burtnyk M, Boyes A, Sugar L, Appu S, Klotz L, Bronskill M. Phys Med Biol. 2009 May 7;54(9):2615-33. Epub 2009 Apr 8.

    6. Strategies to preserve prostate health. Neill MG, Appu S, Zlotta AR. Drugs Today (Barc). 2009 Jan; 45(1):63-80.

    7. Recovery of erectile function after unilateral and bilateral cavernous nerve interposition grafting during radical pelvic surgery. Satkunasivam R, Appu S, Al-Azab R, Hersey K, Lockwood G, Lipa J, Fleshner NE. J Urol. 2009 Mar;181(3):1258-63. Epub 2009 Jan 18.

    8. Peripheral primitive neuroectodermal tumor arising from the seminal vesicle. Lawrentschuk N, Appu S, Chao I, Chan Y, Rogerson J, Davis ID. Urol Int. 2008;80(2):212-5; discussion 216. Epub 2008 Mar 19.

    9. Vascular targeted photodynamic therapy with palladiumbacteriopheophorbide photosensitizer for recurrent prostate cancer following definitive radiation therapy: assessment of safety and treatment response. Trachtenberg J, Bogaards A, Weersink RA, Haider MA, Evans A, McCluskey SA, Scherz A, Gertner MR, Yue C, Appu S, Aprikian A, Savard J, Wilson BC, Elhilali M. J Urol. 2007 Nov;178(5):1974-9; discussion 1979. Epub 2007 Sep 17

    10. Assessing individual risk for prostate cancer. Nam RK, Toi A, Klotz LH, Trachtenberg J, Jewett MA, Appu S, Loblaw DA, Sugar L, Narod SA, Kattan MW. J Clin Oncol. 2007 Aug 20;25(24):3582-8.

    11. Metachronous metastasis to the penis from carcinoma of the rectum. Appu S, Lawrentschuk N, Russell JM, Bright NF. Int J Urol. 2006 May; 13(5):659-61.

    12. Peritoneal “pillowcase” for the displaced spleen post-distal pancreatectomy. Appu S, Young AB, Lawrentschuk N. J Hepatobiliary Pancreat Surg. 2005; 12(6):470-3.

    13. Effectiveness of cyproterone acetate in achieving castration and preventing luteinizing hormone releasing hormone analogue induced testosterone surge in patients with prostate cancer. Appu S, Lawrentschuk N, Grills RJ, Neerhut G. J Urol. 2005 Jul;174(1):140-2.

    14. Gastrointestinal haemorrhage complicating small bowel neurofibromatosis. Appu S, Valentine R, McLaughlin S. ANZ J Surg. 2005 Jan-Feb; 75(1-2):83-4.

    15. Gangrenous ischaemic colitis following non-steroidal anti-inflammatory drug overdose. Appu S, Thompson G. ANZ J Surg. 2001 Nov; 71(11):694-5.

    16. Intracystic papillary carcinoma of the breast. Appu S, Valentine R, Swann J. ANZ J Surg. 2001 Jul;71(7):440-1.

    17. Primary lymphoma of the prostate. Appu S, Pham T, Costello AJ. ANZ J Surg. 2001 May;71(5):329-30.

    18. Extragonadal choriocarcinoma involving the kidney. Appu S, O’Connell HE, Cleeve LK, Fox RM. ANZ J Surg. 2001 May;71(5):325-7

    19. Self reported competence of urethral catherization in interns. Winter M, Manohar P, Appu S and McCahy P. ANZ J Surg. September 2011. 81(9) 583- 584.

    20. Primary Myeloid Sarcoma of the Bladder. Pan D, Tay K, Appu S and Frydenberg M. Internet Journal of Urology July 2011.62(27) 34-35.

    21. A Novel Extraction Technique to Remove a Penile Constriction Device. Katz D, Chin W, Appu S, Vukasin F, Tay YK, Pang C and Dowling C. Accepted for publication Journal of Sexual Medicine.September 2011.

    22. Case Report: Penile Strangulation and Pramipexole in Parkinson Disease. Vukasin F, Singh D, Appu S, Harper M, Tay YK, Pang C, Dowling C, Katz D. Accepted for publication International Journal of Sexual Health. October 2011.

    23. Holmium Laser Enucleation of the Prostate: Comparison of Immediate Postoperative Outcomes in Patients With and Without Antithrombotic Therapy. H Liddell, CV Bishop, J Ischia, PE ldho, SAppu,M Frydenberg and T Pham.Submitted BJUI accepted pending revision November 2011.

    24. Obturator Externus Abscess Post Optical Urethrotomy: Case Report. Ischia J, Sapre N, Winter M, Appu S and Dangerfield D. Accepted for publication BJU October 2011.

    25. The Use of Hyperbaric Oxygen Therapy in Radiation-Induced Haemorrhagic Cystitis. Spernat D, Eapen R and Appu S. The Internet Journal of Urology. 2011 Volume 8 Number 2.

    26. IVC thrombus complicating RCC is no longer a highly morbid procedure. Spernat D, Winter M, Frydenberg M and Appu S. Accepted Asia Pacific Urooncology Meeting 2012.Abstract Malaysian Journal of Medicine October 2011. Paper accepted for publication Asian Journal of Medicine October 2011.

