Abstract: Laparoscopic pelvic lymphadenectomy has become increasingly of interest to Urologists in staging patients not only with prostatic carcinoma but for those patients suffering with carcinoma of the bladder. It also allows access for therapeutic treatment such as treatment of varicoceles and laser phototherapy for transmural coagulation of bladder cancers. Lasers have proven extremely better in allowing surgical incisions through the laparoscope and coagulation of bleeders. Both the KTP and Neodymium Yag Laser have been used for this purpose. The KTP Laser has distinct advantages in that it allows 1) flexible fiber easily used through laparoscopes, 2) the ability to coagulate and cut retroperitoneal tissue, and 3) seal lymphatics when lymph nodes are removed. The KTP fiber can be used to incise the retroperitoneum to expose the lymph node tissue. Grasping the lymph nodes with forceps, the laser can excise and coagulate the proximal and lymphatic channels. The laser fiber will not experience carbonization as can occur with the Yag Laser fiber unless a contact tip sapphire end is utilized. The KTP's laser fiber ability to give coagulation and ablation of tissue through a liquid medium allow it to be an excellent choice for laparoscopic pelvic lymphadenectomy.!
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