Urology (from Greek οὖρον ouron "urine" and -λογία -logia "study of"), also known as genitourinary surgery, is the branch of medicine that focuses on the surgical and medical diseases of the male and female urinary tract system and the male reproductive organs. The organs under the domain of urology include the kidneys, adrenal glands, ureters, urinary bladder, urethra, and the male reproductive organs (testes, epididyms, vas deferens, seminal vesicles, prostate and penis).
The urinary and reproductive tracts are closely linked, and disorders of one often affect the other. Thus a major spectrum of the conditions managed in urology exists under the domain of genitourinary disorders. Urology combines the management of medical conditions such as urinary tract infections and benign prostatic hyperplasia, with the management of surgical conditions such as bladder or prostate cancer, kidney stones, congenital abnormalities, traumatic injury, and stress incontinence.
Urology has traditionally been on the cutting-edge of surgical technology in the field of medicine. Urologists are well-trained in minimally-invasive techniques, employing real-time ultrasound guidance, fiber-optic endoscopic equipment, and various lasers in the treatment of multiple benign and malignant conditions. In addition, urologists are pioneers in the use of robotics in laparoscopic surgery. Urology is closely related to (and urologists often collaborate with the practitioners of) the medical fields of oncology, nephrology, gynaecology, andrology, pediatric surgery, colorectal surgery, gastroenterology and endocrinology.
What is the da Vinci Robot?
The da Vinci Robot, also known as the da Vinci Surgical System, was designed by Intuitive Surgical, Inc. as a tool for surgeons to conduct minimally-invasive procedures.
The da Vinci Surgical System features miniaturized instruments and 3-D cameras which enable your surgeon to make smaller incisions and work with greater precision than traditional, open surgery. By dramatically enhancing visualization, precision, control and dexterity, the da Vinci® System overcomes the limitations of traditional laparoscopic technology, helping physicians to perform complex surgery in a manner never before experienced. With enhanced surgical capabilities, physicians are now able to extend the benefits of minimally invasive surgery to the broadest possible range of patients.
The da Vinci Surgical System consists of an ergonomically designed surgeon’s console, a patient-side cart with four interactive robotic arms, a high-performance vision system and proprietary EndoWrist® Instruments. Powered by state-of-the-art robotic technology, the surgeon’s hand movements are scaled, filtered and seamlessly translated into precise movements of the EndoWrist Instruments.
The System cannot be programmed, nor can it make decisions on its own. The da Vinci System requires that every surgical maneuver be performed with direct input from your surgeon.
The da Vinci Surgical System has been successfully used in tens of thousands of minimally invasive procedures worldwide.
All the urologic procedures that can be done laparoscopically now it is easier for the surgeon to perform them using the Da Vinci Robotic system.
Robotic Prostatectomy is the most often performing operation worldwide.
Main Benefits to the Patient may include:
- Reduced pain and trauma to the body
- Less anesthesia
- Less blood loss and need for transfusions
- Less post-operative pain and discomfort
- Less risk of infection
- Shorter hospital stay
- Less scarring and improved comesis
- Faster recovery and return to normal daily activities
Main Benefits to the Surgeon include:
- Enhanced 3-D Visualization
- Improved Dexterity
- Greater Surgical Precision
- Improved Access
- Increased Range of Motion
ADVANTAGES OF ROBOTIC RADICAL PROSTATECTOMY
- Less blood loss
- Shorter hospital stay
- Faster recovery
- Enhanced visualization and surgical precision
- Reduced risk of a positive surgical margin
- Possibly improved cancer control rates
- Possibly earlier return of continence
- Possibly earlier and more complete return of sexual function
What is laparoscopy?
Laparoscopy is a minimal invasive technique where the operation is performed using instruments inserted through narrow hollow tubes (“ports”) rather than through a larger incision, as in traditional surgery.
In Urology laparoscopic procedures are indicated almost in every surgical case where certain contraindications are not present. Especially, in upper urinary tract diseases (kidneys, ureter, and adrenal glands) laparoscopy is the gold standard surgical technique.
How a laparoscopic operation is performed?
Through a small 1 cm hole a laparoscopic camera is inserted in the abdominal cavity which is insufflated with CO2 and the intra-abdominal organs are inspected. The camera has a magnification 15 times more, so the surgeon can perform all the operation with high accuracy. Surgical trauma is significantly less so the patient has a better postoperative recovery. All the speciments can been removed through very small incisions without compromising the surgical results.
What are the advantages of laparoscopy?
- Less surgical stress response which leads to less pain and shorter hospital stay
- Shorter recovery time
- Better visualization during operation which facilitates precision
- Less bleeding intra operatively so less possibility to transfusion
- Less peri and post-operative complications
- Better cosmetic results
- Method of choice in patients with cardiac and respiratory problems
What are the disadvantages of laparoscopy?
- Laparoscopy needs very good training because is technical demanding and in the beginning needs more time to complete an operation.
What urological operations can be done laparoscopically?
- Laparoscopic Radical Adrenalectomy
- Laparoscopic Radical Nephrectomy
- Laparoscopic Partial Nephrectomy
- Laproscopic Cyst Ablation
- Laparoscopic Cryoablation
- Laparoscopic Pyeloplasty
- Laparoscopic Nephroureterectomy
- Laparoscopic Ureteroureterostomy
- Laparoscopic Radical Cystectomy
- Laparoscopic Radical Prostatectomy
- Laparoscopic Lymph Node Dissection
In experienced hands laparoscopic procedures are the gold standard procedures in every aspect of Urology.