Pyeloplasty is a surgical procedure to correct a problem of the renal pelvis in the kidney where the urine is collected, usually to remove blockage or obstruction that can cause long term serious complications including failure of kidney functions, urinary infections and formation of kidney stones. This abnormality is known as an ureteropelvic junction obstruction. Laparoscopic pyeloplasty is less invasive, safe and effective procedure to perform reconstructive surgery of a narrowing or scarring in the ureter attached to the kidney. Laparoscopic pyeloplasty has significant results and outcomes identical to that of the conventional open surgery procedure but with reduced post surgery pain, shorter hospital stay, faster recovery, less scarring.
Doctor will perform some tests such as complete medical history of the patient, X-rays, CT scan, MRI scan, sonogram to evaluate the overall health of the patient at the time of consultation along with some pre-operative tests like electrocardiogram (EKG), complete blood count (CBC), blood coagulation profile (PT/PTT), urinalysis to determine whether the patient is eligible for surgery or not.
Patient will be asked to avoid some medicines such as steroidal anti-inflammatory drugs that can cause bleeding a week prior to the surgery day. Patient required not eating or drinking after midnight before the day of surgery.
Patient will be given general anesthesia. Surgeon will make 3 small incisions in the patient’s abdomen to insert a telescope and small instruments that allow the surgeon to repair the blockage or narrowing without putting his hands into the abdomen. Surgeon will then place a small plastic tube known as ureteral stent in the ureter at the end of the procedure to bridge the pyeloplasty repair and help drain the kidney. This stent will be left inside for 4 weeks and then will be removed by the surgeon. There is usually a catheter placed inside the body that drains the bladder which is removed after a day or two.
In robotic pyeloplasty surgery instead of the surgeon using their own hands, the surgery is done with surgical instruments attached to a robotic system controlled by the surgeon through a computer interface. The robotic system enhances precision, control and flexibility of the surgeon’s movements. This procedure allows less bleeding and smaller scars, less pain and faster recovery.
Doctor will recommend some pain medicines and antibiotics to avoid infection. Patient should avoid strenuous activities for few weeks, should avoid driving also. The ureteral stent can cause some discomfort while urinating and blood streaks in the urine is common.
Almost all surgeries have some risks and complications associated with them. Laparoscopic radical nephrectomy is less invasive surgery but there are still some complications involved with this that may include:
• Unexpected blood loss
• Injury to surrounding tissues or organ
• Incisional Hernia