Laparoscopic urological surgeries
Laparoscopic surgery is a synonym for minimally invasive surgery in modern-day medicine. The word laparoscopy comes from the Ancient Greek words λαπάρα (lapára), meaning “flank, side”, and σκοπέω (skopéō), meaning “to see”. The technique focuses on displaying the inside of the body cavity via a laparoscope – a thin instrument with an endoscopic camera used to transmit the image from the inside of the body to the monitor.
Aside from anatomic cavities such as the stomach or the chest, using the method of balloon dilation can also form artificial cavities between certain layers of tissue, most often the preperitoneal and retroperitoneal. Laparoscopic procedures, be they diagnostic or otherwise, are performed through making small incisions (between 0.5 cm and 1.5 cm) which are normally located far from the affected organ.
Laparoscopic surgery guarantees all the benefits of minimally invasive surgery. It entails very minor incisions, less tampering with deeper tissue, significantly less pain (and, as such, less need for analgesics), and there are fewer chances of surgical site infections, meaning faster healing. Additionally, time spent hospitalized and in recovery are considerably decreased, so that the patients are able to return to their regular activities much sooner. Last, but not least, the cosmetic effect is improved.
Laparoscopic kidney surgery
In the area of urology, surgical procedures that probably benefit the most from minimally invasive laparoscopic surgery are those done on the kidney. An open surgical approach to kidney involves a wide dissection of multiple layers of muscle, which puts patients out of commission for several weeks, and might even prevent them from doing active sports for months to come. In contrast, laparoscopic approaches allow patients to move normally as soon as several days after the procedure, and in most cases, returning to sports activities is possible within two or three weeks. The laparoscopic method far surpasses the traditional technique, especially in cases where there is no need to remove parts of the organ or the whole organ – and it is esthetically more pleasing, too.
Laparoscopic procedures are performed under general anesthesia. In the example of the transperitoneal laparoscopic approach, a 1 cm incision is made on the skin, allowing a special needle to be inserted into the stomach cavity to begin the carbon dioxide insufflation up to a certain pressure level, in order to form enough space for the surgery to be performed. After the insufflation is complete, the same incision is used to insert a thin tube (a trocar), inside which there is an optic instrument with a light source and a camera (a laparoscope). Following the endoscopic imaging, the surgeon inserts additional two or three trocars for various other laparoscopic instruments. The kidney is reached by opening the internal serous membrane (the peritoneum). If done extraperitoneally instead, we would form the space between certain layers of tissue outside of the stomach cavity using balloon dilation before insufflating, after which we would insert trocars for the necessary laparoscopic instruments.
• Nephrectomy
• Pyeloplasty
• Renal cyst fenestration
• Pyelolithotomy
• Nephropexy
• Radical nephrectomy
• Partial nephrectomy
• Nephroureterectomy
Laparoscopic ureter surgery
Laparoscopic procedures of the ureter are relatively uncommon, regardless of the indication for surgery. All are performed under general anesthesia.
Among the surgeries that required an open surgical technique for access to the ureter, but which can be replaced by a laparoscopic approach today, we single out two.
Laparoscopic urinary bladder surgery
Laparoscopic surgeries of the bladder guarantee all the advantages of minimally invasive surgery, and are performed under general anesthesia. Such surgical procedures enable patients to return to their normal movement range and activity within only a few days post- surgery, which significantly stimulates rehabilitation, especially in cases of major surgeries such as laparoscopic radical cystectomy and supratrigonal cystectomy. In addition, the laparoscopic technique flaunts another advantage over the traditional open surgical approach – a more esthetically pleasing aftermath.
• Cystolithotomy
• Diverticulectomy
• Partial cystectomy
• Radical cystectomy
Laparoscopic prostate surgery
Laparoscopic surgeries of the prostate guarantee all the advantages of minimally invasive surgery, and are performed under general anesthesia. This surgical procedure enables patients to return to their normal movement range and activity within only a few days post- surgery, which significantly stimulates rehabilitation and minimizes risks and effects of stress incontinence, especially in cases of major surgeries such as laparoscopic radical prostatectomy.