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Dr. Julio Gundian was 13 months old when Fulgencio Batista, Cuban dictator at the time, fled Cuba, stealing millions of dollars. Gundian’s grandfather was Batista’s physician, and like others close to Batista, the Gundians also fled Cuba.

“We had no choice but to leave,” said Gundian, who was born in Havana in 1959. The experience, which brought him and his family to Ft. Lauderdale, is part of what makes him such a patriotic American, he said. “America has shown me many opportunities,” Gundian said.

One of those many opportunities was the chance to follow in his grandfather’s footsteps.

“My grandfather died of prostate cancer—and he was a urologist,’’ said Gundian, who has worked at Winter Park Urology Associates for the past 17 years. “He was a urologist before urology was a subspecialty in Cuba, so essentially he was (considered) a general surgeon with a specialty in urology.”

Gundian received his undergraduate education at the University of Miami and obtained his medical education at Tulane University Medical School in New Orleans. He then elected to pursue a six-year residency in urologic surgery at the Mayo Clinic in Rochester, Minnesota. Upon completing his training, Gundian returned to Florida, the place he always considered home.

For Gundian, urology is a specialty that has the ideal blend of surgery, clinical, and long-term patient interaction. “We have a lot of chronic conditions we see patients for, so we follow them for quite some time. And we do have quite a bit of private practice and surgery.”

And technology is completely changing the way urologists do that surgery, he said.

“Almost all of our operations involved major incisions at one time when I was training,’’ Gundian said. “Patients used to be in the hospital for a week or more. Now, most involve some form of laparoscopy or endoscopy. They are much less invasive and usually are outpatient. Now, most of us have very few patients in the hospital when we make rounds.”

And that’s one of the biggest misperceptions urology patients have, he said. Most do not realize just how minimally invasive most urologic procedures are.
Still, as a urologist, Gundian performs major procedures as well, such as removing a bladder due to cancer.

On a typical day, Gundian sees 15 to 20 patients in the morning, performs one or two ureteroscopic stone extractions for removal of kidney stones, and a laser prostatectomy for benign prostatic obstruction (BPH), in which a laser is used to destroy the part of the prostate gland that is squeezing the urethra.

Gundian’s areas of interest are male infertility, including microscopic vasectomy reversal, and minimally invasive procedures using, for example, the da Vinci Surgical System for prostatectomy and other urologic procedures. He began performing the da Vinci procedure at Winter Park Urology three years ago with about 500 patients undergoing the procedure at the practice since.

Incorporating the latest advancements in robotics and computer technology, the da Vinci system allows the surgeon’s hand movements to be scaled, filtered and translated into precise movements of micro-instruments within the operative site. The magnified, three-dimensional view the surgeon experiences enables the physician to perform precise surgery in complex procedures through small surgical incisions.

Patient benefits include reduced pain and trauma to the body, less blood loss and need for transfusions, less post-operative pain and discomfort, less risk of infection, shorter hospital stay, faster recovery and return to work, and less scarring and improved comesis. As a result, minimally invasive surgery reduces trauma to the patient by allowing surgeries to be performed through small ports rather than large incisions, resulting in shorter recovery times, fewer complications and reduced hospitalization costs.

Advancements underway in urology promise quicker recovery for patients for even more procedures, Gundian said, including radio frequency ablation for kidney tumors, holmium prostatectomy for benign enlargement of the prostate, and laparoscopic kidney surgery.

Scopes used also are improving rapidly. “The smaller scopes see much more than the larger scopes – you can do so many things,” Gundian said. “It’s pretty remarkable.”

Had he not been a urologist, Gundian said he most likely would have chosen a career in the sciences, possibly as a teacher.

“I always had a knack for math and science but a pure lab researcher would not have done it for me,’’ said Gundian, who has had three teaching experiences—clinical assistant professor at Florida State University, a urology consultant for the Veteran Administration Hospital and associate clinical professor at the University of Florida, where he still teaches.

Gundian, who is married and has three children ages 10, 12 and 16, said he “really enjoys being able to put a human touch on treating chronic illnesses. I enjoy treating people with compassionate care—that’s sort of my motto.”

A patient who nominated Gundian for Physician Spotlight said he had cared for her father, who had bladder cancer, for the past 10 years, as well as her husband. “Dr. Gundian exemplifies all that a physician should be,’’ she wrote. “He combines great skill and vast knowledge with a wonderful bedside manner and a truly caring heart.”



May 2008

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