Avtor/Urednik		Kmetec, Andrej
Naslov		Laparoskopski posegi v urologiji
Prevedeni naslov		Laparoscopic operations in urology
Tip		članek
Vir		Endoskopska revija
Vol. in št.		Letnik 7, št. 16-17
Leto izdaje		2002
Obseg		str. 53-6
Jezik		slo
Abstrakt		Background. In the future, laparoscopic surgery will play an important role in urology. The purpose of this paper was to review some laparoscopic operations, to assess their technical difficulties, and to identify the scope and limitations of todays laparoscopic surgery. Methods. To present the state-of-the-art and perspectives of laparoscopic surgery, the author reviewed relevant literature data and interviewed some leading experts in the field. Results. Some basic urologic operations are performed laparoscopically as daily routine procedures. The widely adopted indications for laparoscopic surgery include: adrenalectomy for minor tumours, benign nephrectomy and nephrectomy for tumours less than 10 cm in diameter, renal cyst decortication, lymphocoele, renal biopsy, nephropexy, cryptorchidism and pelvic lymphadenectomy in prostate cancer. Future indications are likely to include living donor nephrectomy, partial nephrectomy in renal cancer and radical prostatectomy. Some other indications, such as retroperitoneal lymhadenectomy in testis cancer or nephroureterectomy in urothelial cancer, are still in debate. Conclusions, Further improvement in laparoscopic skills and technology will simplify the procedures and reduce the time required for surgery. Long-term results of laparoscopic surgery, especially in the field of urologic oncology, will be comparable or seven superior to those obtained by open surgery. Because of the increasing popularity of minimally invasive surgery, laparoscopic techniques are to be introduced in everyday urological practice and included in regular urological training programmes.
Izvleček		Izhodišča. Laparoskopska kirurgija bo imela v prihodnosti pomembno vlogo v urologiji. Naš namen je ugotoviti, kakšna je težavnost raznih posegov in kje so današnje meje laparoskopske urologije. Metode. Da bi odgovorili na ta vprašanja, smo pregledali del obširne literature in opravili nekaj pogovorov z izvedenci. Z zbranimi informacijami želimo predstaviti današnje stanje in perspektive laparoskopije v urologiji. Rezultati. Nekaj osnovnih uroloških posegov se danes že rutinsko izvaja laparoskopsko. Splošno sprejete indikacije za laparoskopsko kirurgijo so: adrenalektomija in odstranitev manjših tumorjev, enostavna nefrektomija in nefrektomija pri tumorjih do velikosti 10 cm, dekortikacija ledvičnih cist, limfokela po transplantaciji ledvice, biopsije ledvice, delna nefrektomija, pieloplastika, nefropeksija, kriptorhizem in pelvična limfadenektomija pri raku prostate. Indikacije v prihodnosti bodo verjetno vključevale še donorsko nefrektomijo, parcialno nefrektomijo pri ledvičnih tumorjih in radikalno prostatektomijo. Nekatere druge indikacije, kot sta retroperitonealna limfadenektomija pri tumorjih testisa in nefroureterektomija pri tumorjih votlega sistema, pa so trenutno še zelo vprašljive. Zaključki. Z razvojem laparoskopske tehnike in tehnologije se bo operacijski čas skrajšal. Dolgoročni rezultati operacij, zlasti na področju onkološke kirurgije, se bodo približali ali bodo še boljši kot pri klasični kirurški tehniki. Zaradi zahtev po minimalni invazivni kirurgiji bo laparoskopska kirurgija postala del vsakdanje urološke prakse in jo bo potrebno vključiti v redni program izobraževanja urologov.
Deskriptorji		UROLOGIC NEOPLASMS SURGERY, LAPAROSCOPIC NEPHRECTOMY PROSTATECTOMY LYMPH NODE EXCISION