Traditionally, abdominal or pelvic surgery has been performed via an open incision, also referred to as a “laparotomy.” This approach uses large incisions that cut through skin, fatty tissue, muscle, fascia, and sometimes bone to access the target organ. Although this technique accomplishes the intended goal of removing (or repairing) the affected organ, it does so at a cost — post-operative recovery.
“Laparoscopy” is defined as a minimally invasive technique to look inside the abdomen or pelvis with specialized camera or scopes. The scopes and instruments are placed through the abdominal wall via several small (less than ½ inch) incisions. Laparoscopic surgery inflates the abdomen with gas to create a working space in order to remove or repair the affected organ.
The advantage of laparoscopy over traditional open technique is the ability to accomplish the same surgical goal with less pain, less blood loss, a shorter hospital stay and often better outcomes due to improved vision and precision. Typically, laparoscopic procedures require significantly less narcotic requirement and patients go home 1 or 2 days after surgery with small Band-Aids rather than large incisions.
In Urology, the most commonly treated organs with the laparoscopic approach are the kidneys and the prostate. The removal of the whole kidney (laparoscopic radical nephrectomy) or part of the kidney (laparoscopic partial nephrectomy) can both be accomplished by laparoscopy in cases of kidney tumors. Similarly, the prostate can be excised (radical prostatectomy) via a laparoscopic technique for prostate cancer. Other urological diseases can also be treated via the laparoscopic approach.
One of the most commonly treated conditions in Urogynecology, pelvic organ prolapse; specifically vaginal/apical or uterine prolapse, can be treated with a laparoscopic approach. This is done with a surgery known as a sacrocolpopexy in which a graft is placed in the abdomen and attached to the vagina and a ligament near the spine in order to re-support the vagina.
Although laparoscopy is a “minimally-invasive” modality, it is still surgery and there are potential risks and complications. Furthermore, laparoscopy has become a standard of care for many types of procedures but these are cases in which laparoscopy is not appropriate and traditional open procedure is favored. Your urologist will determine this based on many pre-operative factors such as the extent of your disease and any prior abdominal surgery.