Laparoscopy has finally joined urology as a subspecialty, after being ignored by urologists for decades. Many incisional procedures can now be effectively replaced by a skilled laparoscopic urologist. This area of urologic surgery is quickly evolving, with only the urologist’s imagination limiting its potential. Our urologic practice approaches will evolve considerably in the future years.
Laparoscopy will take the place of the need to cause harm to healing. Laparoscopy surgery combines the benefits of endoscopic surgery (which is less invasive) with the benefits of open surgery, which is used to remove and reconstruct various organs. As a result, the advantages of early postoperative recovery, shorter hospital stays, and quicker recovery are transferred. The single most important development in the area of urology since ESWL has been the emergence of laparoscopic urologic surgery.
Laparoscopic urologic procedures can be performed either transperitoneally or retroperitoneal. The anterior abdominal wall musculature is penetrated by anterior ports in the transperitoneal approach, and the line of Toldt is incised to access the kidneys. Laparoscopic access into the kidney retroperitoneally is by the superior or inferior lumbar triangle. Because these organs are fundamentally positioned in the retroperitoneum, urologic surgery is largely retroperitoneal and extraperitoneal. With the advent of laparoscopic surgery, however, urologists once again found themselves needing to enter the peritoneal cavity to offer their patients the benefits of this less invasive surgery.