Laproscopic
Surgeries
Laproscopic Surgeries
Many traditional urologic surgical procedures require big incisions with prolonged hospitalization and recovery. Laparoscopic or ‘keyhole’ surgery has recently been developed in the field of urology with advanced technologies. Using a small telescope with built-in magnification and a variety of long, thin surgical instruments placed through approximately 3-5 incisions (each less than a cms in size), the surgeon will be able to perform minimally invasive surgery for a variety of urologic diseases and problems. Patients who undergo these procedures not only have the same diagnostic and therapeutic benefits of traditional open surgery but also get the advantage of greatly reduced postoperative pain, shorter hospitalization, faster recovery, and better cosmetic results.
Minimally invasive surgery has been applied to a multitude of benign (non-cancerous) and malignant (oncologic or cancerous) urologic problems. Furthermore, it has been applied to conditions affecting a variety of urologic organs (including kidney, adrenal gland, ureter, bladder, prostate, testis and lymph nodes). Commonly performed laparoscopic procedures are Laparoscopic pyeloplasty, laparoscopic nephrectomy, laparoscopic adrenalectomy to name a few.
Laparoscopic Pyeloplasty
Under general anaesthesia four 10-15mm incisions over the kidney (on the back, just below the ribcage) are made to pass a telescope and operating instruments. The kidney along with the obstructed PUJ is located. The obstruction is divided and opened up before re-joining the ureter to the kidney in an unobstructed fashion with stitches. Any stones within the kidney can be removed, and if present, an obstructing blood vessel is placed in a position away from the reconstructed PUJ. The operation generally takes around 2 hours. A fine bore tube, called a stent, is placed in the ureter from the kidney to the bladder, to allow urine to drain freely through the reconstructed PUJ while it heals. This sits in place internally, for around a month. It is then easily removed under either local or general anaesthetic, by passing a small telescope through the urethra into the bladder and pulling it out.
Laparoscopic Nephrectomy
Laparoscopic nephrectomy is performed under a general anesthetic. The typical length of the operation is 3-4 hours. The surgery is performed through 3 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 completely free and dissect the kidney without having to place his hands into the abdomen. The kidney is then placed within a plastic sack and removed intact through an extension of one of the existing incision sites.
Laparoscopic Adrenalectomy
Surgical removal of the adrenal gland is the preferred treatment for patients with adrenal tumors that secrete excess hormones and for primary adrenal tumors that appear malignant. In the past, making a large 6 to 12 inch incision in the abdomen, flank, or back was necessary for removal of an adrenal gland tumor. Today, with the technique known as minimally invasive surgery, removal of the adrenal gland (also known as “laparoscopic adrenalectomy”) can be performed through three or four 1/4-1/2 inch incisions. Patients may leave the hospital in one or two days and return to work more quickly than patients recovering from open surgery.