About Sickkids
About SickKids

Walid Farhat, MD

The Hospital for Sick Children
Paediatric Urologist
Urology

Research Institute
Team Investigator
Developmental & Stem Cell Biology

University of Toronto
Professor
Surgery & Urology


Phone: 416-813-6580
Fax: 416-813-6461
e-mail: walid.farhat@sickkids.ca

For more information, visit:

Farhat Lab

Brief Biography

Walid Farhat graduated from the American University of Beirut. Dr. Farhat joined the Division of Urology at The Hospital for Sick Children as a staff surgeon in 2001, and was appointed as an Assistant Professor with The University of Toronto.  Prior to this he completed both a 3 year General Surgery, a 3 year Urology residency with the University of Toronto, and subsequently a 3 year clinical/research fellowship in Urology at SickKids.  

In 2014 Dr. Farhat was promoted to the rank of Professor with the Department of Surgery, University of Toronto.

Surgical

Dr. Farhat has gradually developed his own unique niche within the urology field in minimal invasive surgery (MIS). MIS is a new innovative surgical technique by which the surgeon makes small incisions into the patient's surgical site and uses what are called endoscopes to carry a fiber optic camera, light source and miniaturized surgical instruments.  The surgeon then operates by watching a TV monitor.  Despite controversy in regards to morbidity, prolonged operative time and safety revolving around laparoscopy, paediatric urologic laparoscopy procedures or MIS are gradually becoming embraced within paediatric medicine.  By exploring the minimal invasive surgery technique in children, they experience less exposure to immune reactives; the physiological changes are minimal and require a shorter hospital stay.  Dr. Farhat focuses on MIS as a surgical tool, but also introduces, disseminates, and trains others on performing laparoscopy cases in the division.

Dr. Farhat started his practice performing ablative laparoscopic surgery and is very eager to implement these tools to urologic reconstructive procedures.  Thus, he has developed and mastered an innovative procedure for a hybrid laparoscopic/open procedure (retroperitoneal laparoscopic assisted pyeloplasty, RALP) to correct obstruction at the upper end of the ureter adjacent to the kidney, otherwise known as, ureteropelvic junction.  This procedure is innovative because it provided the novice laparoscopist a bridge to cross over from the traditional open technique to the MIS approach while maintaining the benefits of least morbidity and shorter hospital stay.  Dr. Farhat may be the only one to perform advanced pediatric bladder reconstructive surgery across Canada.

Furthermore, Dr. Farhat facilitated a case show of the Da Vinci Robot across various Toronto hospitals in an effort to raise awareness and funding to acquire a surgical robot in Toronto.  This further allowed the purchase of 2 robots, one for Toronto General Hospital and another for St. Michael's Hospital.

Academic Background

The Division of Urology at The Hospital for Sick Children has a long track in educational achievement.  The teaching aspect of Dr. Farhat's job allows him to be involved with the fellows in addition to working closely with the residents and medical students rotating from the University of Toronto.  He is continuously involved with hands on education in the operating room, the clinic and the research lab, and through formal and informal education sessions.  Dr. Farhat was awarded the A.W. Bruce Faculty Undergraduate teaching award for 2007/08.  He is also the Associate Editor for Advancements in Urology and an Editor for the Journal of Urology.

Dr. Farhat has successfully initiated and organized the Paediatric Urology Laparoscopy Course (PULC) for three consecutive years.  The course is for North American paediatric urology first year fellows, teaching them the basic skills of laparoscopy through both didactic lectures and a hands on pig lab.  Condensed versions of this course have also been conducted by Dr. Farhat at SickKids, nationally and internationally.

Dr. Farhat was appointed Associate Surgeon in Chief - Education effective September 1, 2009.  In this role, Dr. Farhat works with the University of Toronto and the Fellowship Coordinator to ensure the Fellowship Programs offered in Perioperative Services at SickKids are world renowned.

Research Interests

As a Team Investigator at the Research Institute at SickKids, Dr. Farhat's basic science research focus is urinary bladder tissue engineering.  His research goals are to study the fundamental structure of the urinary bladder, and its critical physical characteristics to create a suitable bladder substitution that carries the same biocompatibility and versatility as the normal bladder substitution that carries the same diseases such as cancer or abnormal bladder development may affect the proper function of the urinary bladder and these, in turn, cause renal dysfunction, urinary incontinence and ultimately necessitate urinary bladder augmentation or replacement.  

