AUA 2003 Highlights - Endourology & Laparoscopy

Highlights from 2003-04-27
Presented by Dr. Douglas M. Dahl, MD - Assistant professor of urology at Harvard Medical School

Dr. Kim and colleagues (# 305) described a technique of laparoscopic assisted percutaneous nephrolithotomy, thus avoiding the morbidity of a transperitoneal nephrostomy tube.

Ono and colleagues(# 298) from Japan reported on a series of 244 patients treated for renal cell carcinoma with laparoscopic radical nephrectomy. They had a very low conversion rate and few serious complications. The ten year survival comparing their open series with their laparoscopic radical nephrectomy series showed equivalent long term survival at 10 years.

Laparoscopic partial nephrectomy was the subject of several abstracts and multiple techniques were described during the video session (# V421 and # V422). This is clearly a rapidly evolving field and there is no clear definitive technique that is clearly superior at this juncture.

Three different methods of management of upper urinary tract transitional cell carcinoma were described by the Nagoya group (# 299) evolving over the last 5 years. In the last 36 patients where they were able to do a complete laparoscopic nephroureterectomy without opening the bladder. The purely laparoscopic approach was the least morbid and actually the fastest operation of the three.

Tewari (# 304) and his colleagues from Detroit found that the time to return to erection and time to return to continence was better in patients undergoing a robotic-assisted laparoscopic prostatectomy as compared to those undergoing a standard open procedure.

Dr. Carswell (# 489) and his colleagues reported excellent results with extravesical laparoscopic re-implantation for vesicoureteral reflux.

Dr. Parsons (# 297) and his colleagues from John Hopkins reported a 13% per year rate of significant complications of abdominal laparoscopic procedures over 5 years at an institution where a high volume of procedures are done. This is a sobering reality.

Laparoscopic approaches to ilioinguinal node dissection for penile cancer (# 301) and simple prostatectomy were also reported (# V423).

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