- •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.
3.4 Hernia repair
The success of open hernioplasty (Lichtenstein) is indicated by the almost total lack of recurrences (72-76). Similar results are demonstrated by the laparoscopic procedure which is based on the same principle (77-86). However, the latter results are still influenced by the learning curve. In all Phase III trials, the laparoscopic approach was found to have no disadvantages; it was associated with less pain and a shorter convalescence time compared with open hernioplasty (87-93). Laparoscopy is superior to open hernioplasty for recurrent or bilateral hernia management. The good socio-economic aspects of laparoscopically managed hernia repair are another advantage (94).
The current guideline recommendations for hernia repair are given in Table 3.5. Table 3.5 Hernia repair: guideline recommendations
|
Total number of patients |
More than 13,000 |
|
Expert opinion |
Established |
|
Level of evidence |
1a |
|
Grade of recommendation |
A |
|
Current indications |
Primary inguinal hernia Recurrent inguinal hernia Bilateral inguinal hernia |
3.5 Nephrectomy
Among the early attempts to perform urological procedures by laparoscopy, transperitoneal nephrectomy has been a milestone (95). Following this pioneer success, retroperitoneal routes were developed to remove kidneys by laparoscopy (6, 96). Based on those early experiences, the research work continued rapidly to expand, allowing urologists trained in laparoscopy to extend safely the indications for kidney removal by laparoscopy, either by the trans- or retroperitoneal route.
3.5.1 Simple nephrectomy (for benign disease) (Table 3.6)
Laparoscopic nephrectomy is a safe alternative to open nephrectomy for the removal of non-functioning kidneys in benign diseases, and results in less morbidity and a shorter hospital stay (71, 97, 98). Moreover, laparoscopic nephrectomy produces a better cosmetic result; it is also cost-effective and offers advantages with respect to hospital stay and the time taken to resume normal activity. It is safe in children (99, 100). The complication rate depends upon the pathology affecting the kidney to be removed: post-inflammatory conditions have a higher complication and conversion rate (101, 102). Bilateral contemporary nephrectomy in preparation for a kidney transplant is suitable for a laparoscopic approach (103).
The trans- or retroperitoneal route is governed by operator preference. Although a definitive answer regarding the advantages and disadvantages of either route awaits the results of randomized trials, retroperitoneal laparoscopy appears to be associated with less operative time, less conversion rates, and a shorter hospital stay (104-106).
Table 3.6 Simple nephrectomy: guideline recommendations
|
Total number of patients |
Approximately 1200 |
|
Expert opinion |
Established |
|
Level of evidence |
2a |
|
Grade of recommendation |
A |
|
Current indications |
Non-functioning kidneys in benign disease |