| Basic Aspects | |
| Technical Aspects of Pneumoperitoneum and Gasless Laparoscopy | |
| Laparoscopy with Pneumoperitoneum | p. 3 |
| Gas | p. 3 |
| Gas Pressure | p. 5 |
| Complications of Laparoscopy with Pneumoperitoneum | p. 7 |
| Laparoscopic Surgery Without Pneumoperitoneum | p. 9 |
| Intra-abdominal Retraction Systems | p. 10 |
| Subcutaneous Retraction Systems | p. 14 |
| References | p. 17 |
| Equipment and Strategies of Staging Laparoscopy | |
| Historical Perspective | p. 19 |
| Set-Up and Equipment | p. 20 |
| Future Directions | p. 25 |
| References | p. 26 |
| Pathophysiological Aspects of the Pneumoperitoneum | |
| Historical Aspects | p. 27 |
| Complications During Laparoscopic Procedures | p. 28 |
| Changes in Hepatoportal Blood Flow | p. 29 |
| Changes in Renal Blood Flow and Function | p. 30 |
| Alterations of the Cardiopulmonary System | p. 31 |
| Hemodynamic Changes to the Lower Limbs | p. 35 |
| References | p. 37 |
| Risk of Port Site Metastases | |
| Literature Review | p. 41 |
| International Survey | p. 43 |
| Metastases of Nonapparent Gallbladder Cancer | p. 44 |
| Metastases of Colorectal Cancer | p. 45 |
| Metastases of Other Carcinomas | p. 45 |
| Discussion | p. 46 |
| References | p. 49 |
| Results and Strategies of Clinical Applications: Gastrointestinal Tract | |
| Staging Laparoscopy for Esophageal Cancer | |
| Introduction | p. 55 |
| General Therapeutic Approach to Esophageal Cancer | p. 56 |
| Staging Methods and Requirements | p. 56 |
| Operative Technique of Staging Laparoscopy for Esophageal Cancer | p. 58 |
| The Sequence of Explorative Steps | p. 59 |
| Regions of Interest | p. 62 |
| Assessment of Resectability | p. 62 |
| Assessment of Visuable Lesions | p. 62 |
| Peritoneal Spread | p. 62 |
| Assessment of Nonvisuable Lesions | p. 63 |
| Lymph Node Metastases | p. 63 |
| Liver | p. 63 |
| References | p. 65 |
| The Role of Laparoscopy in the Staging of Gastric Cancer | |
| Introduction | p. 69 |
| Technique | p. 70 |
| Results | p. 71 |
| Hospital Stay, Morbidity, and Mortality | p. 71 |
| Economic Considerations | p. 71 |
| Distal Esophagus and Gastroesophageal Junction | p. 72 |
| T Stage (category) | p. 72 |
| N Stage (category) | p. 72 |
| M Stage (category) | p. 73 |
| Distal Cancers | p. 74 |
| Resectability | p. 74 |
| T Stage (category) | p. 74 |
| N Stage (category) | p. 75 |
| M Stage (category) | p. 75 |
| Peritoneal Cytology | p. 77 |
| Optimal Staging Technique in Gastric Cancer | p. 77 |
| The Effect of Laparoscopic Staging on Tumor Management | p. 78 |
| Conclusions | p. 79 |
| References | p. 80 |
| Extended Diagnostic Laparoscopy in Gastric Cancer | |
| Introduction | p. 83 |
| Indication for EDL in Gastric Cancer | p. 84 |
| Technique | p. 84 |
| Practical Aspects of EDL | p. 89 |
| Diagnostic Yield of EDL | p. 89 |
| Modification of the Tumor Stage by Laparoscopy | p. 89 |
| Inspection of the Lesser Sac | p. 90 |
| Laparoscopic Ultrasound | p. 90 |
| Detection of Liver Metastases | p. 90 |
| Assessment of Peritoneal Spread | p. 90 |
| Infliction of Adjacent Organs | p. 90 |
| Comparison of Prelaparoscopic and Laparoscopic Staging with Intraoperative Findings | p. 92 |
| Discussion | p. 92 |
| References | p. 94 |
| Laparoscopic Staging for Pancreatic Malignancy | |
| Introduction | p. 97 |
