Laparoscopic applications in adult urology

Background: Laparoscopic techniques were first described at the turn of the 20th century, but were not used regularly until recently, with the development of laparoscopic cholecystectomy. The authors present current applications of laparoscopy for the management of urologic disease in the adult patient. Methods: Review of the literature to identify laparoscopic procedures that have made an impact in adult urology was performed. Each procedure was assessed for general technique, outcomes compared with open surgery, and controversies surrounding their current use. Discussion: Early in their development, many laparoscopic applications were practiced with general dissatisfaction because of the lack of consistent cases needed to maintain laparoscopic skills. The ongoing efforts of several laparoscopic centers have improved techniques, and laparoscopic procedures are used regularly for various diagnostic, ablative, and reconstructive procedures. Long-term follow-up evaluation data show that many laparoscopic procedures result in improved postoperative recovery times and outcomes equivalent to open surgical procedures. Conclusion: Laparoscopy is well established in the urologic field. Laparoscopic techniques are used for adrenalectomy, pyeloplasty, varicocele repair, bladder suspension, nephrectomy and lymph node evaluation for genitourinary disease. However, the ongoing effort to improve techniques and patient outcomes is necessary.