Urologic laparoscopy initially was confined to a diagnostic role or the treatment of benign conditions. Many of these initial procedures, however, have been abandoned because they offered no significant benefit over open surgery. The treatment of urologic malignancies, however, recently has emerged as the most common indication for laparoscopic urologic surgery.
Laparoscopy reduces pain, blood loss, scars and recovery time. During the procedure, a thin needle is placed into the abdomen through which carbon dioxide gas is introduced to inflate the abdominal cavity, giving the surgeon visibility and space to work. Surgeons make two to five dime-sized incisions into which they inserting hollow tubes called trocars. A specialized fiberoptic telescope with a video camera, called a laparoscope, is inserted through one of the trocars, allowing the surgeon to see inside the abdomen via a television monitor. The trocars are also used as paths for slender surgical instruments, and aid in the removal of cancerous growths and organs. In hand-assisted laparoscopy, a slightly larger incision allows the surgeon to insert a hand inside the abdomen to perform more complex surgery.