Abstract:

Laparoscopy has been a valuable tool in gynecologic practice for many years but it is only recently that this technology has been applied to urological surgery. Initially laparoscopy was used in urology only for diagnostic purposes; however, following the success of laparoscopic cholecystectomy, the technique was utilized to perform therapeutic procedures such as varicocelectomy and pelvic lymphadenectomy. Open surgery has been the standard for nephrectomy for over 100 years and the techniques, results, and complications have been well documented in surgical texts. Laparoscopic nephrectomy is also a relatively new application, having only been first described in 1991. This article will review the current status of laparoscopic nephrectomy and speculate on its future role. The pros and cons of the laparoscopic technique when compared to open nephrectomy will also be discussed.

Authors:

Denis C. O'Sullivan, F.R.C.S.I., M.Ch., Peter Schulam, M.D., Ph.D., Louis R. Kavoussi, M.D., F.A.C.S., Brady Urological Institute, Bayview Medical Center, Johns Hopkins Medical Institutions, Baltimore, MD

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Abstract:

Undescended testis or cryptorchidism remains a common condition. It affects 1% of individuals and is treated by pediatric surgeons, urologists, and general surgeons depending on the age of the patient, specialist services, and expertise available. Laparoscopy has been used for the localization of impalpable testis for more than 15 years. However, minimal access surgery has now made its impact in this field of surgery in terms of surgical intervention. It is used not only for the localization of undescended testis but also to perform laparoscopic orchidectomy and both stages of the Foweler-Stevens orchiopexy. Minimal access surgery is also used for the ligation of the testicular vein for varicocele. The clinical anatomy of the undescended testis and varicocele is interrelated and therefore is dealt with in the same chapter, although there is no association between the two clinical conditions.

Authors:

Raghu S. Savalgi, M.B.B.S., L.R.C.P., M.R.C.S., F.R.C.S., Ph.D.(Surg.), Yale University School of Medicine, New Haven, CT

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