- •1. Introduction
- •1.2 Levels of evidence and grade of guideline recommendations
- •1.3 References
- •2.3.1 Access to, and development of, working room
- •2.3.2 Dissection
- •2.3.3 Haemostasis
- •2.3.4 Suture technique
- •2.4 Access techniques (1, 3, 5, 6)
- •2.4.1 Retroperitoneoscopy
- •2.4.2 Transperitoneal laparoscopy of the upper tract
- •2.4.3 Transperitoneal access to the pelvis
- •2.4.4 Extraperitoneal access to the pelvis
- •2.5 Management of complications (7-14)
- •2.5.2 Placement of the trocars
- •2.5.3 Insufflation of carbon dioxide
- •2.5.4 Vascular injuries
- •2.5.5 Injuries to organs
- •2.6 Specific training
- •2.7.1 Criteria
- •2.7.2 Scoring system
- •2.8 References
- •15. Guilloneau b.
- •27. Rassweiler j, Coptcoat m, Frede t.
- •36. Janetschek g, Hobisch a, Peschel r, Hittmair a, Bartsch g.
- •3.2 Colposuspension
- •3.3 Cryptorchidism treatment
- •3.4 Hernia repair
- •3.5 Nephrectomy
- •3.5.1 Simple nephrectomy (for benign disease) (Table 3.6)
- •3.5.2 Radical nephrectomy (Table 3.7)
- •3.5.3 Partial nephrectomy (Table 3.8)
- •3.5.4 Nephro-ureterectomy (Table 3.9)
- •3.5.5 Live-donor nephrectomy (Table 3.10)
- •3.6 Nephropexy (Table 3.11)
- •3.7 Pyeloplasty (Table 3.12)
- •3.8 Pelvic lymph node dissection (Table 3.13)
- •3.9 Radical prostatectomy (Table 3.14)
- •3.10 Retroperitoneal lymph node dissection (for testicular cancer) (Table 3.15)
- •3.11 Renal cyst treatment (Table 3.16)
- •3.12 Ureterolithotomy (Table 3.17)
- •3.13 Varicocelectomy (Table 3.18)
- •3.14 References
- •1. Gagner m, Lacroix a, Bolte e.
- •2. Rassweiler jj, Henkel to, Potempa dm, Coptcoat m, Alken p.
- •3. Go h, Takeda m, Takahashi h, Imai t, Tsutsui t, Mizusawa t, Nishiyama t, Morishita h, Nakajima y, Sato s.
- •12. Suzuki k, Ushiyama t, lhara h, Kageyama s, Mugiya s, Fujita k.
- •17. Takeda m, Go h, Watanabe r, Kurumada s, Obara k, Takahashi e, Komeyama t, Imai t, Takahashi k.
- •18. Rayan ss, Hodin ra.
- •23. Su th, Wang kg, Hsu cy, Wei hj, Hong bk.
- •83. Liem msl, Van Vroonhoven tj.
- •101. Gill is, Kavoussi lr, Clayman rv, Ehrlich r, Evans r, Fuchs g, Gersham a, Hulbert jc, McDougall em, Rosenthal t, et al.
- •104. Fornara p, Doehn c, Fricke l.
- •114. Gill is.
- •118. Janetschek g, Daffner p, Peschel r, Bartsch g.
- •128. Jones dr, Moisey cu.
- •136. Yang sc, Park ds, Lee dh, Lee jm, Park k.
- •140. Suzuki k, Ishikawa a, Ushiyama t, Nobutaka o, Suzuki a.
- •167. O'Dea mj, Furlow wl.
- •168. Temizkan m, Wijmenga lf, Ypma af, Hazenberg hj.
- •169. MossSw.
- •170. Soulie m, Thoulouzan m, Seguin p, Mouly p, Vazzoler n, Pontonnier f, Plante p.
- •174. Ben Slama mr, Salomon l, Hoznek a, Cicco a, Saint f, Alame w, Antiphon p, Chopin dk, Abbou cc.
- •202. Boeckmann w, Effert p, Wolff jm, Jakse g.
- •224. Bollens r, Vanden Bossche m, Roumeguere t, Damoun a, Ekane s, Hoffmann p, Zlotta ar, Schulman cc.
- •241. LeBlanc e, Caty a, Dargent d, Querleu d, Mazeman e.
- •245. Janetschek g, Hobisch a, Hittmair a, Holtl l, Peschel r, Bartsch g.
27. Rassweiler j, Coptcoat m, Frede t.
Laparoscopic radical nephrectomy and nephroureterectomy for treatment of renal cell and transitional cell carcinoma: Current status. Urol Integr Invest 1999; 4: 225-237.
28. Hobart MG, Gill IS, Schweizer D, Sung GT, Bravo EL.
Laparoscopic adrenalectomy for large-volume (> or = 5 cm) adrenal masses. J Endourol 2000; 14: 149-154.