    27. Photoselective Vaporisation of the Prostate (PVP) and Transurethral Resection of the Prostate (TURP) Have Similar Operative Times in Experienced Hands. Spernat D, Appu S, Pham T, Love C,Frydenberg M and McCahy P. Accepted World Endourology Congress Kyoto 2011. Abstract Journal of EndoUrol October 2011. Selected as part of the meeting highlights and summarised in the “Take Home Message’ section of World Endo Urology 2011. Paper accepted for publication Advances in Urology September 2011.

    28. Salvage of prolonged ischemic priapism with early penile implant. Spernat D, Appu S and Love C. Accepted Asia Pacific Uro-oncology Meeting 2012.Abstract Malaysian Journal of Medicine October 2011. Accepted Urotoday International Journal March 2012.

    29. Can Isolated Adrenal Trauma Be Managed Conservatively? Spernat D, Eapen R and Appu S. Accepted Korean Journal of Urology October 2011.

    30. Incidence of Inguinal Hernia post Open Radical Prostatectomy and Laparoscopic Radical Prostatectomy. Spernat D, Tay YK and Appu S. Abstract in Malaysia Journal of Medicine October 2011. Paper accepted for publication Urology Journal November 2011.

    31. SET Urology trainees have less self assessed surgical competence than the previous BST/AST group. Spernat D, Eapen R and Appu S. Submitted Internet Journal of Urology October 2011.

    32. EAU Guidelines On Renal cell Carcinoma The 2010 Update. Abstract European Urology 2010 58. 398-406.

    33. Self reported competence of urethral catherization in interns. Winter M, Manohar P, Appu S and McCahy P. Published ANZ J Surg. September 2011. 81(9) 583-584. Abstract in Victorian Section Australian Urology Society Conference 2010.

    34. Role of Memokath in Spinal Patients. Dr.Appu S,Dr. Gani J, Dr.Lawrentschuk N and Rogerson JR. Presented at Victorian Urology Scientific Congress 2004 Abstract BJU Feb 2005.

    35. Technical Variations for Retropubic Prostatectomy Post Laparoscopic Mesh Hernia Repair. Appu S, Dandie LA, Kourambas J and Frydenberg M. Presented at Victorian Urology Scientific Congress 2004. Abstract BJU Feb 2005.

    36. When is ectopic stent placement acceptable? Tay YK, Spernat D and Appu S. Accepted for publication Urology Journal November 2011.

    37. Does Radical Prostatectomy Increase the Risk of Inguinal Hernia? Spernat, D., Tay, Y.K., Frydenberg M, Appu, S. Accepted for publication Malaysian Journal of Medicine November 2011.

    38. A Novel Technique for Improving Vision During Flexible Ureterorenoscopy. Spernat, D., Tay, Y.K., Donnellan, S., Appu, S. Accepted for publication Internet Journal of Urology November 2011.

    39. Acute Management of Priapism in Men – Review of Literature. Tay, Y.K., Spernat, D., Appu, S., Love, C Submitted to British Journal of Urology International December 2011- accepted pending revision

    40. Comparative Study of Flank Versus Midline Incision for Renal Vein and Caval Thrombus. Lim I, Spernat D and Appu S. Accepted Internet Journal Urology December 2011.

    41. Flank Incision is a Safe and Effective Surgical Approach for Renal Carcinoma with Inferior Vena Cava Thrombus. Dr Hau Choong AW, Mr Daniel Spernat, Dr Matthew Winter, Dr Yeng Kwang Tay, Mr Sree Appu. Accepted Internet Journal of Urology December 2011

    42. Adrenal trauma in the absence of synchronous intra-abdominal pathology. Dr.Lee JL, Dr.Rugara F, Dr.Spernat D and Appu S.ANZ Journal of Surgery Supplement March 2012.

    43. Pain prevents early activation of penile prostheses. Roth, H., Spernat, D., Tay, Y.K., Aw, H.C, Appu, S., Love, C. Submitted Internet Journal of Urology December 2011

    44. Book Chapter: Risbridger GP, Hayward SW, Clark PR, Frydenberg M, Appu S (2009) Endocrinology on BPH and Prostate Cancer. In Endocrinology. 6th Edition De Groot LJ, Jameson JL, eds. pp.

    45. Recurrent Nephrolithiasis Secondary to Primary Hyperparathyroidism-A Diagnostic Dilemma. Chan OB, Aw H, Li Wai Suen CFD, Spernat D and Appu S. Accepted Internet Journal of Urology March 2012.

  • SURGICAL INNOVATIONS/TECHNIQUES

    1. First Monash Surgeon to commence telerobotic prostatectomy surgery.
    2. Neobladder Surgical Technique with complete preservation of potency, continence and bladder emptying without stoma or catheter passage.
    3. High Intensity Focussed Ultrasound (HiFU) treatment for primary prostate cancer and salvage treatment for recurrence post radiation therapy with preservation of continence and potency.
    4. Novel obturator node “sweep’ technique for prostate cancer node dissection.
    5. Sural nerve grafting to improve potency post radical prostatectomy published in Journal of Urology.
    6. Major Oncology Surgery involving retroperitoneal node dissection and groin dissection with minimal morbidity.
    7. Removal of advanced kidney cancer with invasion into inferior vena cava as solo surgeon with minimal morbidity. Accepted for podium presentation at the Asian Uro-Oncology Conference 2011.
    8. Clinical Investigator in Southern Health Trials for Benign Prostate Treatment including Green Light Laser, Holmium Laser Medical Management Trials.
    9. Complex penile cancer surgery including partial including partial penectomy and groin dissection.

 

Professional Associations and Memberships

 

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