Laparoscopy, also known as keyhole surgery, refers to a minimally invasive surgical procedure; that is performed using a laparoscope, a small fibreoptic instrument with a connected camera and lens.
This small telescope is equipped with a built-in magnification mechanism. During the surgery, different types of surgical instruments are inserted through small incisions made in the skin. Laparoscopy offers several diagnostic and therapeutic benefits, just like traditional open surgery. It also has significantly reduced postoperative pain, ensures a shorter hospitalisation, speedier recovery, and produces far better cosmetic results.
Today, rapid advancements in the field of medicine and technology have enabled us to perform laparoscopic surgeries for the treatment of different types of urological conditions.
Laparoscopic Pyeloplasty is a minimally invasive surgical procedure used to correct a condition called ureteropelvic junction (UPJ) obstruction — a blockage where the ureter (tube that carries urine from the kidney to the bladder) meets the renal pelvis (part of the kidney that collects urine).
Relieve urine flow obstruction
Preserve kidney function
Relieve pain, infection, or swelling (hydronephrosis)
Congenital (present at birth)
Scar tissue from previous surgery or infection
Blood vessels crossing and compressing the ureter
Kidney stones (less commonly)
General anesthesia is given.
3–4 small incisions are made in the abdomen or flank.
A laparoscope (tiny camera) and instruments are inserted.
The surgeon:
Cuts out the narrowed or blocked segment
Reconnects the healthy ureter to the renal pelvis (reconstruction)
A temporary stent may be placed in the ureter to ensure proper healing and urine drainage.
Incisions are closed; the patient usually stays in the hospital for 1–2 days.
Flank or back pain (especially after fluid intake)
Urinary tract infections (UTIs)
Blood in the urine
Nausea or vomiting
Poor kidney function or swelling seen on imaging
Smaller incisions
Less pain
Shorter hospital stay
Faster recovery
Similar long-term success rates (~90–95%)
Laparoscopic Ureteric Reimplantation is a minimally invasive surgical procedure used to reposition (reimplant) the ureter into the bladder. It is typically done to correct problems such as:
Vesicoureteral Reflux (VUR) – a condition where urine flows backward from the bladder into the ureters/kidneys, increasing the risk of infection and kidney damage.
Ureteral obstruction or stricture – narrowing of the ureter near its junction with the bladder, leading to poor drainage and hydronephrosis.
Ureteral injury – often after pelvic surgeries (e.g., hysterectomy) or trauma.
Ectopic ureter – when the ureter inserts into the wrong part of the urinary tract (more common in children).
The patient is placed under general anesthesia.
3–5 small incisions are made in the lower abdomen.
A laparoscope (camera) and surgical instruments are inserted.
The surgeon:
Locates the ureter
Cuts it from its abnormal or damaged insertion point
Reimplants it into a better position in the bladder
May create a tunnel within the bladder wall to prevent reflux (anti-reflux mechanism)
A temporary stent may be placed to help the ureter heal and ensure urine flows properly.
Hospital stay: 1–3 days
Ureteral stent: Removed after a few weeks
Return to normal activity: 2–4 weeks
Success rate: Over 90% in most cases
Children (most often for reflux or congenital problems)
Adults (often due to injury, scarring, or tumors affecting the ureter-bladder junction)
Less postoperative pain
Smaller incisions and scars
Shorter hospital stay
Quicker recovery
Laparoscopic VVF Repair refers to a minimally invasive surgical procedure used to repair a vesicovaginal fistula (VVF) — an abnormal connection between the bladder and the vagina that causes continuous leakage of urine through the vagina.
Constant urinary incontinence
Vaginal irritation
Recurrent infections
Social and psychological distress
Gynecologic surgeries (most common in developed countries), especially hysterectomy
Prolonged obstructed labor (common cause in developing countries)
Radiation therapy for pelvic cancer
Pelvic trauma
Cancer or infection
General anesthesia is administered.
3–4 small incisions are made in the lower abdomen.
A laparoscope (camera) and instruments are inserted.
The surgeon:
Identifies the fistula tract
Carefully dissects and separates the bladder from the vagina
Closes the fistula from both the bladder and vaginal sides (usually in layers)
Sometimes places a tissue flap (e.g., omental flap) between the bladder and vagina to prevent recurrence
A urinary catheter is placed for 10–14 days to allow healing.
