Laparoscopic and Robotic Surgery in Urology

✍ Scribed by Xu Zhang (editor)

• Publisher: Springer
• Year: 2020
• Tongue: English
• Leaves: 310
• Category: Library

✦ Synopsis

This book is a practical guide to the laparoscopic and robotic surgery technique in urology. It includes 34 chapters in three sections, which are adrenal gland, kidney and ureter surgery, bladder and prostate surgery and lympadenectomy. This book covers all parts of laparoscopic and robotic urological surgery, including methods in patient selection, peri-operative management, step-by-step descriptions of specific techniques and complication avoidance. It is accompanied with over 800 illustrations and real-time capture figures. It also includes over 40 surgery videos with online access.

Through the combination of texts, pictures and videos, it presents the surgical designing, surgical procedures and surgical techniques in panorama. This book is a good reference book for urologists who interested in these techniques.

✦ Table of Contents

Preface
Contents
Editors and Contributors
Associate Editors
Contributors
Part I: Adrenal Gland, Kidney and Ureter
1: Patient Position and Trocar Placement for Upper Urinary Tract Surgery
1 Establishment of Retroperitoneal Approach for Adrenal Gland and Upper Urinary Tract Laparoscopic Surgery
2 Establishment of Transperitoneal Approach for Adrenal Gland and Upper Urinary Tract Robotic Surgery
3 Establishment of Retroperitoneal Approach for Upper Urinary Tract Robotic Surgery
References
2: Retroperitoneoscopic Anatomical Adrenalectomy
1 Overview
2 Indications and Contraindications
3 Perioperative Management
4 Operating Procedure
5 Precautions
6 Postoperative Management
7 Complications
8 Technical Status
References
3: Robotic Adrenalectomy
1 Overview
2 Indications and Contraindications
3 Perioperative Treatments
4 Operating Procedure
5 Precautions
6 Postoperative Management
7 Complications and Treatments
8 Technical Status
References
4: Retroperitoneal Laparoscopic Simple Nephrectomy
1 Introduction
2 Indications and Contraindications
2.1 Indications
2.2 Contraindications
3 Preoperative Evaluations and Patient Preparation
3.1 Preoperative Evaluations
3.2 Patient Preparation
4 Step-by-Step Operative Technique (Left Nephrectomy for Renal Tuberculosis)
4.1 Anesthesia and Patient Positioning
4.2 Creation of Retroperitoneal Working Space and Trocar Placement
4.3 Mobilization of Retroperitoneal Adipose Tissue
4.4 Longitudinal Incision of Gerota’s Fascia and Perirenal Fat
4.5 Mobilization of the Kidney
4.6 Control of the Renal Pedicle
4.7 Transection of the Ureter
4.8 Inspection of Hemostasis and Kidney Extraction
5 Postoperative Management
6 Complications and Management
6.1 Intraoperative Complications
6.1.1 Vascular Injury and Bleeding
6.1.2 Visceral Injury
6.2 Postoperative Complications
6.3 Prevention and Treatment of Complications
7 Special Considerations
7.1 Selection of Cases
7.2 The Sequence of Kidney Mobilization
7.3 Control of the Renal Pedicle
7.4 Treatment of the Giant Hydronephrosis
7.5 Management of Infected Nonfunctioning Kidneys
7.6 Management of Atrophic Kidneys
7.7 Management of Combined Renal Disease with Ureteral Lesions
References
5: Retroperitoneal Laparoscopic Radical Nephrectomy
1 Introduction
2 Indications and Contraindications
3 Preoperative Evaluation and Patient Preparation
3.1 Preoperative Evaluation
3.2 Patient Preparation
4 Step-by-Step Operative Technique
4.1 Mobilization of Retroperitoneal Adipose Tissue and Exposure of the Deeper Fascial Structures
4.2 Anterior Dissection of the Kidney and Entering the Anterior Pararenal Space
4.3 Posterior Dissection of the Kidney: Entering the Anterior Psoas Space (Part of the Posterior Pararenal Space)
4.4 Exposure of the Renal Hilum
4.5 Redirection Towards the Previous Dissected Anterior Space
4.6 Mobilization of the Upper and Lower Poles of the Kidney
