[Laparoscopic approach through optic trocars]

Laparoscopy has not reached the same levels of development in Urology as it has in other surgical specialties. Consequently, the average urologist is not sufficiently accustomed to using laparoscopic trocars, a difficulty which becomes even more noteworthy since treatment is occasionally preferably by the extraperitoneal approach (preperitoneoscopy and retroperitoneoscopy). Our experience with different visualizing trocars is presented.

We reviewed our experience with different visualizing trocars. The advantages and inconveniences of each type, utilized in different approaches, are discussed.

Active visualizing trocars are preferred because they are safe and permit pre and retroperitoneal blunt dissection without difficulty. However, cost is the major disadvantage of these instruments because they are not reusable.

Lately, we are more inclined to utilize the reusable visualizing trocars with the helicoidal cannula, which are very safe for the transperitoneal and perhaps slightly less for the extraperitoneal approach. These instruments cause less injury when they go through the abdominal wall and, furthermore, they cost less.