| Goal of Laparoscopic Staging | p. 97 |
| The Role of CT in the Staging of Pancreatic Malignancy | p. 97 |
| The Early Experience with Laparoscopy for Pancreatic Malignancy | p. 100 |
| The Memorial Sloan-Kettering Experience | p. 100 |
| Management Algorithm | p. 100 |
| The Technique of Extended Laparoscopic Staging | p. 101 |
| Laparoscopic Ultrasound | p. 105 |
| Palliative Bypass | p. 106 |
| Is There a Role for Prophylactic Bypass? | p. 107 |
| Length of Stay | p. 107 |
| Cost of Laparoscopic Staging | p. 107 |
| Summary | p. 108 |
| References | p. 108 |
| Laparoscopic Ultrasonography for Staging of Gastrointestinal Cancer | |
| Introduction | p. 113 |
| Equipment | p. 114 |
| Examination Technique | p. 116 |
| Results | p. 117 |
| Gastroesophageal Cancer | p. 117 |
| Pancreatic Cancer | p. 119 |
| Hepatic Metastases and Hepatocellular Carcinoma | p. 121 |
| Summary | p. 122 |
| References | p. 123 |
| Further Results and Strategies of Clinical Application | |
| Contribution to Initial Staging and Assessment of Treatment Results in Gynecologic Cancers | |
| Overview | p. 127 |
| Ovarian Neoplasms | p. 127 |
| Adnexal Mass | p. 127 |
| Preoperative Evaluation | p. 128 |
| Reproductive-Age Patients | p. 129 |
| Postmenopausal Patients | p. 131 |
| Second-Look Laparoscopy | p. 132 |
| Cervical Neoplasms | p. 133 |
| Laparoscopy in the Treatment of Early-Stage Disease | p. 133 |
| Laparoscopically Assisted Radical Vaginal Hysterectomy | p. 134 |
| Laparoscopic Radical Hysterectomy | p. 135 |
| Laparoscopic Staging of Advanced-Stage Disease | p. 136 |
| Endometrial Neoplasms | p. 137 |
| Laparoscopically Assisted Surgical Staging | p. 137 |
| Complications | p. 139 |
| Conclusion | p. 140 |
| References | p. 141 |
| Indications in Urologic Tumors | |
| Laparoscopy in Urologic Oncology | p. 145 |
| Introduction | p. 145 |
| Laparoscopy and Prostate Cancer | p. 145 |
| Laparoscopic Node Dissection: Applications in Other Malignancies | p. 147 |
| Testicular Cancer | p. 148 |
| Laparoscopy and the Kidney | p. 148 |
| References | p. 150 |
| Is There Any Role for the Laparoscopic Staging of Urologic Malignancies? | |
| Introduction | p. 153 |
| Prostate Cancer | p. 154 |
| Technique of Laparoscopic Pelvic Lymphadenectomy | p. 155 |
| Testicular Cancer | p. 156 |
| Technique of Laparoscopic Retroperitoneal Lymphadenectomy | p. 157 |
| Role of Laparoscopy for Staging of Transitional Cell Carcinoma of the Bladder and Upper Urinary Tract | p. 157 |
| Renal Cancer | p. 158 |
| Penile Cancer | p. 159 |
| Discussion | p. 161 |
| Role of Laparoscopy for Staging of Prostate Cancer | p. 161 |
| Role of Laparoscopy for Staging of Testicular Cancer | p. 163 |
| Role of Laparoscopy for Staging of Transitional Cell Carcinoma of the Bladder and Upper Urinary Tract | p. 164 |
| Conclusions | p. 165 |
| References | p. 166 |
| Impact of Laparoscopy in Malignant Lymphomas | |
| Introduction and Background | p. 169 |
| Role of Laparoscopy in Diagnosis | p. 170 |
| Laparoscopic Biopsy After Previous Attempts | p. 171 |
| Staging | p. 172 |
| Residual Disease | p. 173 |
| Impact on Treatment | p. 173 |
| Technical Aspects | p. 174 |
| Conclusion and Future Directions | p. 176 |
| References | p. 177 |
| Subject Index | p. 179 |
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