4.7 Specimen Entrapment and Extraction
5 Postoperative Management
6 Complications and Management
6.1 Peritoneum Injury
6.2 Bleeding
6.3 Injuries of the Adjacent Organs
7 Special Considerations
7.1 Kidney Mobilization
7.2 Concomitant Adrenalectomy
7.3 Specimen Extraction: Intact or Morcellation
7.4 Lumbar Tributaries of the Left Renal Vein (Fig. 5.24)
8 Future Perspectives
References
6: Robotic Inferior Vena Cava Thrombectomy
1 Introduction
2 Indications and Contraindications
2.1 Indications
2.2 Contraindications
3 Preoperative Preparation
3.1 General Patient Preparation
3.2 Special Patient Preparation
4 Step-by-Step Operative Technique
4.1 Anesthesia and Patient Position
4.2 Right Radical Nephrectomy and Inferior Vena Cava Thrombectomy
4.2.1 Patient Position and Port Placement
4.2.2 Dissection of Inferior Vena Cava, Left Renal Vein and Right Renal Vein
4.2.3 Dissection of Inferior Vena Cava at the Thrombus Level, Left Renal Vein and Part Lumbar Vein
4.2.4 Sequential Occlusion of Distal IVC, Left Renal Vein, and Proximal IVC
4.2.5 Extraction of Thrombus
4.2.6 Right Radical Nephrectomy
4.3 Left Radical Nephrectomy and Inferior Vena Cava Thrombectomy
4.3.1 Patient Position and Port Placement
4.3.2 Dissection of Inferior Vena Cava
4.3.3 Isolation of Right and Left Renal Vein
4.3.4 Dissection of Right Renal Artery and Inferior Vena Cava at the Thrombus Level
4.3.5 Sequential Occlusion of Distal IVC, Right Renal Artery, Right Renal Vein, and Proximal IVC
4.3.6 Extraction of Thrombus
4.3.7 Left Radical Nephrectomy
5 Complications and Management
5.1 Tumor Thrombus Detachment
5.2 Vascular Injury and Bleeding
5.3 Organ Injury
5.4 Surgical Site Infection
5.5 Peritonitis
5.6 Pneumonia
5.7 Other Complications
6 Future Perspectives
References
7: Retroperitoneal Laparoscopic Nephroureterectomy
1 Introduction
2 Indications and Contraindications
3 Preoperative Evaluation and Patient Preparation
3.1 Preoperative Evaluation
3.2 Patient Preparation
4 Step-by-Step Operative Technique
5 Cautions
6 Postoperative Management
7 Long-Term Results
References
8: Robotic Nephroureterectomy
1 Introduction
2 Indications and Contraindications
3 Preoperative Evaluation and Patient Preparation
3.1 Preoperative Evaluation
4 Step-by-Step Operative Technique
4.1 Endouroligical Manipulations
4.2 Patient Positioning and Port Placement
4.3 Kidney Dissection
4.4 Distal Ureterectomy
5 Postoperative Management
6 Complications and Management
6.1 Bleeding
6.2 Urine Leakage
7 Special Considerations
References
9: Retroperitoneal Laparoscopic Donor Nephrectomy
1 Introduction
2 Indications and Contraindications
2.1 Indications
2.2 Contraindications
3 Preoperative Evaluation and Patient Preparation
3.1 Preoperative Evaluation
3.2 Patient Preparation
4 Step-by-Step Operative Technique (Retroperitoneal Laparoscopic Left Donor Nephrectomy)
4.1 Anesthesia and Patient Positioning
4.2 Creation of Retroperitoneal Working Space and Trocar Placement
4.3 Mobilization of Retroperitoneal Adipose Tissue
4.4 Free of the Kidney and Ureter
4.5 Renal Pedicles Dissection
4.6 Transection of the Ureter
4.7 Surgical Incision for Extraction of Donor Kidney
4.8 Transecion of the Renal Pedicle
4.9 Kidney Extraction
4.10 Single Hand Assisted Technique
4.11 Inspection of Hemostasis
4.12 The Matters Needing Attention
5 Postoperative Management
6 Complications and Management
6.1 Injury of the Renal Capsule and Renal Parenchyma
6.2 The Renal Blood Vessels Are Too Short
6.3 Hem-o-Lock clip Dislodgement
References
10: Robotic Donor Nephrectomy
1 Introduction
2 Step-by-Step Operative Technique (Transperitoneal Robotic-Assisted Laparoscopic Left Donor Nephrectomy)
2.1 Anesthesia, Patient Positioning and Trocar Placement
2.2 Medialization of the Descending Colon and Retraction of Spleen
2.3 Skeletonization of the Renal Vessels
2.4 Moblization of the Ureter
2.5 Mobilization of the Upper Pole Kidney
2.6 Lateral and Posterior Dissection of the Kidney
