What is New In Minimally Invasive Surgery for Urology

What’s New in Minimally Invasive Surgery for Urology Ho Siew Hong Consultant Urological Surgeon S H Ho Urology and Laparoscopy Centre

Introduction – Basic Qualifications ,[object Object],[object Object],[object Object],[object Object]

Introduction – Subspecialty training ,[object Object],[object Object]

Minimally invasive surgery ,[object Object],[object Object],[object Object],[object Object],[object Object]

Minimally Invasive Surgery Laparoscopy Endoscopy Percutaneous surgery ESWL

Extracorporal Shockwave Lithotripsy (ESWL) ‘ A thousand grains of sand pass through the eye of a needle before a single pebble’ W. Spencer

ESWL ,[object Object],[object Object],[object Object],[object Object],[object Object]

Development of ESWL ,[object Object],[object Object],[object Object],[object Object]

What is new in ESWL ? ,[object Object]

What is new in ESWL ? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

What is new in ESWL ? ,[object Object],[object Object]

Endoscopy in Urology (endourology) Cystoscopy TURP / transurethral resection Ureteroscopy

What is new in endourology ? ,[object Object]

TURP ,[object Object],[object Object],[object Object]

What is new in TURP ? ,[object Object],[object Object],[object Object],[object Object],[object Object]

What is new in TURP ? ,[object Object],[object Object],[object Object],[object Object]

Bipolar TURP ,[object Object],[object Object],[object Object],[object Object],[object Object]

Laser TURP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Endoscopic ureter procedures ,[object Object],[object Object],[object Object],[object Object],[object Object]

Ureteroscopy for stones ,[object Object],[object Object],[object Object]

Ureteroscopy for stones Laser lithotripsy

Percutaneous surgery ,[object Object],[object Object],[object Object]

PCNL (percutaneous nephrolithotomy) ,[object Object],[object Object],[object Object],[object Object]

Laparoscopic surgery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Challenges of laparoscopic surgery ,[object Object],[object Object],[object Object],[object Object]

What is new in laparoscopy in urology? ,[object Object],[object Object],[object Object]

Laparoscopic urological surgeries Procedure Standard of care Current opinion Laparoscopic radical nephrectomy Yes Proven long term results for tumour upto 7cm Laparoscopic radical nephroureterectomy Yes Replaces open Laparoscopic marsupilazation of kidney cyst Yes Replaces open Laparoscopic adrenalectomy Yes Replaces open Laparoscopic pyeloplasty Not yet Very promising, awaiting long term results

Laparoscopic urological surgeries Procedure Standard of care Current opinion Laparoscopic radical prostatectomy No Divided (laparoscopic, robotic assisted laparoscopic, open) Laparoscopic varicocelectomy No Divided (open microscope) Laparoscopic extra peritoneal herniorraphy No Promising, awaiting long term results Laparoscopic ureterolithotomy No Advantage over open, but other options available Laparoscopic partial nephrectomy No At best, similar to open Laparoscopic radical cystectomy No At best, similar to open Laparoscopic retroperitoneal lymp node dissection No Promising, development stage Laparoscopic reimplatation of ureter No Early development stage Laparoscopic augmentation cystoplasty No Early development stage

Laparoscopic nephrectomy ,[object Object],[object Object]

Laparoscopic Prostatectomy ,[object Object],[object Object],[object Object]

Laparoscopic Prostatectomy ,[object Object],[object Object],[object Object],[object Object]

Laparoscopic Extraperitoneal Radical Prostatectomy - Our Initial Experience Siew Hong Ho, Li-Tsa Koh , Sam Peh Department of Urology Changi General Hospital Winner of 2 nd best presentation in International College Of Surgeons Meeting, 2006

Laparoscopic prostatectomy v/s robotic prostatectomy ,[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],Laparoscopic prostatectomy v/s robotic prostatectomy

Summary ,[object Object],[object Object],[object Object]

What is New In Minimally Invasive Surgery for Urology

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