| WHAT IS IT?
| HISTORY
| ADVANTAGES
| RADICAL PROSTATECTOMY
   - What is it?
   - Advantages
   - Urinary continence
| LUMBAR FLANK SURGERY
   - Radical & Parcial Nefrectomy
   - Other techniques
   
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Medical Center Teknon

Marquesa surgery
Office 45
C/ Marquesa de Villalonga 12
T 933 933 168| M 606 79 24 42
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LAPAROSCOPY | history

HOW DID IT START?
Surgical approaches by means of external instruments exist since the last century with the development of the first cystoscope (instrument introduced through the urethra to examine the inside of the bladder). Since then endoscopic surgery in Urology has evolved, allowing procedures through the urethra (transurethral), the urethers (transuretheral) and of the kidney from the exterior (percutaneous). Other specialties as Gynecology or Digestive Surgery have developed their own techniques. Gynaecologic laparoscopy as a diagnostic procedure was developed for female pelvis exploration and as a therapy for Fallopian tube ligature. In the field of Digestive Surgery, laparoscopic cholecystectomy has been established as first option treatment, with the appearance of several techniques for other organs.

In the field of Urology it started with some indications in the nineties as the iliobturatrice limfadenectomy for prostate cancer staging or the intrabdominal testis diagnosis. In 1992 the first laparoscopic nefrectomy (kidney extirpation) was described. Since then the technique has spread, being slowly incorporated by different Urology departments. Laparoscopic radical prostatectomy, described in 1998 in France, revolutionized laparoscopy in Urology. A great number of urologists became interested in this extremely detailed technique due to the large number of patients with prostate cancer. Since that first laparoscopic radical prostatectomy in 1997, thousands of procedures have been undergone in Europe.

In the United States the technique has been incorporated more recently with the help of French and German laparoscopic urologists. In that country the incorporation of robotic appliances have been very successful. These robotic systems allow for an easier job for the surgeon and helps shortening the learning curve in laparoscopic suturing. Nowadays they are still too much voluminous machines and make the procedure much more expensive, reason why in Europe its expansion has not been so generalized
.

HOW DID IT START IN SPAIN?
In Spain first laparoscopic radical prostatectomy was undergone in 2002 in the Hospital Universitari ‘Germans Trias i Pujol’ of Badalona by the team of Drs. Saladié, Cecchini and Areal, with the collaboration of Dr. Nicolas Roques from Perpignan (France).

Since that moment, Dr. Cecchini has been practicing this and other laparoscopically approach procedures in his hospital, in private practice as well as in live surgery venues across Spain. Today many centers in Spain do lap surgery partly thanks to the divulgation and teaching done by some pioneers, Dr. Cecchini among them.


 
laparoscopic instrumental