Spotlight: Dr. Nouf Akeel

To establish a pelvic floor center at her hospital in Saudi Arabia, she travelled more than 8,000 miles to learn from the experts at Stanford

Dr. Nouf Akeel, an Associate Professor and Colorectal Surgeon at King Abdulaziz University Hospital in Jeddah, Saudi Arabia, was recently a visiting scholar for three months working with Stanford Surgery Clinical Professor Dr. Brooke Gurland and Stanford Surgery’s Pelvic Floor Center. 

Tell us how you heard about this program and how did you initiate communication with Dr. Gurland? 

I met Dr. Gurland for the first time while completing my fellowship at the Cleveland Clinic. Dr. Brooke Gurland is a leading figure in the field of pelvic floor surgery, and she arrived at Stanford several years ago to establish a center. The center she created is one of the best in the United States.

Such centers are not available in Saudi Arabia or the Middle East. Therefore, more awareness and specialization in this field are needed for adequate diagnosis and treatment. The management of patients with pelvic floor disorders cannot be effectively achieved by one individual alone; it requires a multidisciplinary team. My ultimate goal is to establish a similar center upon my return to Saudi Arabia.

With this in mind, I reached out to Dr. Gurland and explained that many patients need this type of care. Still, I cannot provide the level of assistance they require due to limited resources and a lack of necessary infrastructure. I asked if I could visit her center to learn how to serve my patients better. I expressed my intention to enhance my skills in managing pelvic floor disorders within a multidisciplinary team. I requested the opportunity to observe clinics and surgeries and participate in research and educational activities.

Dr. Gurland graciously agreed to assist me and made this arrangement possible. She and her team warmly welcomed me. I also discussed this opportunity with my department, and they expressed remarkable enthusiasm to support me throughout this trip.

How would you describe the experience?

Three months before coming, Dr. Gurland and I met on Zoom. We created a plan, and she introduced me to the team members I would work with. All details of my anticipated visit were discussed in advance, so I started working immediately after my arrival, and I had no problem integrating with the team.

This experience opened my eyes to many things, and I'm very excited to incorporate these details and transform our center.

What was your day like here at Stanford?

I had the flexibility to arrange my schedule. I attended the clinic and saw patients with Dr. Gurland and Dr. Laila Neshatian—a clinical associate professor in Gastroenterology and Hepatology. We are now working on multiple research projects together. Dr. Gurland provided me with training in robotic surgery, a valuable tool for performing pelvic surgeries. Additionally, I attended clinics with pelvic physical therapists to learn about their techniques, resources, and the educational materials they provided to patients. Furthermore, they have guided me in training our physical therapists and recommended courses for them to specialize and obtain certification in pelvic floor physiotherapy. 

King Abdulaziz University Hospital has successfully integrated multi-disciplinary approaches into several programs, such as cancer care and inflammatory bowel disease. Regarding pelvic floor health, we are proud of our strong patient-care service in various specialties, including colorectal surgery, urogynecology, gastroenterology, and radiology. However, we recognize that there is need for improvement in certain areas, such as the inclusion of pelvic floor physical therapy and the creation of a comprehensive setup that offers all necessary services. We understand the importance of this holistic approach, as it would significantly enhance the patient experience.

Tell us about the collaboration you are developing between surgeons from different health systems?

We encounter diverse experiences due to the differences in the characteristics of the patients we treat. Their lifestyle, background, and genetic makeup vary. One notable example is Crohn's disease, which tends to be more aggressive, often presenting with complications. Through our dedicated efforts, we have gained expertise in handling complex cases. Our distinct experiences offer a valuable mutual learning and benefit opportunity. When I return, I intend to emphasize the potential of this collaboration and its potential to encompass various other specialties.