2.7 Surgical Incision for Kidney Extraction
2.8 Transection of the Ureter
2.9 Treatment of the Renal Pedicle
2.10 Kidney Extraction
References
11: Retroperitoneal Laparoscopic Partial Nephrectomy
1 Introduction
2 Indications and Contraindications
2.1 Indications
2.2 Contraindications
3 Preoperative Evaluation and Patient Preparation
3.1 Preoperative Evaluation
3.2 Patient Preparation
4 Step-by-Step Operative Technique
4.1 Anesthesia and Patient Positioning
4.2 Creation of Retroperitoneal Working Space and Trocar Placement
4.3 Clearance of Retroperitoneal Fat Tissue External to Gerota’s Fascia
4.4 Exposure and Localization of the Kidney Tumor
4.5 Exposure and Occlusion of the Renal Pedicle
4.6 Tumor Resection and Reconstruction
4.7 Declamping and Extraction of the Specimen
5 Postoperative Management
6 Complications and Management
7 Special Considerations
7.1 Mobilization of the Kidney
7.2 Localization of the Renal Artery
7.3 The Margin of Excision
7.4 Management of the Endophytic Renal Tumors
7.5 Repair of the Collecting System
7.6 Suturing Techniques
8 Future Perspectives
8.1 Expansion of the Surgical Indications and Surgical Score System
8.2 The Selection of Surgical Approaches
8.3 Renal Function Preservation in LPN
8.4 Renal Hypothermia in LPN
8.5 Technical Advances in LPN
8.6 Biological Hemostats
8.7 Intraoperative Frozen Section Margin Evaluation
8.8 Preoperative Placement of Ureteric Stent or Catheter
References
12: Robot Assisted Laparoscopic Partial Nephrectomy
1 Introduction
2 Indications and Contraindications
2.1 Patient Preparation
3 Transperitoneal Approach Robot Assisted Partial Nephrectomy
3.1 Patient’s Position
3.2 Trocars Configuration
3.3 Operating Procedure (Right Partial Nephrectomy)
4 Retroperitoneal Approach Robot Assisted Partial Nephrectomy
4.1 Patient’s Position
4.2 Reverse-Trapezoid Trocars Configuration
4.3 Right-Angle Robot Docking
4.4 Operating Procedure (Right Partial Nephrectomy)
5 Experiences and Notes
5.1 Identification of Renal Artery
5.2 Renal Pedicle Clamping
5.3 Initiatory Experiences of RPRPN
5.4 Surgical Techniques for Complicated Partial Nephrectomy
5.4.1 Tumour of Renal Hilum
5.4.2 Complete Endophytic Renal Tumors
6 Post Operation Medical Care
7 Complication and Precaution
8 Technical Status of Current RPN
8.1 Learning Curve
8.2 Indication of RPN
8.3 Cold Perfusion Techniques for Complex Renal Tumors
References
13: Retroperitoneal Laparoscopic Pyeloplasty for Ureteropelvic Junction Obstruction
1 Introduction
2 Indications and Contraindications
2.1 Indications
2.2 Contraindications
3 Preoperative Evaluation and Patient Preparation
4 Step-by-Step Operative Technique
5 Postoperative Management
6 Complications and Management
7 Special Considerations [14]
8 Retroperitoneal Laparoscopic Hellström Technique for UPJO by a Crossing Vessel
9 Future Perspectives
References
14: Robotic Dismembered Pyeloplasty for Ureteropelvic Junction Obstruction
1 Introduction
2 Indication and Contraindication
3 Preoperative Evaluation and Patient Preparation
4 Step-by Step Operative Technique
4.1 Anesthesia, Body Position, Establishment of Pneumoperitoneum, the Distribution Of Puncture Cannula and the Docking of Robot Operating System
4.2 Operation Process
5 Postoperative Treatment
6 Complications and Management
7 Special Considerations
References
15: Retroperitoneal Laparoscopic Ureterolithotomy
1 Introduction
2 Indications
3 Contraindications
4 Preoperative Evaluation and Patient Preparation
5 Step-by-Step Operative Technique
5.1 Step 1: Patient Position and Trocar Placement
5.2 Step 2: Retroperitoneal Space Creation and Stone Localization
5.3 Step 3: Ureterotomy and Stone Extraction
5.4 Step 4: Double-J Catheter Placement
5.5 Step 5: Ureterotomy Closure and Stone Removal
6 Postoperative Management
7 Complications and Management
8 Special Considerations
9 Future Perspectives
References
