الفهرس 
Anatomical ConsiderationsOnly 14 pages are availabe for public view
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Abstract
The field of urologic laparoscopy has continued to expand and will
be limited only by the imagination of interested urologists and the
continuous improvement of instruments.
Laparoscopic management of urologic malignancies had started by
simple procedures as nephrectomy and pelvic lymph node dissection.
Nowadays, laparoscopic and robotic surgeries represent a main line for
management of most of urologic malignancies.
It was shown at the end of our study that laparoscopy was
applicable for management of most of urological malignancies.
Even in a low budget hospital with limited resources like ours,
laparoscopy was used effectively with comparable efficacy and low
complication rate.
Different approaches and novel techniques were developed during
the course of our study in order to lower the cost of laparoscopic
procedures without affecting its efficacy.
Although it was considered to be one of the most challenging
laparoscopic procedures, laparoscopic partial nephrectomy was
performed successfully but with steeply rising learning curve. We found
that the technique is feasible. No significant bleeding was encountered
except for one case that was managed effectively. Diode laser was used
effectively in the clampless procedures with striking safety margin.
Laparoscopic nephrectomy and laparoscopic radical nephrectomy
are gaining acceptance for management of renal and pelvic tumors in our
institute. Our operative time now improved dramatically due to the
availability of cases. Results are nearly comparable to the open procdure.
Review of literature 2013
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Laparoscopic radical cystectomy is still our main challenge.
Although we have a large numbers of patients of bladder cancer at our
institute, we still have a very slow progress curve. The main drawback is
the very lengthy procedures if compared to open surgery.
Of course, we are still far away from intracorporeal reservoir
reconstruction. But a new technique was developed to decrease the
operative time by limiting the urethroileal anastomosis after
extracorporeal reservoir reconstruction.
Time is still a disabling problem for most of laparoscopic
procedures. The operative time was long especially if compared with
standard open procedures. Nevertheless, it decreases continuously by
more cases we operate and more experience we get.
Further studies needed to prove that laparoscopy could be
considered the gold standard for management of urological malignancies
within the next few years.