PRELIMINARY EXPERIENCE WITH URO-LAPAROSCO PIC PROCEDURES AND BENEFIT ANALYSIS

Preliminary experience with uro-laparoscopy was retrospectively analys ed to determine whether patients profited from the laparoscopic proced ure. Between 8/91 and 1/93 we performed 28 operations laparoscopically . Four more began likewise, but ended in open surgery. 11 varicocele-p rocedures were carried out. A reduced postoperative morbidity, hence a profit, was obvious in 3/11 patients with bilateral varicoceles, but not in the remaining 8/11 patients affected only on the left side. 11 pelvic lymphadenectomies in patients with prostatic carcinoma Tl-3, an elevated prostatic acid phosphatase, a PSA > 30 ng/ml and/or a suspec ted N+ on CT detected 8 pN0- and 3 pN1-patients. Three of the pN0-pati ents with a T3-Tumor were given radiotherapy Five with a T2-tumor rece ived a radical prostatectomy, 3 of whom with margin-negative specimens profited form the laparoscopic lymphadenectomy by getting a curative operation which, according to established rules, would otherwise have been withheld. Two patients with margin-positive specimens were damage d by the laparoscopic lymphadenectomy, as they were subjected to a use less operation. 6 nephrectomies were carried out for benign, clinicall y relevant lesions of the kidney, which are rare. They produced a clea r-cut profit for all patients, as the postoperative morbidity was mini mal. We conclude: The present indications for urolaparoscopic procedur es are either disputable or rare. Unless more frequent and uncontested ly useful indications are added, laparoscopy will remain of marginal i mportance in urology.