Less pain
Minimal blood loss
Shorter hospital stay
Quicker return to normal activities
Comparable success rate to open surgery (typically 85–95%)
Transvaginal repair – often used for small, low-lying fistulas
Open abdominal repair – used for large or complex fistulas
Robotic-assisted repair – for added precision
Hospital stay: 2–3 days
Catheter removal: 1–2 weeks post-op
Return to normal activities: 2–4 weeks
Full healing: 6–8 weeks
Laparoscopic Ureterolithotomy is a minimally invasive surgical procedure used to remove large or impacted stones (calculi) from the ureter, especially when other less invasive treatments fail or are not feasible.
Is too large to pass naturally (usually >1.5–2 cm)
Fails to respond to shock wave lithotripsy (SWL) or ureteroscopy
Causes obstruction, infection, or severe pain
Is impacted (stuck) in the ureter for a long time
Is in a location where endoscopic access is difficult (e.g., upper ureter)
The patient is placed under general anesthesia.
3–4 small incisions are made in the abdomen or flank.
A laparoscope (camera) and surgical instruments are inserted.
The surgeon locates the ureter and:
Makes an incision directly over the stone (ureterotomy)
Removes the stone
Closes the ureter with fine sutures
A ureteral stent is often placed to ensure proper urine drainage and help healing.
Hospital stay: 2–4 days
Catheter and stent may remain for 1–2 weeks
Return to normal activity: ~2–3 weeks
High success rate (>95% for stone removal)
Effective for large or complex stones
Minimally invasive (vs. open ureterolithotomy)
Less postoperative pain
Shorter recovery time
Bleeding
Urine leak
Ureteral stricture (scar tissue causing narrowing)
Infection
Procedure |
Best For |
Invasiveness |
Notes |
|---|---|---|---|
| Laparoscopic Ureterolithotomy | Large or impacted stones | Moderate | Used when other methods fail |
| Ureteroscopy + Laser | Small to moderate stones | Minimally | Common first-line treatment |
| Shock Wave Lithotripsy (SWL) | Small, non-impacted stones | Non-invasive | Success varies by size and location |
Laparoscopic Orchidopexy is a minimally invasive surgical procedure used to locate and reposition an undescended testicle (also called cryptorchidism) into the scrotum. It's commonly performed in children, but may also be done in adolescents or adults in rare cases.
A condition where one or both testicles fail to descend into the scrotum before birth.
Affects about 1–3% of full-term male infants.
If untreated, it can lead to:
Infertility
Increased risk of testicular cancer
Hernia
Psychological or cosmetic concerns
Laparoscopic orchidopexy is typically used when the undescended testis is non-palpable, meaning it cannot be felt on physical examination. These testicles are usually:
In the abdomen
Occasionally absent (atrophic or vanishing testis)
General anesthesia is given.
3 small incisions are made in the abdomen.
A laparoscope (camera) is inserted to locate the testicle.
Depending on its location:
The testicle is mobilized and brought down into the scrotum.
It is fixed (sutured) in a pouch in the scrotum (orchidopexy).
If the testicle is too high or the blood vessels are short, a two-stage Fowler-Stephens procedure may be done.
If the testicle is non-functional or very small, it may be removed (orchidectomy).
Usually outpatient surgery
Full recovery in 1–2 weeks
High success rate (90–95%)
Most children resume normal activity quickly
Small incisions, better cosmetic resultc
Clear visualization of abdominal structures
Can confirm presence or absence of testis
Less postoperative pain and quicker recovery than open surgery
Ideally done between 6–18 months of age for best long-term outcomes
If both testes are undescended, endocrine evaluation may be needed
Laparoscopic Radical Nephrectomy is a minimally invasive surgical procedure used to remove an entire kidney, typically due to kidney cancer or other serious kidney diseases.
Radical = complete removal
Nephrectomy = removal of the kidney
So, a radical nephrectomy involves removing:
The entire kidney
The adrenal gland (in some cases)
Surrounding fatty tissue
Sometimes nearby lymph nodes
It refers to a minimally invasive technique using small incisions and a camera (laparoscope).
The surgeon uses special instruments inserted through these incisions to perform the surgery.
