Laparoscopic Urologic Sutured Reconstruction

As this textbook will attest, the number and complexity of urologic reconstructions is rapidly expanding. In 2003, for instance, only about 700 robotic prostatectomies were performed worldwide. In 2004, this number is expected to rise above 7000, representing a log growth in the number of sutured vesicourethral anastomoses (1). Over 500 laparo-scopic pyeloplasties have been reported with sutured repair. Also emerging with larger series are laparoscopic radical cystectomy with either orthotopic or heterotopic sutured/stapled urinary diversion. The implications and abilities for the urologist to intervene and reconstruct the urinary tract are now widely being applied. In this section, each urinary organ will be isolated and discussed with a review of the relevant literature. Every aspect of urologic reconstruction has been attempted upon the kidney, ureter, bladder, bladder neck, urethra, and genitalia. Even the inferior epigastric artery has been isolated and harvested for reconstruction of the penile vasculature for impotence using laparoscopic techniques (2). Laparoscopic ileal vaginal reconstruction has been accomplished in a young woman with Mayer-Rokitansky-Kuster syndrome (3). Virtually every intersexual condition has now been reported to be successfully treated with the aid of laparoscopic reconstructive measures (4). We have pursued an endoscopic model of gra-cilis muscle flap harvesting with intracorporeal transposition to the bladder neck and isolation of the neurovascular pedicle in rabbits. The following discussion of the most recent series of laparoscopic urologic reconstructive surgeries with historical references when relevent. Emphasis will be upon the sutured nuances within these reports.

0 0

Post a comment