16: Retroperitoneal Laparoscopic Ureteroureterostomy for Retrocaval Ureter
1 Introduction
2 Preoperative Evaluation and Patient Preparation
3 Step-by-Step Operative Technique
4 Postoperative Management
5 Complications and Management
6 Special Considerations
7 Future Perspectives
References
17: Retroperitoneal Laparoscopic Heminephrectomy for Duplex Kidney Anomaly
1 Introduction
2 Indications
3 Contraindications
4 Preoperative Evaluation and Patient Preparation
5 Step-by-Step Operative Technique
5.1 Step 1: Patient Position and Trocar Placement
5.2 Step 2: Retroperitoneal Space Preparation and Moiety Demarcation Exposure
5.3 Step 3: Upper-Pole Moiety Vessels Ligation and Heminephrectomy
5.4 Step 4: Upper-Pole Remnant Moiety Urothelium Stripping Off and Ureterectomy
5.5 Step 5: Upper-Pole Remnant Moiety Closure and Specimen Removal
6 Postoperative Management
7 Complications and Management
8 Special Considerations
9 Future Perspectives
References
18: Retroperitoneal Laparoscopic Renal Pedicle Lymphatic Disconnection for Chyluria
1 Introduction
2 Indications and Contraindications
2.1 Indications
2.2 Contraindications
3 Preoperative Evaluation and Patient Preparation
4 Step-by-Step Operative Technique
4.1 Anesthesia and Position
4.2 Surgical Procedure
5 Postoperative Management
6 Complications and Management
7 Special Considerations
8 Future Perspectives
References
Part II: Bladder and Prostate
19: Patient Position and Trocar Placement for Lower Urinary Tract Surgery
1 Establishment of Transperitoneal Approach Lower Urinary Tract Laparoscopic Surgery
1.1 Patient Position
1.2 Establishment of Pneumoperitoneum and Trocar Placement
1.2.1 Veress Needle Technique
1.2.2 Hasson Technique
2 Establishment of Transperitoneal Approach Lower Urinary Tract Robotic Surgery
3 Establishment of Extraperitoneal Laparoscopic Radical Prostatectomy
4 Establishment of Extraperitoneal Approach Robotic Radical Prostatectomy
References
20: Laparoscopic Radical Cystectomy in Male Patients and Urinary Diversion
1 Introduction
2 Indications and Contraindications
3 Preoperative Evaluation and Patient Preparation
4 Step-by-Step Operative Technique
5 Postoperative Care
6 Complications and Management
References
21: Robotic Radical Cystoproatatectomy and Intracorporeal Neobladder
1 Summarization
2 Operating Procedure
3 Technology Status Quo
3.1 Robotic Assisted Laparoscopic Urinary Diversion: Extracorporal Ileal Orthotopic Neobladder or Ileal Conduit
3.2 Operative Procedure for Robot-Assisted Laparoscopic Reconstruction of the Neobladder or Ileum Conduit
4 Postoperative Treatment
5 Complications Prevention and Treatment
Further Readings
22: Laparoscopic Radical Cystectomy for Female Patients
1 General Introduction
2 Anatomy of Female Pelvis (Uterus Ligaments)
3 Indications and Contraindications
3.1 Indications
3.2 Contraindications
4 Step-by-Step Operative Technique
4.1 Preoperative Preparation
4.2 Anesthesia and Surgical Position
4.3 Surgical Procedures
4.3.1 Surgical Steps
5 Attentions
References
23: Laparoscopic Partial Cystectomy
1 Introduction
2 Indications and Contraindications
2.1 Indications
2.2 Contraindications
3 Preoperative Evaluation and Patient Preparation
4 Step-by-Step Operative Technique
5 Postoperative Management
6 Complications and Management
7 Future Perspectives
References
24: Laparoscopic Ureteral Reimplantation
1 Indications
2 Preoperative Preparation
3 Procedure
4 Complications
References
25: Robot-Assisted Laparoscopic Ureteral Reimplantation
1 Introduction
2 Indications
3 Preoperative Preparation
4 Procedure
4.1 Psoas Hitch
5 Comments
6 Postoperative Handling
7 Complications
References
26: Extraperitoneal Laparoscopic Radical Prostatectomy
1 Indications
2 Contraindications
3 Preoperative Preparation
4 Surgical Procedure
4.1 Anesthesia and Patient Position
4.2 Creation of Extraperitoneal Space and Trocar Placement
4.3 Separation of Retzius Space and Removal of Prostate Surface Fat
