| What is it? |
A laparoscopic pyeloplasty is an operation where a narrowing or scarring at the junction of the kidney with the ureter is repaired using keyhole surgery. |
|
| Why do I need a laparoscopic pyeloplasty? |
Your surgeon will have explained that your urine is not draining from the kidney properly because of a narrowing at the pelviureteric junction (PUJ). This may be causing you pain. He has chosen this method of surgery to reduce the length of your recovery and to allow you to resume a normal life in a shorter period of time when compared to the more conventional open method of repairing the narrowing. |
|
| The Surgery |
The Operation
Laparoscopic pyeloplasty is performed under a general anesthetic. The typical length of the operation is 3-4 hours. The surgery is performed through 3-4 small (1cm) incisions made in the abdomen. A telescope and small instruments are inserted into the abdomen through these keyhole incisions, which allow the surgeon to repair the blockage/narrowing without having to place his hands into the abdomen. |
|
| Open Procedure |
|
| Ureteropelvic Junction (UPJ) Obstruction |
|
|
|
A small plastic tube (called a ureteral stent) is left inside the ureter at the end of the procedure to bridge the pyeloplasty repair and help drain the kidney. This stent will remain in place for 4 weeks and is removed after 4-6 weeks. A small drain will also be left exiting your flank to drain away any fluid around the kidney and pyeloplasty repair. |
|
| Potential Risks and Complications |
Although this procedure has proven to be very safe, as in any surgical procedure there are risks and potential complications. The safety and complication rates are similar when compared to the open surgery. Potential risks include: |
| • |
Bleeding: Blood loss during this procedure is typically minor (less than 100 cc) and a blood transfusion is rarely required. |
| • |
Infection: All patients are treated with broad-spectrum intravenous antibiotics prior to starting the surgery to decrease the chance of infection from occurring after surgery. If you develop any signs or symptoms of infection after the surgery (fever, drainage from your incision, urinary frequency, discomfort, pain or anything that you may be concerned about) please contact us at once. |
| • |
Hernia: Hernias at incision sites rarely occur since all keyhole incisions are closed carefully at the completion of your surgery. |
| • |
Tissue / organ injury: Although uncommon, possible injury to surrounding tissue and organs including bowel, vascular structures, spleen, liver, pancreas and gallbladder could require further surgery. Injury could occur to nerves or muscles related to positioning. |
| • |
Conversion to open surgery: this surgical procedure may require conversion to the standard open operation if extreme difficulty is encountered during the laparoscopic procedure. This could result in a larger standard open incision and possibly a longer recuperation period. |
| • |
Failure to correct UPJ obstruction: Roughly 3 % of patients undergoing this operation will have persistent blockage due to recurrent scarring. If this occurs additional surgery may be necessary. |
|
|
| What are the possible complications? |
Occasionally infection and pain may occur at the wound site. A hernia of the incision site may occur which would require further treatment. There is a rare chance that the surgeon may have to proceed to open repair should he encounter problems such as bleeding during surgery. A blood transfusion may also be very rarely required. Very rare complications include injury to organs/blood vessels near the kidney, which then require conversion to open surgery. |
|
| At Home |
It may take 6 weeks for you to fully recover from this surgery. It is important to avoid heavy lifting and strenuous exercise during this period. We recommend that you should avoid driving for 2 weeks. You will be given an appointment to have your stent removed in 6 weeks time. You will be seen in out patients approximately 3 months after surgery. |
|
