Laparoscopy – less invasive operative technic alowing to manipulate inside human body withe the access by the transperitoneal manner. All organs located inside the intraperitoneal space are directly accessible with laparoscopy, whereas extraperitoneal ones shoud be extracted from within.
Retroperitoneoscopy – a little bit different technic comparing to laparoscopy, because during retroperitoneoscopy direct access to extraperitoneally located organs (kidneys, suprarenal glands, bladder, prostate) is gained with intraperitoneally located organs (intestine, gut, liver, spleen) intact. Such difference keeps the intraperitoneal organs without risk of injury, recovery is quicker, but the technic is slightly more difficult because of less free space to proceed with surgery.
The goal of laparo/retroperitoneoscopy is to work inside human body with the aim of the scope, organs of surgeon`s interest are managed with thin, long surgical tools introduced through the skin by so called “ports” – small cuts 5-15mm in lenght. The amount of ports is determined by difficulty and complexity of the procedure, usually 3-5. To proceed inside the body with the scope, the cavity shoud be filled with gas (carbon dioxide) allowing free manipulation inside. After extracting of sick organ, it shoud be removed outside the body, dependig on ones dimensions surgeon makes smaller or bigger cutting on the skin, usually lenghtening one of the port`s cut to put out the extracted tissue previously closed in specjal kind of plastic bag inside the body. After tissue removal, extracted organ`s bed is controlled for accidental bleeding and if there is no doubt, the trockars are removed and wounds closed with surgical sutures. As to destructive procedures the reconstructive ones look similarily, with the difference there is no need to remove anything outside. In almost all lap procedures the drain is left close to the extraction/reconstruction place to pipe out some blood or extravasations from nearby, urethral catheter is usually left inside the bladder for few days, sometimes at the operative day some other catheters are introduced like ureteral ones.
Recovery is usually quick with low pain feeling, patient leaves the department on the second, third postop day, seldom with any drain.