Urologists at the Lahey Clinic Institute of Urology have earned an international reputation as leaders in the field of minimally invasive urologic surgery. The Institute's progressive environment continues to attract surgeons and residents from around the world who take a special interest in the development of laparoscopic techniques.

While the notion of surgery has changed dramatically with the advent of minimally invasive techniques and robotic technology, a urologist's surgical skill and experience in determining the best course of treatment remains paramount.

At Lahey Clinic, teams of specialists work together to pinpoint the most appropriate surgical approach for each patient. When deemed a viable alternative to open surgery, traditional and robot-assisted laparoscopic methods are preferred. In some cases, however, surgeons may recommend open surgery as the means to the best possible outcome.

Laparoscopic techniques pioneered by director Ingolf Tuerk, MD, PhD, and other members of the Center for Minimally Invasive Urologic Surgery, have had significant impacts on the lives of men and women with urologic cancer.

'Open' versus 'Laparoscopic' Surgery

Over the last decade, advances in technology have allowed surgeons to perform laparoscopic or "keyhole" surgery through tiny incisions, without the surgeon's hand ever entering the abdominal cavity. As a result, operations that previously required large, eight- to ten-inch incisions are now performed through three to four small (0.5 to 1-cm) incisions.

Both traditional and robot-assisted ("keyhole surgery") laparoscopic surgery is performed with the help of an endoscopic camera and several long, thin instruments that enter the body through tiny incisions. At Lahey Clinic, operating rooms contain advanced video, lighting, computer and robotic technology that allow the doctors to view the tools close-up, guide them through the body and monitor the operation in detail on large screens. A specialized videoconferencing system allows for two-way interfacing between operating rooms and physicians' offices, providing opportunities for collaboration and education.

Advantages of Laparoscopy and Robotic Laparoscopy

Advantages for patients:

• Avoidance of a large incision
• Decreased blood loss
• Reduced postoperative pain and discomfort
• Shorter hospital stay
• Faster recovery time
• Improved cosmetic result

Advantage for surgeons:

• Magnification of tissues and structures through the optical system
• Greater precision
• More delicate handling of sensitive structures (i.e. vessels, nerves)

Specialized Surgical Training

Minimally invasive laparoscopic and robotic surgery requires very different skills than traditional open surgeries. In addition to completing traditional surgical residencies and fellowships, Lahey surgeons go through rigorous training in order to perform both traditional and robotic laparoscopy. At the Lahey Clinic MAST (minimal access surgery and technology) Center, laparoscopic techniques are practiced and refined through the use of inanimate surgical training tools.