Laparoscopy is a surgical technique involving the placement of instruments and telescopes into the abdominal cavity. Although many surgical procedures are routinely performed through the laparoscope (gall bladder removal and gynecologic procedures, for example), we have only recently begun to appreciate the full potential of this technique for surgery of the urinary tract.
One of the most widely accepted applications of laparoscopy in urology has been the so-called laparoscopic pelvic lymph node dissection. The presence or absence of lymph node involvement in patients with prostate cancer can be a critical piece of information for treatment planning. Traditionally, patients undergoing surgical staging of their pelvic lymph nodes required open surgical biopsy of their lymph nodes. With the advent of laparoscopy, the nodes can be sampled with minimally invasive techniques resulting in a much more rapid recovery.
A more recent development is the laparoscopic bladder neck suspension. Many women with urinary incontinence will opt to undergo surgical correction of their incontinence by having a bladder neck suspension or urethropexy. As we have gained experience with laparoscopic bladder neck suspensions, we are finding patients experience a much shorter recovery period with no apparent compromise of long-term success rates.
One of the most exciting developments in laparoscopic surgery is the advent of laparoscopic kidney surgery. A number of benign conditions such as congenital obstruction, kidney cysts and stones, and small malignant tumors lend themselves to a laparoscopic approach. Again, the primary advantage is a quicker return to full activity levels compared to open surgical approaches.