The use of laparoscopy or minimal access surgery has become more widespread in urology in the last 15 years. The current applications for laparoscopy are mainly in renal (kidney) and prostate surgery. It is now my preferred choice in the operative treatment of kidney cancer for tumours up to 10 cm in diameter, provided there are no other contraindications. Not every one is suitable for a laparoscopic approach and the decision to have laparoscopic or open surgery is discussed fully preoperatively. The recovery time is much quicker following this laparoscopic kidney surgery, and current studies indicate equivalent cancer cure and control rates to open surgery. The surgery takes between 120 and 180 minutes, similar to that for open surgery.
In prostate cancer, the case for laparoscopy and particularly robotic assisted laparoscopy is evident now. The data from international groups show while there is no major improvement in continence and erectile dysfunction rates compared to open surgery, intraoperative blood loss is reduced. The length of time needing a catheter tube post op is unchanged. The length of operation time is around the same with robotic surgery, but the time to discharge from hospital is less and return to work and recovery are much quicker for robotic surgery. Robotic equipment is of high capital costs to hospital, and there can be significant extra out of pocket expenses due to this.