Laparoscopic pyeloplasty is a surgical procedure that is used to perform the reconstruction of the narrowing or blockage of the ureter, at the point, where the ureter leaves the kidney. So, it is performed to treat the abnormality called UPJ or Ureteropelvic Junction obstruction. Ureter is the tube, which has the function of draining out the urine passing from the kidney towards the bladder. The surgery makes use of minimally invasive procedure.
The symptoms of UPJ are
- Stones in the kidneys
- Abdominal Pain
- Flank pain
- High blood pressure
- Deterioration of the function of the kidney
Before the Surgery
Prior to the surgery, the following tests are done as preoperative tests.
- Physical Examination
- Comprehensive metabolic plan for blood chemistry profile
- PT or PTT, for blood coagulation profile
- EKG or Electrocradiogram
- CBC or Complete Blood Count
Medication that has been going on for other health problems must be stopped before a few days of the surgery and according to the suggestion of the surgeon team. The patient has to stop taking food or drink after the midnight, before the day of the surgery. The patient has to take one bottle containing Magnesium Citrate, in the evening before the day of the surgery. Clear liquids can be taken from before 24 hours of the surgery.
Laparoscopic pyeloplaty surgery is initiated with the general anesthesia. Typically, the surgery takes about 3 to 4 hours of duration. Three small incisions, each of 1cm are made on the abdomen. Through these incisions, telescope is initially inserted and later some small instruments are also inserted for repair of the narrow or block.
A ureteral stent, which is a small plastic tube is placed in the ureter, after the repair of the block is performed. The arrangement of the stent helps to drain easily from the kidney and also to bridge the repair of the pyeloplasty. The stent is to be removed after 4 weeks of duration at the doctor’s office. Another arrangement of small drain is done at the flank, so that any of the fluid present at the surroundings of the kidney can be drained away.
After the Surgery
After the surgery is performed, the patient will be taken to the recovery room and will then be transferred to another room in the hospital, once the patient is completely awake. Transfer to another room is done, after ensuring that the vital signs are good and stable enough. Patient may need to stay in the hospital for 1 to 2 days of time. Patient is suggested to attempt to walk at the supervision of the health care professionals.
Risks and Complications
Though laparoscopic pyeloplasty is a proven and safe procedure, the risks and complications that are associated with the surgeries are possible.
- Failure of the procedure, like failed to obstruct UPJ
- Conversion towards the open surgery
- Organ or tissue injury
When the laparoscopic pyeloplasty is performed, it results in much decreased pain after the surgery and shorten the stay in the hospital. The patient will be able to get back to the daily activities as well as to the work soon after the surgery. The cosmetic results as well as the outcomes are almost identical to the open procedure.
Cost of Laparoscopic Pyeloplasty
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