Andrzej Szedel, Marcin Życzkowski, Andrzej Potyka, Magda Duda, Maciej Kupajski, Wiesław Duda, Piotr Bryniarski, Andrzej Paradysz, Mieczysław Fryczkowski
- Oddział Urologii, Szpital im. E. Michałowskiego w Katowicach
Katedra i Klinika Urologii w Zabrzu ¦l±skiego Uniwersytetu Medycznego
Oddział Urologii, Szpital Wojewódzki w Rybniku
Introduction. Laparoscopy is the treatment of choice in many diseases of genito-urinary tract system, but we don’t know in which cases it may be a standard.Objective of the research. The objective of the research is the clinical evaluation of the laparoscopy application in treatment of the non-malignant diseases of the urinary system as the standard urological procedure.
Material and method. 1976 patients aged from 18 to 78 (average age 48) have been the subject of the analysis. They were operated on in a laparoscopic way in the years 1995 – 2007. The interventions were applied to the non-malignant diseases of the urinary system. 1219 interventions of the laparoscopic treatment of the varicocele were performed. 472 renal cysts were removed. The simple nephrectomies were applied to 98 patients. 34 excessive moving kidneys were suspended. The stricture of the subpelvis section of the ureter was removed by means of the plastic surgery in 39 patients. 42 ureter stones were removed. 25 laparoscopic interventions were performed in the treatment and diagnosis of the abdominal testicles. 31 female patients underwent the m. Burch operation. 7 gonads in the Goldberg-Maxwell syndrome were removed and 5 laparoscopic interventions were applied to the kidney and bladder injuries. There were evaluated: the access path to the operated organ, the number of conversions, reoperations, the intervention time, the hospitalization time and complications.
- Results. The retroperitoneal access was preferred in the case of the renal cysts operations, simple nephrectomies and the kidney suspension. The transperitoneal access was applied only in the plastic surgery of the subpelvis – ureter obstruction and it was preferred in the case of the urolithiasis. The transperitoneal access by choice was applied to the treatment of spermatocele and abdominal testicles. The intervention time in the majority of cases was compared to the open surgeries. The time of a patient’s stay in hospital was much shorter than in the case of the open surgeries. There were only a few reoperations and conversions. Late complications were not different from the open surgeries.
Conclusions. 1 For 12 years, in the Urology Departments in Silesia, laparoscopic, urinary interventions have been fully applied in the treatment of many non-malignant diseases of the urinary system organs and male sexual organs. 2. The laparoscopic interventions are safe for the patient and they shorten the patient’s stay in hospital. 3. The laparoscopic interventions are becoming a method of choice in specified disease units and they are replacing the open urological interventions.