Laparoscopic surgery in urology: a proven improvement

Laparoscopy has represented an evolution in the field of urological surgery. This technique has meant an improvement in the quality of life of patients, by reducing the discomfort and complications of large incisions. It is also an advantage for urologists who can visualize more precisely the anatomical structures of the "target" organs, due to the amplification of the image offered by the lenses, cameras and monitors that are available today.

In the same way as in other surgical specialties, laparoscopy is widespread, being used in different areas of urological surgery. Laparoscopic surgery represents less aggression for the patient than conventional surgery. In addition, this technique reduces the morbidity associated with the incision, decreases bleeding and the rate of blood transfusion and shortens hospital stays and convalescence.

Laparoscopic surgery has been applied in different subspecialties of urology. In the field of reconstructive urology : repair of ureteral strictures, exeresis of large benign obstructive prostates. Bladder enlargements with bowel, corrections of bladder and rectum prolapses, etc.. In patients with renal lithiasis , laparoscopy can minimize complications of open-air approaches or it can be combined with endoscopic procedures through natural or minimally invasive orifices, for example, to allow kidney cavities to be free of stones. In patients with renal insufficiency and transplantation , laparoscopic surgery can be an alternative to solve the problems derived from a polycystic kidney disease, ureteral complications of transplantation and has been a procedure that has improved the kidney donation of live because it minimizes the trauma that represents a nephrectomy for transplant for the donor.

But it is in uroncologic surgery where laparoscopy is mostly used, due to its prevalence. The extraction of the prostate secondary to cancer (radical prostatectomy) is one of the most used laparoscopic surgeries in our environment, the editor having extensive experience to carry more than 700 procedures performed since 2002. The continence, potency and oncological results obtained are similar to those of open surgery in expert hands, but minimizing bleeding and incision.

The extraction of the urinary bladder due to urothelial cancer can benefit from this type of approach, being able to reduce the rate of digestive complications and the early recovery of intestinal transit after the reconstruction of the digestive system when constructing the urinary diversion.. In the field of nephrectomy (exeresis of the kidney) laparoscopy is currently the recommended procedure in all clinical guidelines. The improvement in techniques and surgical experience has been able to establish that part of the kidney can be removed by laparoscopic surgery, being a complex intervention but allowing the patient to retain a higher percentage of renal function after the exeresis of the malignant kidney tumor.