What is laparoscopy?
Laparoscopy is the minimally invasive alternative to conventional open surgery. In it is introduced into the abdomen a small chamber through a small cut in the navel 0.5-1 cm in length. In this way, the image of the internal organs is transmitted to a television monitor located on the outside, which allows the surgeon to visualize the movements of different instruments inserted in the abdomen by another 2-3 small holes. Conventional laparoscopy became popular in urology in the mid-1990s.
What are the benefits of laparoscopy?
Patients operated by laparoscopy have the same benefits as those treated with open surgery, for example the removal of organs with cancer but with notable advantages in regard to less operative bleeding, much less postoperative pain (wounds are less than 1 centimeter ), fewer hospital days, better esthetic result, and more rapid recovery from normal patient activity.
What is 3D (three-dimensional) laparoscopy?
Conventional laparoscopy has an optics and a processor so the vision is two-dimensional (2D) so the surgeon loses the perception of depth and may occur wrong maneuvers or accidents. 3D laparoscopy is the latest advancement of laparoscopic surgery, although for several years it has been used in robotic surgery. With this new three-dimensional system the images are captured by two optics, passed to two different processors and sent to a mixer that combines them to be visualized through the glasses of the surgeon in the screens of the operating room. With the new HD system, images are captured with a resolution of 1,080 lines.
What are the advantages of 3D laparoscopy?
3D laparoscopy improves resolution and definition of anatomical structures, facilitates manipulation, decreases surgical time, and reduces surgeon fatigue. All this reduces the possibility of accidents during surgery, which translates into greater patient safety. The urologic procedures that can benefit from the incorporation of 3D laparoscopy are the removal of organs with cancer (kidney, prostate, bladder), removal of adrenal gland tumors, treatment of kidney cysts, repair of the ureteral stenosis, extraction of ureter lithiasis and surgery for urinary incontinence and vaginal prolapse in women, etc.. In a recently published study (May 2014) in the Journal of Endourology we compared the results of radical prostatectomies performed with 2D and 3D systems, observing that with the 3D system the operative time was significantly shorter (130 versus 190 minutes), and bleeding was lower , and a higher percentage of patients recovered urinary continence more quickly. The authors conclude that in economic terms 3D laparoscopy may represent a valid alternative to robotic surgery.
In the Unit of Laparoscopic Surgery of our Institutes created in the year 2004 have been made hundreds of urological surgeries with the system 2D. We have recently incorporated the new 3D surgical tower with the latest high-resolution camera system from Olympus. This technology is the definitive advance in laparoscopic urological surgery since it facilitates the performance of delicate maneuvers such as dissection of the renal artery and vein during radical nephrectomy, placement of sutures during the performance of a radical prostatectomy for prostate cancer or during the performance of a partial nephrectomy for kidney cancer. The 3D system allows the surgery to be safer to be able to perform all the movements with one more dimension and decreases the visual fatigue of the surgeons that usually appears after two hours of intervention.