Compared to open surgery, it usually results in:
Less pain
Smaller scars
Shorter hospital stay
Faster recovery
Renal cell carcinoma (kidney cancer)
Large or complex benign tumorsc
General anaesthesia is administered.
3–5 small incisions are made in the abdomen.
A laparoscope (camera) is inserted to guide the surgery.
The kidney and surrounding structures are detached and removed, usually through one slightly larger incision.
The incisions are closed.
A simple Nephrectomy refers to the removal of the affected kidney. Laparoscopic nephrectomy is recommended for patients with symptomatic hydronephrosis, chronic infection, polycystic kidney disease, shrunken blocked kidneys, or renal calculus.
Laparoscopic Adrenalectomy is a minimally invasive surgical procedure to remove one or both adrenal glands, which sit above the kidneys and produce important hormones like cortisol, aldosterone, and adrenaline.
This procedure is done using a laparoscope (a thin camera) and specialized instruments inserted through small incisions in the abdomen or flank.
Adrenal tumors, including:
Functioning (hormone-producing) tumors, such as:
Pheochromocytoma – produces excess adrenaline
Aldosteronoma (Conn’s syndrome) – overproduces aldosterone
Cortisol-producing adenoma (Cushing's syndrome)
Non-functioning adrenal masses (usually >4–6 cm or growing)
Adrenocortical carcinoma (in selected cases)
Metastasis from other cancers
General anesthesia is administered.
The surgeon makes 3–5 small incisions in the abdomen or flank.
A laparoscope and surgical tools are inserted.
The adrenal gland is carefully separated from surrounding structures (e.g., kidney, major blood vessels).
The gland is placed in a retrieval bag and removed through one of the incisions.
Incisions are closed; a drain may be placed temporarily.
Transabdominal (most common): through the front or side of the abdomen
Posterior retroperitoneoscopic: through the back, avoiding abdominal organs (good for small tumors)
Smaller incisions, less scarring
Less pain after surgery
Shorter hospital stay (1–3 days)
Faster return to normal activities
Lower risk of infection and complications
Unilateral adrenalectomy: Most common (for tumors on one side)
Bilateral adrenalectomy: Rare; needed in some cases of Cushing’s disease, bilateral tumors, or genetic syndromes
Most patients go home in 1–3 days
Full recovery in 2–4 weeks
Hormonal monitoring continues post-op
If both glands are removed, lifelong hormone replacement is required
Laparoscopic Radical Nephroureterectomy is a minimally invasive surgical procedure in which the entire kidney, ureter, and a portion of the bladder where the ureter inserts (called the bladder cuff) are removed. This surgery is primarily performed to treat upper urinary tract urothelial carcinoma (UTUC) — a type of cancer that affects the lining of the kidney and ureter.
Urothelial carcinoma of the kidney or ureter
High-grade or invasive tumors
Tumors that are not suitable for kidney-sparing treatments
A cancer arising from the urothelium — the lining of the renal pelvis, ureter, and bladder
Similar to bladder cancer but located higher in the urinary tract
Often requires complete removal of the kidney and ureter to prevent recurrence
General anesthesia is administered.
Multiple small incisions are made in the abdomen or flank.
A laparoscope (camera) and instruments are inserted.
The surgeon removes:
The entire kidney
The entire ureter
The bladder cuff (the part of the bladder where the ureter connects)
Lymph nodes may be removed if cancer spread is suspected.
A specimen retrieval bag is used to remove the organs through a slightly larger incision.
Hospital stay: 2–4 days
Catheter: Often left in place for 1–2 weeks
Return to normal activities: 2–4 weeks
Full recovery: 4–6 weeks
Less blood loss
Smaller incisions and better cosmetic results
Shorter hospital stay and faster recovery
Comparable cancer control to open surgery
Procedure |
Scope |
Used For |
|---|---|---|
| Laparoscopic Radical Nephroureterectomy | Kidney + ureter + bladder cuff | UTUC (high-grade) |
| Laparoscopic Nephrectomy | Kidney only | Kidney cancer (renal cell carcinoma) |
| Segmental Ureterectomy | Part of ureter | Low-grade, localized ureteral tumors |
| Endoscopic Resection | Tumor only | Select low-risk, small tumors |
Laparoscopic Radical Cystectomy is a minimally invasive surgery to remove the entire urinary bladder (and nearby tissues/organs) through small abdominal incisions using a laparoscope (a thin camera). It is primarily used to treat muscle-invasive bladder cancer or high-risk non-muscle invasive bladder cancer that has not responded to other treatments.
