[Initial experience with surgical uro-laparoscopy].

Preliminary experience with uro-laparoscopy was retrospectively analyzed to determine whether patients profited from the laparoscopic procedure. Between August 1991 und July 1993 we performed 53 operations laparoscopically. Four more began in this way but ended in open surgery. 29 varicocele procedures were carried out. A reduced postoperative morbidity, and hence a benefit, were obvious in 3/29 patients with bilateral varicocele, but probably not in the remaining 26/29 patients affected only on the left side. 13 pelvic lymphadenectomies in patients with prostatic carcinoma T1-3, elevated prostatic acid phosphatase, a PSA > 30 ng/ml and/or a suspected N+ on CT, served to identify 10 pN0 and 3 pN1 patients. Four of the pN0 patients with a T3 tumor were given radiotherapy. Six with a T2 tumor underwent radical prostatectomy, four with margin-negative specimens benefited from laparoscopic lymphadenectomy by securing a curative operation which according to established rules would otherwise have been withheld. Two patients with margin-positive specimens suffered harm from laparoscopic lymphadenectomy, which had led to a needless operation. Another lymphadenectomy performed on one more patient suffering from deep venous thrombosis of the left leg associated with pelvic lymphadenopathy established the benign histology of the enlarged lymph nodes with minimal morbidity. 10 nephrectomies were carried out for benign, clinically relevant lesions of the kidney, which are rare. They produced a clear-cut benefit for all patients as the postoperative morbidity was minimal. We conclude that the present indications for uro-laparoscopic procedures are either disputable or rare.(ABSTRACT TRUNCATED AT 250 WORDS)