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This text explores the history and development of the many technologies that have led to how we treat contemporary urologic problems. From the development of the cystoscope, the advances in laparoscopy, the birth of the field of endourology, to the era of robotics today, urologists have pushed the envelope in technologic innovation. The editors highlight the development of the cystoscope and the early tools used to treat ureteral stones, the development of ureteroscopy, and the applications of lasers and shock wave lithotripsy in the treatment of urolithiasis. Furthermore, they explore the history of minimally invasive treatments in urologic oncology from the story behind the first laparoscopic nephrectomy, the application of hand-assisted technology to the development of robotics and percutaneous treatment approaches (radiofrequency ablation and cryoablation). As the field of urology continues to evolve, urologists will continue to look to the future with the recent applications of histotripsy and regenerative medicine. This text chronicles the creativity, innovation and discovery of the developments of the instruments that allow to practice urology today, as well as glimpse what the future of urology holds.
Technology seems to be an integral part of modern living. Urologists have over the years embraced new technological advances for patient beneft. On some occasions, however, the initial enthusiasm in something new has failed to endure rigorous scientifc scrutiny. Thus, while being technological leaders, we urologists know better than most other surgical speci- ties that what is new is not necessarily good. This textbook is aimed at urologists and surgeons at all levels and has contributions from international experts. The topics vary from robotics to lasers to single port laparoscopy. The comprehensive chapters should be of equal interest to uro-oncologists and those involved in treating benign urological diseases. While the contents are meant to bring the reader up to date with technological advances, the authors have attempted to balance their enthusiasm with basic science, translational research, and clinical outcomes. It will be obvious that some of the s- jects mentioned here, such as nanotechnology, are still evolving, and it will be a while before they undergo clinical trials that establish their position in clinical medicine. We hope you enjoy reading this book as much as we have enjoyed creating it. London, UK Prof. Prokar Dasgupta Dublin, Ireland Prof. John Fitzpatrick London, UK Prof. Roger Kirby CA, USA Prof. Inderbir S. Gill vii Acknowledgements The editors thank all authors for their time and valuable contributions. We are also grateful to our developmental editors Joni Fraser and Barbara Lopez-Lucio.
The introduction of lasers into operative medicine and advances in fiberoptic technology have made a significant contribution to minimally invasive surgery. This book was written to raise awareness of the capabilities and advant ages of lasers in urological surgery and to make this tech nology more widely accessible. The book reflects the cumulative experience of 25 years of laser research and clinical application, starting in 1972 with studies on laser tissue interactions, endoscopic studies with fiberoptic "sutures;' and the first clinical use of lasers in 1975 and 1976. These early efforts were followed by the develop ment oflaser lithotripsy in the early 1980 s and a Lubeck based research program leading to the development of a "smart" laser lithotriptor (Lithognost) in the late 1980s. There have been recent advances in the field of photo dynamic diagnosis based on the use of locally adminis tered photo sensitizers, a development that will redefine the role of the Nd:YAG laser in the treatment of bladder cancer. Perhaps the most interesting concept is the inter stitiallaser therapy of prostatic hyperplasia and, perhaps one day, certain forms of prostatic cancer. We have also developed a technique, first described in 1986, for the laser treatment of schistosomal bladder lesions. I dedicate this book to the many pioneers oflaser medi cine and to all the colleagues and research assistants who accompanied me on this journey. I cannot name them all; their names can be found in more than 300 publications.
This text explores the history and development of the many technologies that have led to how we treat contemporary urologic problems. From the development of the cystoscope, the advances in laparoscopy, the birth of the field of endourology, to the era of robotics today, urologists have pushed the envelope in technologic innovation. The editors highlight the development of the cystoscope and the early tools used to treat ureteral stones, the development of ureteroscopy, and the applications of lasers and shock wave lithotripsy in the treatment of urolithiasis. Furthermore, they explore the history of minimally invasive treatments in urologic oncology from the story behind the first laparoscopic nephrectomy, the application of hand-assisted technology to the development of robotics and percutaneous treatment approaches (radiofrequency ablation and cryoablation). As the field of urology continues to evolve, urologists will continue to look to the future with the recent applications of histotripsy and regenerative medicine. This text chronicles the creativity, innovation and discovery of the developments of the instruments that allow to practice urology today, as well as glimpse what the future of urology holds.
The use oflasers in clinical practice is increasing rapidly, both in the definitive treatment of disease and in the palliation of symp toms. Consequently, this sixth contribution to the Bloomsbury Series in Clinical Science is particularly timely. It opens with an introduction to the basic physics of lasers and then focuses on the current use of lasers in urological practice, and concludes by reflecting on their potential for the future. Edited, and with several contributions by Tom McNicholas, the book also contains contributions from a number of workers at the National Medical Laser Centre in University College Hos pital. London. Given their ever widening application, there can be little doubt that lasers will be a subject the series will return to again. To date, the series has been concerned with a wide range of topics of fundamental importance in clinical science. It has now gained momentum and future titles continue to reflect its wide sphere of interest. As Series Editor, I would welcome suggestions from readers of topics and issues that could usefully be addressed in the series.