Muscle-invasive bladder cancer (MIBC)
High-grade non-muscle invasive bladder cancer (NMIBC) unresponsive to BCG therapy
Certain aggressive bladder tumors or large, multifocal tumors
Urinary bladder
Surrounding lymph nodes
Nearby organs, depending on gender:
Prostate
Seminal vesicles
Uterus
Ovaries
Part of the vagina
1. General anesthesia is given.
2. 4–6 small incisions are made.
3. A laparoscope and specialized instruments are inserted.
4. The bladder, surrounding structures, and lymph nodes are carefully removed.
5. A urinary diversion is created to allow urine to exit the body:
Ileal conduit (most common)
Continent urinary reservoir (e.g., Indiana pouch)
Neobladder (a bladder substitute using intestine)
Smaller incisions
Less blood loss
Faster recovery
Less postoperative pain
Shorter hospital stay
Hospital stay: 5–10 days
Full recovery: 6–8 weeks
May require a urinary stoma or learning to self-catheterize, depending on the diversion type
Good long-term cancer control for muscle-invasive bladder cancer
5-year survival varies with cancer stage
Laparoscopic Radical Prostatectomy is a minimally invasive surgical procedure to remove the entire prostate gland along with some surrounding tissue (and sometimes lymph nodes) to treat prostate cancer.
Localized prostate cancer (confined to the prostate)
Some cases of locally advanced prostate cancer
Remove the cancer completely
Preserve urinary control and sexual function if possible
General anesthesia is used.
5–6 small incisions are made in the lower abdomen.
A laparoscope (camera) and long instruments are inserted.
The surgeon:
Removes the entire prostate gland
Removes the seminal vesicles
May also remove nearby lymph nodes
Reconnects the urethra to the bladder (vesicourethral anastomosis)
A urinary catheter is placed temporarily (usually for 7–14 days).
Smaller incisions and less scarring
Less blood loss
Shorter hospital stay (1–2 days)
Faster recovery and return to normal activity
Similar cancer control in early-stage cases
Entire prostate gland
Seminal vesicles
Sometimes surrounding lymph nodes
Nerve-sparing techniques may be used depending on cancer location and patient priorities
1–2 days Hospital stay
1–2 weeks Catheter removal
2–4 weeks Light activity, fatigue common
6+ weeks Return to normal activities
Months Gradual return of urinary control and erectile function
Urinary incontinence (improves over months)
Erectile dysfunction (may improve with time or treatment)
Infection, bleeding, or blood clots
Scar tissue at bladder-urethra junction (rare)
Very effective for localized prostate cancer
PSA levels monitored post-op to detect recurrence
VEIL: Video Endoscopic Inguinal Lymphadenectomy
VEIL is a minimally invasive surgical technique used to remove lymph nodes from the groin (inguinal region) using endoscopic (keyhole) instruments. It’s primarily performed in patients with penile cancer to manage or prevent the spread of cancer to the inguinal lymph nodes.
Stage the cancer (find out how far it has spread)
Treat cancer that may have reached the lymph nodes
Prevent recurrence in high-risk cases
General anesthesia is given.
Small incisions (usually 3) are made in the upper thigh or groin.
A camera (endoscope) and long instruments are inserted under the skin.
The surgeon:
Dissects and removes inguinal lymphatic tissue
Avoids cutting large skin flaps, unlike open surgery
A drain is often left in place temporarily to prevent fluid buildup.
Feature |
VEIL |
Open Lymphadenectomy |
|---|---|---|
| Incisions | Small | Large skin incisions |
| Recovery | Faster | Longer |
| Infection risk | Lower | Higher |
| Wound complications | Fewer | Common (e.g. skin necrosis) |
| Hospital stay | Shorter | Longer |
Hospital stay: Usually 1–3 days
Drain: Removed in 1–2 weeks
Resume light activity in 2–3 weeks
Regular follow-up for cancer surveillance
VEIL is a modern, less invasive option for inguinal lymph node dissection, especially in patients with penile cancer, offering similar cancer control to open surgery with fewer complications.