29. Puppo P, Perachino M, Ricciotti G, Bozzo W, Pezzica С
Retroperitoneoscopic treatment of ureteropelvic junction obstruction. Eur Urol 1997; 31: 204-208.
30. Chen RN, Moore RG, Kavoussi LR.
Laparoscopic pyeloplasty. Indications, technique, and long-term outcome. Urol Clin North Am 1998; 25: 323-330.
31. Janetschek G, Daffner P, Peschel R, Bartsch G.
Laparoscopic nephron sparing surgery for small renal cell carcinoma. J Urol 1998; 159: 1152-1155.
Janetschek G, Jeschke K, Peschel R, Strohmeyer D, Henning K, Bartsch G. Laparoscopic surgery for stage T1 renal cell carcinoma: radical nephrectomy and wedge resection. Eur Urol 2000; 38: 131-138.
Cadeddu JA, Ono Y, dayman RV, Barrett PH, Janetschek G, Fentie DD, McDougall EM, Moore RG, Kinukawa T, Elbahnasy AM, Nelson JB, Kavoussi LR.
Laparoscopic nephrectomy for renal cell cancer: evaluation of efficacy and safety: a multicenter experience. Urology 1998; 52: 773-777.
Dunn MD, Portis AJ, Shalhav AL, Elbahnasy AM, Heidom C, McDougall EM, dayman RV. Laparoscopic versus open radical nephrectomy: a 9-year experience. J Urol 2000; 164: 1153-1159.
Rassweiler JJ, Seemann O, Henkel TO, Stock C, Frede T, Alken P.
Laparoscopic retroperitoneal lymph node dissection for nonseminomatous germ cell tumors: indications and limitations. J Urol 1996; 156: 1108-1113.
36. Janetschek g, Hobisch a, Peschel r, Hittmair a, Bartsch g.
Laparoscopic retroperitoneal lymph node dissection for clinical stage I nonseminomatous testicular carcinoma: long-term outcome. J Urol 2000; 163: 1793-1796.
37. Rassweiler JJ, Frede T, Lenz E, Seemann O, Alken P.
Long-term experience with laparoscopic retroperitoneal lymph node dissection in the management of low-stage testis cancer. Eur Urol 2000; 37: 251-260.
38. Leventhal JR, Deeik RK, Joehl RJ, Rege RV, Herman CH, Fryer JP, Kaufman D, Abecassis M, Stuart FP.
Laparoscopic live donor nephrectomy - is it safe? Transplantation 2000; 70: 602-606.
39. Jacobs SC, Cho E, Dunkin BJ, Flowers JL, Schweiter E, Cangro C, Fink J, Farney A, Philosophe B, Jarrel B, Bartlett ST.
Laparoscopic live donor nephrectomy: the University of Maryland 3-year experience. J Urol 2000; 164: 1494-1499.
40. Guillonneau B, Vallancien G.
Laparoscopic radical prostatectomy: the Montsouris technique. J Urol 2000; 163: 1643-1649.
41. Guillonneau B, Vallancien G.
Laparoscopic radical prostatectomy: the Montsouris experience. J Urol 2000; 163: 418-422.
42. Abbou CC, Salomon L, Hoznek A, Antiphon P, Cicco A, Saint F, Alame W, Bellot J, Chopin DK. Laparoscopic radical prostatectomy: preliminary results. Urology 2000; 55: 630-634.
3. LAPAROSCOPIC PROCEDURES
3.1 Adrenalectomy
From the very beginning of laparoscopy, laparoscopic adrenalectomy provided a truly beneficial approach to avoiding a large incision and extensive organ manipulation to remove small glands (1-8). Both the transperitoneal and retroperitoneoscopic approaches have proven efficacious. In fact, after only a few years of clinical experience (9-14), laparoscopy is considered to be a definitively minor invasive approach compared to open surgery, with the same efficacy and safety for removing the adrenal glands (15-19). Following the comparative experience of multicentre studies (20-21), it has been shown that laparoscopic adrenalectomy is feasible and safe with a low cost-to-benefit ratio, regardless of the pathology. Only large tumours (> 6 cm) are still under investigation (14).
Because of the different anatomy of the left adrenal gland compared to the right adrenal gland, the retroperitoneal approach has been assessed as the approach of choice for the left adrenal gland. The approach for removal of the right gland is optional and depends on the surgeon's preference and familiarity with the technique being used (17). Partial adrenalectomy is feasible, provided the pathology of the lesion has been previously assessed.
A summary of the current guideline recommendations for adrenalectomy is given in Table 3.1. Table 3.1 Adrenalectomy: guideline recommendations
|
Total number of patients |
More than 1000 |
|
Expert opinion |
Superior |
|
Level of evidence |
1b |
|
Grade of recommendation |
A |
|
Current indications |
Adrenal tumours < 6 cm diameter |