4.4 Incision of Endopelvic Fascia and Pubic Prostatic Ligament
4.5 Ligation of Dorsal Venous Complex
4.6 Division of the Prostatovesical Junction and Bladder Neck Dissection
4.7 Dissection and Ligation of the Seminal Vesicles and Vas Deferens
4.8 Incision of Denonvillier Fascia and Dissection of Posterior Prostate
4.9 Neurovascular Bundle and Prostatic Pedicle Dissection
4.10 Prostatic Apex Dissection and Division of Urethra
4.11 Vesicourethral Anastomosis
4.12 Laparoscopic Pelvic Lymph Node Dissection
4.13 Remove the Specimen and Close the Incision
5 Handling of Special Cases
6 Postoperative Management
6.1 Diet and Body Position
6.2 Infection Prevention
6.3 Prophylaxis of Lower Limb Deep Venous Thrombosis
6.4 Removal of Drainage
6.5 Removal of Catheter
7 Complications Control
7.1 Haemorrhage During the Operation
8 Complications of Digestive System
8.1 Injury of Rectum
8.2 Peritonitis (Intra-Abdominal Infection)
8.3 Urine Leakage of Vesicourethral Anastomosis
8.4 Bladder Injury
8.5 Ureter Injury
8.6 Urethrostenosis
8.7 Incontinence and Impotence
8.8 Positive Surgical Margin (PSM)
8.9 Symptomatic Venous Thromboembolism (VTE)
8.10 Obturator Nerve Injury
References
27: Robotic Radical Prostatectomy
1 Introduction
2 Anatomy of Prostate
3 Indications and Contraindications
4 Step-by-Step Technique (Transperitoneal Approach)
5 Step-by-Step Technique (Extraperitoneal Approach)
6 Postoperative Management and Complications Control
7 Complications Control
7.1 Intraoperation Bleeding
7.2 Bowel Related Complications
7.2.1 Rectum Injury
7.2.2 Peritonitis (Intra-abdominal Infection)
7.3 Complications of Urinary System
7.3.1 Urine Leakage of Vesicourethral Anastomosis
7.3.2 Bladder Injury
7.3.3 Ureteral Injury
7.3.4 Anastomotic Stenosis
7.3.5 Incontinence and Impotence
7.3.6 Positive Surgical Margin (PSM)
7.4 Other Complications
7.4.1 Symptomatic Venous Thromboembolism (VTE)
7.4.2 Obturator Nerve Injury
8 Special Considerations
9 Present Technology and Development
28: Robotic Excision of Seminal Vesicle Tumor
1 Introduction
2 Indications and Contraindications
2.1 Indications
2.2 Contraindications
3 Preoperative Evaluation and Patient Preparation
4 Step-by-Step Operative Technique
5 Postoperative Management
6 Complications and Management
7 Special Considerations
8 Future Perspectives
References
Part III: Lympadenectomy
29: Laparoscopic Retroperitoneal Lymph Node Dissection
1 Introduction
2 Anatomy
3 Indications and Contraindications
3.1 Indications
3.2 Contraindications
4 Preoperative Evaluation and Patient Preparation
5 Step-by-Step Operative Technique
6 Postoperative Management
7 Complications and Management
8 Special Considerations
9 Future Perspectives
References
30: Robotic Retroperitoneal Lymph Node Dissection
1 Introduction
2 Step-by-Step Operative Technique
2.1 Left Side RLRPLND
2.2 Right Side RLRPLND
3 Special Considerations
4 Future Perspectives
References
31: Laparoscopic Pelvic Lymph Node Dissection for Bladder Cancer
1 Introduction
2 Anatomy
3 Lymphatic Drainage of the Bladder
4 Indications and Contraindications
4.1 Indications
4.2 Contraindications
5 Preoperative Evaluation and Patient Preparation
6 Step-by-Step Operative Technique
7 Postoperative Management
8 Complications and Management
9 Special Considerations
10 Future Perspectives
References
32: Robotic Pelvic Lymph Node Dissection for Bladder Cancer
1 Introduction
2 Anatomy
3 Indications and Contraindications
3.1 Indications
3.2 Contraindications
4 Preoperative Evaluation and Patient Preparation
5 Step-by-Step Operative Technique
6 Special Considerations
7 Future Perspectives
References
33: Femoraloscopic Inguinal Lymphadenectomy
1 Introduction
2 Indications and Contraindications
3 Preoperative Evaluation and Patient Preparation
4 Step-by-Step Operative Technique
5 Postoperative Management
6 Complications and Management
7 Special Considerations
8 Future Perspectives
References