Research Results from The Surgical Interventions of Urological Laparoscopy

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Laparoscopic Techniques Less Traumatic and Laparoscopic Needle Holder

The use of laparoscopic techniques is fundamentally subject to the premise makes that these are just as safe and effective. But essential, for the patient are less traumatic than comparable open surgical   procedures. Any kind of tissue traumatization, including that caused by an operation Tissue trauma.  Both locally and at a systemic level, triggers several reactions that primarily support the healing process and, in extreme cases, should ensure survival.  Use of Laparoscopic Needle Holder is a prudent choice for Training.

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Acute Phase Reaction

Patho-physio-logically, this complex response bases, generally known as the acute phase reaction. It bases on a coordinated response to immunological, endocrine, and metabolic levels. Depending on the extent of the tissue traumatization. This response reaction can overshoot, see above that the side effects compete with positive effects and, depending on the weight, the affect the organism accordingly.

Reduction In the Systemic Stress

Ultimately, all these reactions define the Invasiveness of a surgical intervention. The aim of minimally invasive techniques must be Reaction of the organism to an operation trauma. As far as possible to the local ones Limiting reactions and avoiding the systemic ones. We can demonstrate in several experimental and clinical studies that laparoscopy leads to a reduction in the systemic stress response compared to open interventions with their lesser access trauma.

Post-Aggression Phase of Laparoscopy

The Lubeck working group was able to show that the intensity of the acute phase reaction correlates directly with the surgical approach. Serum concentrations of cytokines such as IL-1, IL-6, IL-10, serotonin.  And CRP were significantly lower in laparoscopically operated patients as compared to open surgically treated patients. The generally less pronounced post-aggression phase of laparoscopically operated patients thus generally leads to a more favorable postoperative course with faster recovery and resumption of physical activity in these urological patients.

The working group from the Surgical Clinic. Her investigations into the immunological stress response and on acute phase reaction after laparoscopic and conventional open Colon resection also show an advantage in favor of laparoscopy.  The lower levels of cytokines and CRP in the laparoscopy group are indicative less surgical trauma with reduction of negative side effects (pain) and shortening the rehabilitation period (hospital stay).

Research Results from The Surgical Interventions

Further research results from the surgical clinic concern tumor seeding and the development of port metastases after laparoscopic interventions in malignancies. We can show that with increasing intraperitoneal gas pressure, tumor cell growth suppresses while Carbon dioxide principally promotes the development of subcutaneous metastases. The additional intraoperative lavage with cytotoxic or anti-adherent agent substances reduces tumor growth or tumor cell seeding and thus that Risk of metastases after laparoscopic interventions.

Pneumoperitoneum For Laparoscopy

Recently, with the application of helium instead of Carbon dioxide for preparing the pneumoperitoneum for laparoscopy. Related to both gases showed an influence on the cardiovascular system (embolism). No difference, but helium reduces the formation of subcutaneous Tumor metastases after laparoscopic colon resection for malignancy.

Oncological Safety in Clinical Practice

Both these above-mentioned scientific investigations as well as further in studies published in the literature on basic research in laparoscopy show the theoretical advantage of this method in terms of reduced intra- and postoperative morbidity. Regarding oncological safety, the Laparoscopy considers a real alternative in the treatment of malignancies. It stays However, to clarify the question of whether these theoretical data really translate into clinical Practice can implements to the benefit of patients?

Evaluation Of Laparoscopy in Urology

Our focus was the evaluation of laparoscopy in urology. Our goal was to find out whether these sometimes technically complicated procedures can safely use in daily routine as an alternative or even as a standard procedure for the diagnosis and therapy of urological diseases, including urological malignancies.

It was particularly important to us to clarify the following questions for our specialist area:

  1. To what extent can laparoscopic techniques surgically replace existing ones replace conventional interventions in urology?
  2. Is an extension of today’s generally accepted list of indications possible?
  3. Reduces the use of laparoscopy in diagnostics and therapy urological diseases the intra- and postoperative morbidity?
  4. What is the role of less pain, faster convalescence, and the cosmetic result?
  5. Is the integration of complicated laparoscopic techniques into therapy urological diseases associated with a higher complication rate?
  6. Can see the good results of open uro-surgical interventions laparoscopic techniques can achieves or even improved?
  7. Is the use of laparoscopy in the therapy of urological tumors

Justifiable and recommended from an oncological point of view?

For this purpose, the results of a ten-year intensive examination of the Working Group for Laparoscopic Surgery of the Urological Clinic examined and critically evaluated. The individual chapters of the present Habilitation thesis describe the main results of our work. Laparoscopic Needle Holder is a significant choice.

The mostly presented in publications. It became aware of one repetition of the detailed presentation of methods, results and their Discussion omitted. Please refer to the relevant publications in the appendix referred.

Conclusion

The focus was rather on the summary and discussion of the individual results within the framework of the overall concept of the use of laparoscopic Operations in various benign and malignant urological diseases with the aim of answering the questions formulates the Laparoscopy in Urology.

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