Laparoscopic Surgery

Key-Hole Surgery
Minimally Invasive Surgery

Many traditional urologic surgical procedures require large incisions with lengthy hospitalization and recovery. Minimally invasive surgery, also often known as laparoscopic or keyhole surgery to patients, has recently been developed in the field of urologic surgery with the advancement of engineering and computer technologies. Using a small telescope with built-in magnification mechanism and a variety of long, thin surgical instruments placed through approximately 3-5 incisions (each of which is usually no larger than a dime in size), the surgeon is able to perform minimally invasive surgery for a variety of urologic diseases and problems. Patients who have undergone these procedures have enjoyed not only the same diagnostic and therapeutic benefits of traditional open surgery but also greatly reduced postoperative pain, shorter hospitalization, faster recovery, and better cosmetic results.

Minimally invasive surgery has been applied to a multitude of benign (non-cancerous) and malignant (oncologic or cancerous) urologic problems. Furthermore, it has been applied to conditions affecting a variety of urologic organs (including kidney, adrenal gland, ureter, bladder, prostate, lymph nodes).

One application of minimally invasive surgery/laparoscopy is kidney cancer removal. Using only 3 small puncture holes (each of which ranging from 5-12 millimetersÑno larger than a dime in size generally), the entire kidney may be removed (See Pictures 1 and 2, below). This is very different from conventional open surgical removal of the kidney, in which a much larger surgical cut (frequently in excess of 10-15 centimeters or 100 to 150 millimeters) is typically needed.

Recently, robotic technology (Da Vinci Surgical System by Intuitive Surgical) has been used in the field of laparoscopic urologic surgery. Radical prostatectomy for prostate cancer is an area with increasing widespread use of such robotic technology. When robotics are involved, such procedure is often called “robotic-assisted laparoscopic radical prostatectomy” or “Da Vinci radical prostatectomy.” Robotic surgery has been reported to provide better visualization and greater dexterity to the surgeon, and the clinical data to date appear to be promising and similar to those of the established conventional open surgery. The new generation robotic system is currently available at Stanford, and the robotic laparoscopic surgery is offered to the appropriate patients after thorough evaluation in the Urology Clinic.

Minimally invasive surgery may not be an appropriate option to every patient. At Stanford, individualized evaluation and consultation will provided to all patients interested in this surgical modality.

For information regarding minimally invasive/laparoscopic surgery at Stanford, please call (650) 725-5546.

Picture 1. One method of removing kidney cancer via laparoscopic technique (Transperitoneal laparoscopic radical nephrectomy), which requires only 3 small puncture holes (each ranging from 5 to 12 millimeters in size). Large cut (frequently in excess of 10 centimeters, or 100 milimeters) associated with conventional surgery can be avoided.

Picture 2. One method of removing kidney cancer via laparoscopic technique (Retroperitoneal laparoscopic radical nephrectomy), which requires only 3 small puncture holes (each ranging from 5-12 millimeters in size). Large cut (frequently in excess of 10 centimeters, or 100 milimeters) associated with conventional surgery can be avoided.