الفهرس 
INTRODUCTION AND AIM OF WORKOnly 14 pages are availabe for public view
 |  | from | 176 |  |  |
| | | from | 176 | | |
Abstract
from the current study we can conclude that:
1-Recent applications of laparoscopy to urologic surgery have demonstrated the efficacy, safety, and shorter convalescence times with these techniques. A future trend toward day surgery might favor laparoscopy, which requires a smaller skin incision and thus enables young men to return to work earlier. Overall, It could be considered as a viable alternative to open surgery.
2-Laparoscopic radical nephrectomy can be performed efficiently and effectively by the transperitoneal or the retroperitoneal approach. Renal hilar control may be quicker and total operative time shorter with the retroperitoneoscopic approach. Operative morbidity, complications and pathological characteristics of the intact extracted specimen are similar with both approaches. Ultimately, in most instances the choice of approach depends on the comfort level, training and preference of the individual laparoscopic surgeon.
3- Hand assisted laparoscopic nephrectomy is a reasonable treatment option in the setting of suspected renal cell carcinoma, offering the advantages of direct manual control of the operative field, no need for specimen morcellation, , and operative cost and postoperative convalescence similar to those of standard laparoscopic nephrectomy. Hand assisted laparoscopic surgery is especially useful in difficult cases involving large tumors, difficult anatomy or comorbidities that require a rapid procedure.
4- Trans-peritoneal partial nephrectomy was the preferred technique in this study due to the larger working space, and superior instrument angles for tumor excision and intracorporeal sutured renal reconstructionRetro-peritoneal partial nephrectomy is technically more challenging due to the decreased working space and difficult angles for suturing. However, it provides better access to posterior, particularly posteromedial lesions.
5- The specific reconstructive technical challenge during laparoscopic partial nephrectomy is to achieve parenchymal hemostasis and watertight pelvicaliceal repair in a time sensitive manner. Laparoscopic partial nephrectomy should be viewed as a technically complex operation requiring advanced laparoscopic skills.
6- The extraperitoneal approach for da Vinci assisted laparoscopic radical prostatectomy is feasible. The extraperitoneal robotic approach using more distal port placement appears to permit better access to the prostate and a more coordinated approach between the surgeon and assistant.
7- For pediatric urologists who assess nonpalpable testes with laparoscopy, laparoscopic ligation of the spermatic vessels becomes a natural extension. A staged approach for the intra-abdominal testis with laparoscopic spermatic vessel ligation followed by open orchiopexy provides adequate viability of the testis. A staged approach is successful, well tolerated and results in minimal morbidity.
8- Laparoscopic urologists have to keep themselves and the patients informed not only of improved procedures and technical advances, but also of the complications encountered during the course of experience. Such exchanges of documented information will help to decrease and avoid major complications, and will also improve the training of future laparoscopic urologists. Thus, laparoscopy in urology will continue the path of development, now and in the future.