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Ideas to ease difficulties in Laparoscopic Urology

Ideas to ease difficulties in Laparoscopic Urology. Dr. Anmar Nassir, FRCS(C) Fellowship in Andrology (U of Ottawa) Fellowship in EndoUrology and Laparoscopy (McMaster Univ) Chairman, Department of Surgery Umm Al-Qura Univ Consultant Urology, King Faisal Specialist Hospital, Jeddah.

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Ideas to ease difficulties in Laparoscopic Urology

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  1. Ideas to ease difficulties in Laparoscopic Urology Dr. Anmar Nassir, FRCS(C) Fellowship in Andrology (U of Ottawa) Fellowship in EndoUrology and Laparoscopy (McMaster Univ) Chairman, Department of Surgery Umm Al-Qura Univ Consultant Urology, King Faisal Specialist Hospital, Jeddah

  2. Introduction • During the last 25 years, probably urology was the surgical specialty that presented the most extraordinary technological development. • Evolution { open  minimally invasive}. • Development {techniques  technology}. Clayman. From knife to needle to nothing, Braz J Urol 2001

  3. Introduction • Laparoscopic procedures are continuously evolving in Urology. This includes • Ablative procedures: • radical nephrectomy • Reconstructive techniques: • pyeloplasty. • Both: • radical prostatectomy. • radical cystectomy.

  4. Why to accept laparoscopy as an alternative to open

  5. LAPAROSCOPIC NEPHRECTOMY COMMUNITY HOSPITAL. Michigan, USA HUYNH, HOLLANDER, J of Urol, February 2005

  6. LAPAROSCOPIC DONOR NEPHRECTOMY COMMUNITY HOSPITAL. Michigan, USA HUYNH, HOLLANDER, J of Urol, February 2005

  7. Raftopoulos et al, Surgical Endoscopy Oct 2004

  8. Raftopoulos et al, Surgical Endoscopy Oct 2004

  9. Raftopoulos et al, Surgical Endoscopy Oct 2004

  10. Recent advances … • In laparoscopic surgery • technological improvements. • In imaging technologies  Hemal, Menon. Laparoscopy, robot, telesurgery & urology: future perspective. J Postgrad Med 2002

  11. Recent advances in laparoscopic surgery • technological improvements. • Advances in imaging technologies • Urologist acceptance • Decrease morbidity • Patients interest. Hemal, Menon. Laparoscopy, robot, telesurgery & urology: future perspective. J Postgrad Med 2002

  12. RPLND

  13. But.. The major impediment to widespread application of laparoscopy in urology has been the complexity and technical demands of urological procedures Bishoff, Kavoussi: Urological Laparoscopy, Why bother? J Urol 1998

  14. Difficulties • In starting • While practicing • Patients’ factor • Instruments • Toward advancement

  15. How to overcome?

  16. Difficulties • In starting • While practicing • Patients’ factor • Instruments • Toward advancement

  17. Longer OR time • In preparing or starting • Visualization • Instruments

  18. Laparoscopic Fenger-plasty.

  19. Atlas of the Uro Clin Oct 2003 Vrabec, Al-Zahrani

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