Currently the large intestine is used as a substitute tissue for the urinary bladder; however, has several reported problems such as infection, stone formation, metabolic abnormalities (secondary to absorption or urine), perforation and carcinogenesis, which in turn have ignited interest in bladder tissue engineering for bladder regeneration.  Dr. Farhat has thus focused his research towards developing a bladder outside the patient which, when ready, can be placed back in the patient.  However, this organ must be exposed to the same environment outside, as it will need to function under inside the patient, in order to contract, expand and hold urine the way a normal bladder functions.  In order to accomplish this goal, Dr. Farhat invented and patented the urinary bladder bioreactor.  The bioreactor exposes the tissue to the same stretching and environmental stresses that the bladder is exposed to within the body, resulting in the tissue adopting similar characteristics to those of normal bladder cells.

Currently, there are a few ongoing projects that Dr. Farhat's lab is working on:

Learning Intersts

VOLUNTEER WORK

No Boundaries Missions

  • Kingston, Jamaica - March 2005
  • Cusco, Peru - April 2006

Dr. Farhat operated on a total of 36 patients (Hypospadias, Hernias, Undescended Testicles, Laparoscopic Pyeloplasties, Cystoscopies, Laparoscopic Pyelolithotomies and Laparoscopic Orchidopexies)

External Funding

Acellular bladder matrix allograft for bladder replacement in a porcine model:  collagen structure, mechanical and neurophsiological properties. Merguerian PA, Farhat W,: Phyisicans Services Incorporated (PSI) (2000)

Use of tolterodine in treatment of neuropathic overactive bladder in children.  Farhat W, Khoury AE: Pharmacia-Upjohn Canada (2000 - 2001)

Feasibility of contrast-enhanced sonography to detect pyleonephritis in a pig model.  McLorie G, Farhat W:  HSC Seed Grant program (2002 - 2004)

Porcine Partial Bladder Substitution Using Autologous Cell Seeded and Fibrin Glue Bladder Acellular Matrix Construct. Farhat W: Canadian Urological Association Scholarship Foundation (2003 - 2004)

The Search for an Optimal Bladder Substitute. Farhat W: The Hospital for Sick Children Foundation and the Institute of Human Development, Child and Youth Health (2004 - 2006)

Biologically Enchanced Fascia Lata Graft for Soft Tissue Repair. Farhat W, Derwin K: In collaboration with Cleveland Clinic Foundation (Biomedical Research and Technology Transfer Program-part of Ohio's Third Frontier Initiative (2005 - 2008)

Small Bowel Acellular Matrix as a Small Intestinal Substitute in a Porcine Model. Wales P, Farhat W, Kim J:  The Canadian Association of General Surgeons (2004 - 2005)

Quantitative MRI of Angiogenesis and Cellularization in Tissue Engineering.  Hai-Ling C, Farhat WA, Stanisz GJ: University of Toronto Dean's Fund (2007 - 2012)

Quantitative MRI of Angiogenesis and Cellularization in Tissue Engineering. Hai-Ling C, Farhat WA, Stainsz GJ: SickKids Foundation New Investigator Awards (2008 - 2010)

Physiologoic Urinary Bladder Simulator (PUBS): Novel Urinary Bladder Bioreactor. Farhat WA: BioDiscovery Toronto (BDT) (2008 - 2009)

Disruptive Technologies in Pediatric and Fetal Intervention.  Kim P, Farhat WA, Wright J: Canadian Foundation of Innovation (CFI) (2009 - 2010)

Achievements

INVITED LECTURES

Nationally

  • American Urological Association, Anaheim, California - May 19 -23, 2007:  "Pediatric Laparoscopic Reconstructive Urology"
  • Vanderbilt University, Research Conference, Nashville, Tennessee - April 30 - May 2, 2007: "The ABC's of Urinary Bladder Tissue Engineering"
  • Society of Pediatric Urology, 54th Annual Meeting, Atlanta, Georgia - May 20, 2006: "Tissue Engineering in Urology - Where are we now?"
  • Specialty Lecture, Oklahoma City, Oklahoma - January 16 - 18, 2006: "Laparoscopy in Pediatric Urology: SickKids - Toronto Experience"
  • Wayne State University, Detroit, Michigan - January 28 - 30, 2005: "Why Tissue Engineered Bladders are not yet available for Clinical Use".

