Center for Advanced Urologic Laparoscopy

The Urologic Institute of New Jersey has established the Center for Advanced Laparoscopy in order to provide minimally invasive and laparoscopic alternatives to the following traditionally open surgical procedures. Our doctors have specialty training in performing highly complex operations such as laparoscopic removal of kidneys, adrenal glands and prostate glands.

Our doctors belong to a hand-full of surgeons in New York/New Jersey Metropolitan to have successfully performed laparoscopic cystectomy (removing the bladder for cancer), ureterolithotomy (removing impacted ureteral stones), ureterolysis (digging out ureters from scars to improve kidney outlet drainage), and pyeloplasty with concomitant pyelolithotomy (removing kidney stones and correcting kidney outlet obstruction at the same time), as well as complex and advanced laparoscopic adrenal and renal surgery in patients with multiple and anomalous vasculature, obesity, and those with prior surgery.

The institute offers both transperitoneal (thru the abdomen) and retroperitoneal (behind the abdominal contents) approaches depending on the condition being treated. Patients, who have laparoscopic surgery generally experience less pain, have a quicker recovery and less risk of infection than those who have traditional open surgery.


What is Laparoscopy?


How are laparoscopic procedures performed?

What urologic conditions can be treated using laparoscopic surgery?

What are the benefits of laparoscopy?

What are the risks of laparoscopic surgery?

Who are not good candidates for laparoscopic surgery?


What is Laparoscopy?

Laparoscopy is a technique of performing a surgical operation using instruments inserted through narrow hollow tubes ('ports') rather than through a larger incision, as in traditional surgery. Laparoscopy is a minimally invasive alternative to standard open surgery in which a special camera called a laparoscope is used to produce an inside view of the abdominal cavity. Surgeons use the laparoscope, which transmits a true picture of the internal organs onto a video monitor, to guide them through surgical procedures. The laparoscope magnifies these images many times their actual size, providing surgeons with a better view of the abdomen than with standard open surgery. Laparoscopy often results in shorter hospitalization and earlier convalescence, less bleeding and post-operative pain and fewer wound complications.

How are laparoscopic procedures performed?

During laparoscopy, 3 or 4 small (1/2-inch) incisions are made in the abdomen. Carbon dioxide is passed through one of the incisions into the abdomen to enlarge the cavity and lift the abdominal wall away from the organs. This creates more operating space, making it easier to manipulate the abdominal organs. The pencil-thin laparoscope and surgical instruments are then inserted through the other incisions. Sometimes, a hand is inserted thru a small (6-7cm) incision to facilitate dissection in difficult cases.

  Laparoscopy Open Surgery
Incision Either 3 or 4 small incisions (less than 1 inch) in the abdomen A 6 to 10 inch incision in the abdomen; may require removal of part of one rib
Length of hospital stay 1 to 2 days 3 to 5 days
Recovery Less bleeding & scarring after surgery.
Less pain
Increased scarring after surgery
More pain
Return to normal activity 2 to 4 weeks 8 to 12 weeks


What urologic conditions can be treated using laparoscopic surgery
at our institution?


Adrenalectomy
Partial adrenalectomy
Radical nephrectomy for cancer
Radical nephroureterectomy for cancer
Simple nephrectomy
Partial nephrectomy for cancer
Renal cryoablation (freezing renal cancers in the elderly)
Calyceal diverticulectomy
Renal cyst excision
Pyeloplasty
Ureteral surgery
Large ureteral stone
Female urinary incontinence
Vaginal prolapse
Pelvic lymph node dissection
Undescended testis
Retroperitoneal lymph node dissection for testicular cancer
Radical prostatectomy for prostate cancer
Radical cystoprostatectomy and urinary diversion for bladder cancer



What are the benefits of laparoscopy?

Patients who have laparoscopic surgery generally experience less pain, have a quicker recovery and less risk of infection than those who have traditional open surgery. Because the incisions are small, laparoscopic surgery produces less bleeding and scarring, reduced post-operative pain and shorter hospital stays, and patients experience a quicker return to normal eating habits and daily activities. (See chart below).

What are the risks of laparoscopic surgery?

As with all surgical procedures, there is a small risk of complications. A physician will complete a preoperative evaluation to ensure that the procedure is appropriate for you. However, in a small percentage of cases, even approved laparoscopic procedures may be converted to open procedures.
Reasons for conversion to an open procedure may include:
A significant complication during surgery If the operation is not proceeding as smoothly as the surgeon would like it to.

Who are not good candidates for laparoscopic surgery?

Most people are eligible for laparoscopic surgery. However, you may not qualify for the procedure if you have had multiple previous abdominal surgeries.

Video and Publication Citations:

Relevant Videos:
    Video: Robotic-assisted laparoscopic pyeloplasty with concomitant laparo-endoscopic pyelolithotomy
    of calyceal calculi
    .
    Ilbeigi P, lovallo GG, bhalla RS, sawczuk IS, munver R
    Awarded HONORABLE MENTION and the ANNUAL AUDIO VISUAL AWARD
    Production November 2005

    Video: Evaluation of the laparoscopic LigaSure Vessel-sealing system during Laparoscopic Adrenalectomy.
    Ilbeigi P, Lombardo SA, Munver R.
    Production October 2005

    Video: Laparoscopic Pyelo-Ureterolithotomy
    Ilbeigi P, Dakwar G, Rome S, Bhalla RS
    Production August 2006

    Video: Laparoscopic Ureterolysis for retroperitoneal fibrosis
    Description of techniqueIlbeigi P, Dakwar G, Rome S.
    Production: August 2006

    Video: Transurethral Cystolitholapaxy Made Simple
    Ilbeigi P, Brison DI, Sadeghi-Nejad H, Jordan M.
    Production: June 2006

Relevant Publications:

    1. Ilbeigi P, Munver R; Advanced hand-assisted laparoscopy: The new standard of care. Contemporary Urology. April 2006. Cover Manuscript

    2. Esposito M, Ilbeigi P, Ahmed M, Lanteri V; Use of the fourth arm in the da Vinci robot-assisted extraperitoneal laparoscopic prostatectomy: novel technique. Urology 2005, Sep:66(3):649-52.

    3. Ilbeigi P, Volfson IA, Lombardo SA, Munver R; Minimizing complications during laparoscopic extirpative renal surgery in the setting of complex anatomy or anomalous renal vasculature. J Endourol 2005, Aug: 19(Supp): A41.

    4. Ilbeigi P, Volfson IA, Munver R; Evaluation of the laparoscopic Ligasure™ vessel-sealing system during laparoscopic adrenalectomy. J Endourol 2005, Aug: 19(Supp): A163.

    5. Ilbeigi P, Lovallo GG, Bhalla RS, Sawczuk IS, Munver R; Robotic-assisted laparoscopic pyeloplasty with concomitant laparo-endoscopic pyelolithotomy of calyceal calculi. J Endourol 2005, Aug: 19(Supp): A270.