The development of laparoscopic and consequently robotic urological surgery have improved the visual field for the urological surgeon and led to reductions in postoperative pain, reduced convalescence, and improved cosmesis for the patient. Laparoscopy and robotics require video systems and telescopes to produce high-resolution images. Trocars have been developed to access the surgical field together with devices to deliver the insufflating gases. Instruments have been developed to allow for tissue dissection and incision together with haemostatic devices and sealants for control of small diameter vessel bleeding. Clips and staplers are used to control larger diameter vessels. Methods of access and skills training are discussed. Robotic surgery provides three-dimensional vision, greater range of movement, and the lack of tremor. Whether these are real benefits in terms of patient outcome is not yet clear, but the learning curve for robotic surgery does appear to be shorter than for pure laparoscopy.
Three-dimensional printing in urological surgery: What are the possibilities?
