Professor P.A. Shcheplev, Associate Professor Z.A. Kadyrov, Federal State Institution Clinical Hospital of the Presidential Administration of the Russian Federation. Over the past two decades, laparoscopic procedures have become widely used in the surgical treatment of urological patients. Consequently, a new approach to urological surgery, commonly referred to as urological laparoscopic surgery, has emerged. This approach is gradually replacing many open surgeries that have been performed for centuries. Minimally invasive techniques in urology, and in medicine in general, are appealing not only to physicians but also to patients. Particularly noteworthy is the improved quality of life for patients in the postoperative period, where they report minimal pain, a short hospital stay, and a rapid recovery. However, this approach is distinctly different from traditional surgical treatment and requires specific costs and training for both specialists and patients. One of the primary differences between laparoscopic and surgical techniques is the way the surgeon obtains anatomical information regarding the location of the surgical site. Laparoscopic surgery involves performing surgery on the kidneys and ureters in the retroperitoneal space through the abdomen via punctures. This is a relatively new area of ??modern urology. The main feature of laparoscopic surgery is that all procedures are performed virtually without incisions – through small punctures in the skin (using instruments 5 and 10 mm in diameter) under television control. The surgeon inserts instruments through the abdomen, opens the peritoneum, and then enters the retroperitoneal space, where the kidney, ureter, and their vessels are located. The working space is created by introducing carbon dioxide (a safe gas) into the abdomen. Today, the advantages of laparoscopic treatment of many urological diseases over the traditional open approach are undeniable. Reduced surgical trauma, shorter hospital stays, shorter recovery times, and a quick return to normal life are just a few of the advantages of these procedures. As Figure 1 shows, the number of laparoscopic procedures is steadily increasing worldwide. [ /upload/medialibrary/e98/Laparoscopy_grafik.jpg ] Fig. 1. Dynamics of growth in the number of laparoscopic surgeries according to global statistics. For the first time, surgeons used a cystoscope for laparoscopy. Laparoscopy began to be performed in the 70s for the diagnosis of urological diseases, such as abdominal cryptorchidism, hydronephrosis, kidney cancer, solitary cysts, polycystic kidney disease. In the late 80s, laparoscopic procedures such as pelvic lymphadenectomy and ligation of varicose veins of the testicle were mastered. In the early 90s, new technologies were developed that allow for nephrectomy, ureterolithotomy, cyst resection, cystectomy, etc. Despite the short period of their use, today it is difficult to list urological diseases that would not be performed using this method. Moreover, in many clinics, laparoscopic surgeries for varicocele, abdominal cryptorchidism, secondary contracted kidney, urinary incontinence in women, and pelvic lymphadenectomy for prostate cancer are used as the method of choice. Laparoscopic surgeries require general anesthesia, requiring complete patient relaxation. Since postoperative wounds are minor, patients can be discharged from the hospital 3-5 days after surgery in most cases. Today, it is difficult not to list the urological surgeries that are not performed using this method. [ /upload/medialibrary/168/Laparoscopy_urology5.jpg ] The most important of them are: Nephrectomy – removal of a contracted kidney or tumors. Adrenalectomy – removal of the adrenal gland in benign and malignant processes. Excision of renal cysts, especially multi-chambered, large, and recurrent ones. Heminephrectomy is the removal of one half of the kidney due to damage. Pyeloplasty is plastic surgery of the ureteropelvic junction in cases of hydronephrosis. Nephropexy is suturing of a prolapsed kidney. Ureterolithotomy is the removal of large ureteral stones when other methods (such as crushing) are impossible or impossible to remove. Radical nephrectomy, partial nephrectomy is the removal of the kidney or part of it in cases of benign or malignant processes. Radical prostatectomy is the removal of the prostate gland in cases of cancer. Kidney biopsy is a sample of kidney tissue taken for examination. Varicocelectomy is ligation and dissection of the internal spermatic vein in cases of varicocele. Pelvic lymphadenectomy is the removal of pelvic lymph nodes. Colposuspension is a procedure for stress urinary incontinence in women. Pyelolithotomy is the removal of kidney stones.