Laparoscopy refers to surgery that is done by using instruments inserted into the body through a tiny incision. A camera attached to a small telescope inserted through another tiny incision provides visualization for the surgeon.
This is one technique in a field that is now called minimally invasive surgery, or surgery that seeks to minimize the size of incisions as well as the manipulation of tissues necessary during conventional surgery. The major benefits in general are decreased blood loss, decreased postoperative pain, and an earlier return to work or normal activity.
Over the last 10 years, dramatic improvements in instruments and technique have allowed surgeons to perform virtually every type of surgery using a laparoscope. The first widespread use of the technique was to remove the gallbladder.
Laparoscopic gallbladder removal can now be performed quickly and safely and is cost-effective for the healthcare system. This procedure is, however, relatively easy from a surgical standpoint. As more complicated procedures have been performed laparoscopically, questions have arisen as to their safety, speed, and cost.
In surgery performed for cancer, questions arise as to whether the procedure can remove the cancer as effectively as traditional surgery. The answers to these questions for most procedures are that they are similar in safety, moderately to dramatically slower, and moderately more expensive. The cancer outcomes so far have been similar. Laparoscopy in bladder cancer remains an experimental procedure at this point, although it is being done successfully at some centers. Only a specialized, highly skilled laparoscopic urologist should per-form the procedure at this time.