Internationally

  • 6th International Congress of Jordanian Association of Urological Surgeons, Amman, Jordan - October 27 - 30, 2009: "Minimal Invasive Urological Surgery in Children: Current Status (20 mins) Urinary Tract Infection".
  • 2nd Kuwait International Congress in Pediatric Surgery, Kuwait City, Kuwait - November 24 - 27, 2008: "Outcome Analysis of Minimal Invasive Approach to UPJ Obstruction in Children".
  • 5th Tissue Engineering Symposium, Tampere, Finland - April 23 - 25, 2008: "Clinician's Approach to Tissue Engineering and Regenerative Medicine".
  • Lebanese Urology Congress, Beirut, Lebanon - September 22 - 27, 2004: "Laparoscopy in Pediatric Urology".

Publications

Brown AL, Farhat WA, Merguerian PA, Wilson GJ, Khoury AE, Woodhouse KA: 22 week assessment of bladder acellular matrix as a bladder augmentation material in a porcine model. Journal of Biomaterials 2002: 23(10): pp 2179-90.

Halachmi S, El-Ghoneimi A, Farhat WA: Successful subcapsular laparoscopic nephrectomy in a child with xanthogranulomatous pyelonephritis. The Journal of Pediatric Endosurgery & Innovative Techniques 2003: 6(4): pp 269-272.

El-Ghoneimi A, Farhat WA, Bolduc S, Bagli D, McLorie G, Khoury AE: Retroperitoneal Laparoscopic vs. open partial nephroureterectomy in children. British Journal of Urology 2003: 91(6)532-5: pp 532-535.

El-Ghoneimi A, Farhat WA, Bolduc S, Bagli D, McLorie G, Algrain Y, Khoury AE: Laparoscopic dismembered pyeloplasty by a retroperitoneal approach in children. British Journal of Urology 2003: 92(1): pp 104-108.

Farhat WA, Khoury AE, Bagli D, McLorie G, EL-Ghoneimi A: Mentored retroperitoneal laparoscopic renal surgery in children: a safe approach to learning. British Journal of Urology 2003: 92(6): pp 617-620.

Halachmi S, El Ghoneimi A, Bissonnette B, Zaarour C, Bagli DJ, McLorie GA, Khoury AE, Farhat WA: Hemodynamic and Respiratory Effect of Pediatric urologic Laporoscopic Surgery: A Retrospective Study. Journal of Urology 2003: 170: pp 1651-1654.

Farhat WA, Afshar K, Papanikolaou F, Austin R, Khoury AE, Bagli DJ: Retroperitoneal assisted laparoscopic pyeloplasty (RALP) in children: Initial experience. Journal of Endourology 2004: 18 (9): pp 879-882.

Farhat WA: Retroperitoneal laparoscopic urological surgery in children. Arab Journal of Urology 2005: 3(1): pp 8-12.

Cheng Hai-Ling M, Chen J, Babyn P, Farhat WA: Dynamic GD-DTPA Enhanced MRI as a Surrogate Marker of Angiogenesis in Tissue-Engineered Bladder Constructs: A Feasibility Study in Rabbits. Journal of Magnetic Resonance Imaging 2005: 21 (4): pp 415-23.

Cook A, Khoury AE, Bagli D, McLorie GA, El-Ghoneimi A, Farhat WA: The development of lapaoscopic surgical skills in pediatric urologists: longterm outcome of a mentorship-training model. Canadian Journal of Urology 2005: 12(5): pp 2824-2828.

Cartwright L, Shou Z, Yeger H, Farhat WA: Porcine Bladder Acellular Matrix Porosity: Impact of Hyaluronic Acid and Lyophilization. Journal of Biomedical Research 2006: 77(1): pp 180-4.

Farhat WA, Chen J, Sherman C, Cartwright L, Bahoric A, Yeger H: Impact of Fibrin Glue and Urinary Bladder Cells Spraying on the In-Vivo Accellular Matrix Cellularization: Pilot Study. Canadian Journal of Urology 2006: 13(2): pp 3000-8.

Lorenzo A, Karsli C, Halachmi S, Kolci M, Luginbuehl I, Bissonnette B, Farhat WA: Hemodynamic and respiratory effects of pediatric urological retroperitoneal laparoscopic surgery: A prospective study. Journal of Urology 2006: 175(4): pp 1461-5.

Cartwright L, Farhat WA, Sherman C, Chen J, Shou Z, Yeger H, Babyn P, Cheng HL: Dynamic Contrast-Enhanced MRI to Quantify VEGF Enhanced Tissue Engineered Bladder Graft Neovascularization: Pilot Study. Journal of Biomedical Materials Research 2006: 77(2): pp 390-5.

Wallis MC, Khoury AE, Lorenzo AJ, Pippi-Salle JL, Bagli D, Farhat WA: Outcome analysis of retroperitoneal laparoscopic heminephrectomy in children. Journal of Urology 2006: 175(6): pp 2277-80.

