The majority of traditional laparoscopic urology procedures include large incisions with a long hospital stay and recovery duration. This process can seem both tiring and scary for the patient.
Using a small telescope with an integrated magnifying mechanism and a range of long, thin surgical instruments put through roughly 3-5 incisions (each typically no larger than one penny), the surgeon can do minimally invasive surgery. This procedure can be used for many different urological diseases and problems.
Patients undergoing these procedures not only enjoy the same diagnostic and therapeutic benefits of traditional open surgery, but also greatly reduced postoperative pain, shorter hospital stays, faster recovery and better cosmetic results. When patients refer to a urologist, they can learn whether laparoscopic surgery is suitable for them. (1)
Definition and Overview
Treatment for cancers of the prostate, kidney, bladder, testes, and adrenal glands is provided by laparoscopic surgical procedures. Laparoscopic surgery is a minimally invasive procedure that calls for particularly trained surgeons and the most delicate types of equipment.
Laparoscopy decreases pain, blood loss, wounds, and time for recovery. In order to give the surgeon visibility and working area during the procedure, a tiny needle is placed into the belly and carbon dioxide gas is administered to expand the abdominal cavity.
One of the trocars is used to install a special fiber optic telescope with a video camera, known as a laparoscope, which enables the surgeon to see the operation on a television monitor. It has been developed into a standardized technique, but its true impact will be determined over time. While future indications may change, laparoscopy has established itself as a valuable tool in urology and is expected to continue being used in the field. (2,3)
Many common urological surgeries can be performed laparoscopically. Some of them are as below.
- Laparoscopic Nephrectomy
Laparoscopic Nephrectomy is an operation to remove a kidney through a series of small incisions located in the abdomen. Keyhole surgery is another name for this procedure.
A nephrectomy is typically performed to remove a kidney tumor that is cancerous or cancerous in suspected. When the kidney no longer functions properly, it must occasionally be removed. (4)
- Laparoscopic Pyeloplasty
A narrowing or scarring where the ureter (the tube that transfers urine from the kidney to the bladder) connects the kidney can be surgically corrected with a minimally invasive procedure called laparoscopic pyeloplasty. This procedure is intended to fix a narrowing or blockage of the ureter where it exits the kidney. (5)
- Laparoscopic Adrenalectomy
A laparoscopic adrenalectomy is a minimally invasive procedure that uses tools and small incisions to access the adrenal gland. Three to four tiny (0.5–1 centimeter) incisions are created in the abdomen to execute the procedure. Through these tiny incisions, the surgeon inserts a telescope and small tools into the belly, enabling the full removal of the damaged adrenal gland. The adrenal gland is placed in a plastic sack and taken away intact via one of the incisions. (6)
- Laparoscopic Cystectomy
It is a form of minimally invasive surgery used to remove symptomatic kidney cysts while preserving the remainder of the kidney. It is intended for individuals who have flank pain, abdominal pain, or a kidney that is clogged as a result of kidney cysts. (7)
- Laparoscopic simple or radical nephrectomy
A simple nephrectomy simply involves the removal of one kidney, whereas a radical nephrectomy also involves the removal of the kidney's surrounding lymph nodes and adrenal gland.
For people with kidney cancer, serious kidney damage, symptomatic hydronephrosis, chronic infection, polycystic kidney disease, shrunken kidneys, hypertension, or kidney stones, laparoscopic nephrectomy is advised.
- Laparoscopic Ureterolithotomy
For patients with large, impacted ureteral stones as well as those who have a history of unsuccessful primary treatment, laparoscopic ureterolithotomy is a safe, effective procedure that ensures rapid recovery. (8)
Laparoscopic surgery eligibility is assessed on an individual basis, taking into account a number of factors including the patient's
- medical history,
- general health,
- specific conditions.
Laparoscopic urology procedures can be applied to patients with the following conditions.
- having benign (non-cancerous) urological problems,
- having malignant (oncological or cancerous) urological problems,
- having conditions affecting various urological organs (including the kidney, adrenal gland, ureter, bladder, prostate, and lymph nodes). (9)
Risks and Side Effects
Laparoscopic urological procedures are generally safe but, like any surgical intervention, they carry certain risks and side effects. However, the risks are generally lower than with open surgical procedures. Some of the risks associated with laparoscopic urological procedures include:
- Vascular injuries
- Diaphragm, bowel, and pancreas injuries
- Urine leak
- Bleeding during trocar access
Post-Procedure and Follow-up
Laparoscopic surgery generally provides fewer hospital stays, fewer wound infections, less pain, and faster recovery time. Laparoscopic surgery results in the easier dissection of abdominal scar tissue (adhesions), less surgical trauma, and better results in certain groups such as the elderly and overweight individuals.
The patient is moved to a post-operative recovery room where vital signs will continue to be monitored until awakening. At this point, a new type of pain reliever may be needed. After laparoscopic surgery, gas pain caused by the remaining carbon dioxide in the body may be experienced.
Depending on the individual surgery and how the body responds, they may go home the same day or stay overnight. The healthcare team instructs the patient on how to take care of himself when the patient goes home. This may include wound care, drain care if applicable, and feeding guidelines.
It takes two to three weeks to fully recover. An ordinary sore throat is to be expected throughout this period. This ought to be treatable with short-term painkillers, and it ought to get better within the first several days.
1,9- Stanford Medicine. Laparoscopic Surgery. (https://urology.stanford.edu/patient_care/laparoscopic.html)
2- National Library of Medicine. Laparoscopic surgery in urology (https://pubmed.ncbi.nlm.nih.gov/10918974/)
3- Augusta University. Laparoscopic Urologic Surgery. (https://www.augusta.edu/mcg/surgery/urology/laparoscopic.php)
5- (https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/laparoscopic-pyeloplasty )
8- National Library of Medicine. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4801647/)
10- National Library of Medicine. Complications of 411 laparoscopic urological procedures: A single surgeon experience.(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6060592/)