Laparoscopic Urology
What is Pyeloplasty?
Laparoscopy is a procedure to treat and remove Uretero Pelvic Junction (UPJ) obstruction. Kidney is made of millions of small units known as nephrons, where the blood from the body is filtered and urine is formed. Kidney excretes the collected urine from all the nephrons into a trilateral structure called renal pelvis. Ureters, the thin tubes of both the kidneys carry Urine from the renal pelvis to the bladder.
Generally the intersection point of the pelvis and the ureter, called the Ureteropelvic Junction (UPJ) constricts or crimps and so the urine flow is hindered. This results in the accumulation of urine in nephrons. This state is known as hydronephrosis and it can be congenital. This abnormal condition is named as ureteropelvic junction (UPJ) obstruction, which leads to poor and sluggish drainage of urine from the kidney.
UPJ obstruction can cause stones, abdominal pain, flank pain, infection, high blood pressure and failure of kidney function. This UPJ Obstruction can be repaired and ensure smooth flow of urine with the help of Pyeloplasty.
Congenital abnormalities like horseshoe kidney, fibrous scarring due to stone or former operations, a blood vessel that may cause it to kink or an impacted stone in the upper part of ureter can also cause Ureteropelvic junction Obstruction. Over the days, this may lead to the damage of kidney tissues and ultimately deterioration of kidney function and kidney failure. Laparoscopic Pyeloplasty helps to relieve all these symptoms
Laparoscopic Pyeloplasty Procedure:
Followed by a general anaesthesia, a telescope is placed into the bladder through the urethra. Ureter, the tube that connects kidney to the bladder is set with a small tube (stent). Later the sides of the abdomen are incised. Normally 3 to 4 incisions are made between 0.5cm and 2 cm right below the ribs on the problematic side. The junction between the renal pelvis and the ureter is excised on its narrow path. Then a new joint between the ureter and the kidney is built. It may take about 2 to 3 hours for the surgery or even longer, based on the patient’s condition. This is especially in the case of a patient who has a crossing vessel and if the joint is to be made on the other side of the crossing vessel. The stent that is initially kept internally in-between the kidney and the bladder remains after the operation and will be removed after 6 weeks of the surgery.
Advantages of Laparoscopic Pyeloplasty:
In laparoscopic pyeloplasty procedure, large Incisions on open pyeloplasty are replaced with small cuts and microscopic instruments are majorly used to conduct the surgery. Laparoscopic pyeloplasty is considered to be the minimally invasive surgical procedure. It comparatively reduces hospital stay and assures speedy recovery. The patient will experience very less pain and needs less medication after the surgery. Faster return to work and regular activities and less scarring due to smaller incisions are the major advantages of this surgery.