EAU 2013 - Programme Book - YouMed

ESU Courses, 17 March
ESU Course 9
08.30 - 11.30 Advanced course on upper tract laparoscopy (UPJ, adrenal and
stones)
Green Hall 3 - Level N-1
Chair: G. Janetschek, Salzburg (AT)
Transperitoneal approach to the kidney and adrenal gland: Standard technique and modifications
G. Janetschek, Salzburg (AT)
Retroperitoneoscopy: Lateral and posterior approach
F. Porpiglia, Turin (IT)
Dismembered pyeloplasty: Technique, problems, complications
H. Baumert, Paris (FR)
Non-dismembered pyeloplasty: Indication, technique
G. Janetschek, Salzburg (AT)
Adrenalectomy
H. Baumert, Paris (FR)
Partial adrenalectomy
G. Janetschek, Salzburg (AT)
Stone surgery
F. Porpiglia, Turin (IT)
Questions and discussion
Faculty
Aims and objectives
Surgery of the kidney and adrenal gland by means of laparoscopy has become standard of care. Most
frequently this surgery is performed transperitoneally; this approach has been standardized. However, the
anatomy of the right and left side differs substantially which has to be taken into consideration. Also several
modifications have been developed such as a direct approach to the left renal pelvis through the colonic
mesentery. Retroperitoneoscopy is an alternative which should be mastered as well.
Adrenalectomy was the first widely recognized indication for laparoscopy in urology, and open surgery
has almost vanished for this indication. Partial adrenalectomy may be considered as an alternative
in benign solitary tumours such as Conn adenoma but is strongly recommended in familial bilateral
pheochromocytoma.
For the treatment of UPJ obstruction laparoscopy has to compete with both open surgery and endopyelotomy.
Compared to open surgery the results are the same but morbidity is lower. Morbidity of endopyelotomy is
lower, however, but the results are not as good in the long-term. The technique of dismembered and nondismembered
pyeloplasty will be discussed in detail.
Laparoscopic stone surgery is usually not a first line therapy. In specific situations it may be helpful,
however.
EAU Milan 2013
329
ESU Courses