By Dr. Chetan Sheladia, Urology
The laparoscopic pyeloplasty is an effective and safe alternative to a reconstructive surgery – scarring or narrowing of the tube that aids in draining out the urine from the bladder to the kidney. The laparoscopic pyeloplasty is a minimally invasive treatment method. It is a corrective operation to narrow or block the tube from the point where it leaves the kidney. This problem or abnormality is referred to as the ureteropelvic junction (UPJ) obstruction that causes improper drainage of urine from the kidneys. Ureteropelvic junction has the potential to lead to abdominal pain. It can also cause infections, stones, deteriorate the functioning of the kidneys and give rise to high blood pressure.
Why Is Laparoscopic Pyeloplasty Preferred?
Laparoscopic Pyeloplasty is much preferred to the conventional open surgery technique because it leads to lesser post-surgery complications. The patient also doesn’t need to spend too much time in the hospital for recovery, can return back to his or her daily activities faster.
How Is The Surgery Performed?
The laparoscopic pyeloplasty surgery takes place with the help of general anesthesia and can take up to four hours to complete. Three tiny incisions of about 1 cm are made within the abdomen and through these incisions, the surgery is performed. Via these tiny incisions, a telescope is inserted in order to perform the surgery. A plastic tube known as the ureteral stent is kept within the ureter after the completion of the surgical procedure in order to help the Pyeloplasty bridge faster and in the process also help drain the kidneys. The stent is allowed to remain for around a month and is removed under the supervision of a healthcare provider. A tiny drain will be kept near the flank in order to help drain fluids.
The common risks include:
• Infection-Patients will be treated with antibiotics as a pre-treatment process in order to lower the chances of infections. However, it is recommended that upon noticing signs of infection such as pain, drainage from the incision, discomfort and fever that you contact your healthcare provider right away.
• Bleeding- The chances of bleeding is very less with this surgical procedure and rarely is a blood transfusion ever required. However, if the patient still feels that they want to opt for autologous blood transfusion then they need to make the surgeon aware beforehand.
• Tissue Injury- Injury to surrounding tissues or organs is very rare with this procedure. In case of any damage to the liver, spleen, gallbladder, bowel or pancreas, the patient might need another surgery.
As is common with every surgical procedure there are a few complications as well as risks that are associated with this surgical method, however, on the whole, Laparoscopic Pyeloplasty is a safe and effective treatment option.