Dave, S., Farhat, , WA: Physiological aspects of pediatric urological laparoscopic surgery. Indian Journal of Urology 2006: 22 (4): pp 304-309.

Cheng, M., Shou, Z., Wallis, C.M., Farhat, W: Quatifying Angiogenesis in VEGF-Enhanced Tissue-Engineered Bladder Constructs by Dynamic Contrast-Enhanced MRI using Contrast Agents of Different Molecular Weights. Journal of Magnetic Resonance Imaging 2007: 25(1): pp 137-45.

Lorenzo, A.J., Cerveira, J., Farhat, W: Pediatric Laparoscopic Ileal Cystoplasty: Complete Intracorporeal Surgical Technique. Journal of Urology 2007: 69 (5): pp 977-81.

Braga, L., Pippi Salle, JL., Lorenzo, AJ., Bagli, DJ., Khoury, AE., Farhat, WA: Pediatric laparoscopic pyeloplasty in a referral centre: Lessons learned. Journal of Endourology 2007: 21 (7): pp 738-742.

Lorenzo, AJ., Wallis, MC., Raikhlin, A., Chait, PG., Farhat, WA: Minimally invasive approach for the management of urinary and fecal incontinence in selected spina bifida patients. Urology 2007: 70 (3): pp 568-71.

Farhat WA, Kropp BP: Surgical Treatment of Pediatric Urinary Stonres:  Lesson 3 AUA Update 2007: 26.

Wallis, MC., Yeger, H., Cartwright, L., Shou, Z., Radisic, M., Haig, J., Suoub, M., Farhat, W: Feasibility study of a novel urinary bladder bioreactor. Tissue Engineering Part A 2008: 14(3): PP 339-348.

Derwin KA, Baker AR, Spragg RK, Leigh DR, Farhat WA, Iannotti JP: Regional variability, processing methods, and biophysical properties of human fascia lata extracellular matrix. Journal of Biomedical Materials Research 2008: 84(2):pp 500-507.

Farhat WA, Chen J, Haig J, Antoon R, Litma J, Sherman J, Derwin K, Yeger H: Porcine bBladder Acellular Matrix (ACM): Protein Expression, Mechinaical Properties biomedical Materials. 2008: 3(2): pp 250-255

Dave S, Khoury AE, Braga LH, Farhat WA: A Single Institutional Study on the Role of Ureteroscopy and retrograde Intrarenal Surgery in Treatment of Pediatric Renal Calculi. Urology 2008.

Tavares A, Maniboriboon N, Lorenzo A, Farhat WA: Insertion of an Internal-External Nephroureteral Stent During Perdiatric Laparoscopic Pyeloplasty: Description of Technique. Urology 2008: 71(6): pp 1199-1202.

Farhat WA, Yeger H: Does Mechanical Stimulation have any role in urinary Bladder Tissue Engineering?  World Journal of Urology 2008: 26(4): pp 301-305.

Moriya K, Farhat WA: Complete Intracorporeal laparoscopic Enterocystoplasty.  Dialogues in Pediatric Urology 2008: 30(1): pp 11-12.

Braga LH, Moriya K, El-Hout Y, Farhat WA: Ureteral Duplication With Lower Pole Ureteropelvic Junction Obstruction: Laparoscopic Pyeloureterostomy as Alternative to Open Approach in Children.  Urology 2008: 73(2): pp 374-376.

Book Chapters

Moore K, Farhat WA:  Laparoscopic Ureteric Reimplantation and cystotomy repair. In:Laparoscopy Surgery for Gynecologic Oncology 2008.

Casale P, Farhat WA: Advantages of Robotic-Assisted Laparoscopy.  In: Pediatric Robotic Urology (Palmer JS, Springer/Humana Press, eds).  Humana Press, part of Springer Science & Business Media, New York, NY 2009: pp 59-68

Casale P, Farhat WA: Pediatric Laparoscopy Pyeloplasty. In:  Glenn's Urology (Leonard Comella, ed).

Geutjes P, Farhat WA: Artificial Biomaterials for Urologic Tissue Engineering.  In:  Biomaterials and Tissue Engineering in Urology (John Denstedt, Anthony Atala, Eds). 

Intellectual Property

Intellectual PropertyModified Acellularization Processes and Techniques
Canadian Patents Database

Novel Bladder Tissue Bioreactor for Treatment of Bladder Dysfunction & Disease
Corporate Ventures