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On a bleak Sunday morning, as I was on duty working as a doctor in newborn medicine at the Royal London hospital in the UK, I got the ....

Laparoscopic Urology

Laser ProstatectomyLaparoscopic urology has made a big impact on the practice of urology. Urology was traditionally at the forefront of all endoscopic advancements in surgery. The first laparoscopy was done using urological endoscopes! Laparoscopic urology made its presence felt around the early 1990s but it isn’t until the late 90s and early part of this century that laparoscopic urology got adopted more widely. One of the main hurdles has been that laparoscopic urology, unlike general surgery and surgical gastroenterology, has no ‘easy’ procedures (such as lap cholecystectomy or appendicectomy, with due apologies to the general surgeons!). All the lap urology procedures fall under the category of advanced laparoscopy. Hence, the learning curve has been steep and a vast majority of urologists in India still do not perform lap urology.

Since 2005 we have now performed a large number of laparoscopic urology procedures ranging from ablative removal of diseased kidneys to complex reconstructions such as pyeloplasty. Laparoscopic procedures often take longer to perform than their open counterparts and may occasionally require conversion.
Laparoscopic right reimplantation in patient who had left open implant done elsewhere earlier
Laparoscopic view while performing anastomosis (re-joining) of the renal pelvis to the ureter in a 58y woman with pelviureteric junction obstruction

Laparoscopic adrenalectomy

Adrenal tumors may present because of the hormones that they produce, or more commonly, they get identified incidentally on imaging done for some other reason (the so-called incidentallomas). There is no secure method of distinguishing a benign (non-cancerous) tumor from a cancer and the most widely accepted indication for surgery is an incidental mass that is more than 5cm in size. Functioning tumors (tumors that produce abnormal amounts of hormones) may require removal even if they are smaller. Adrenal tumors can be removed by conventional open surgery. More recently, adrenal tumors are being operated laparoscopically with much less morbidity and with rapid recovery and discharge from hospital.

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Laparoscopic Adrenalectomy
Right Adrenal Tumor
Laparoscopic adrenalectomy

Laparoscopic pyelolithotomy

Photo showing minimally invasive removal of giant stone
Plain X-ray KUB showing huge stone in kidney
Stone after laparoscopic removal

Laparoscopic pyeloplasty

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Laparoscopic Pyeloplasty
Laparoscopic view while performing anastomosis (re-joining) of the renal pelvis to the ureter in a 58y woman with pelviureteric junction obstruction

Laparoscopic retrocaval ureter surgery

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Laparoscopic Retrocaval Ureter
Retrocaval ureter CT image
Retrocaval ureter IVP image

Laparoscopic ureteric reimplantation

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Laparoscopic Ureteric Reimplantation
Laparoscopic right reimplantation in patient who had left open implant done elsewhere earlier

Lap nephrectomy

coming soon

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