Laparoscopic renal / kidney surgery

 
 CT scan showing an abnormality in             3 small incisions required to
         lower part of right kidney                            remove a kidney
 
 

Laparoscopic renal surgery has several advantages over traditional open surgery including:

  • shorter hospital stay
  • less blood loss
  • smaller scars
  • less pain with quicker return to work and normal activities
  • less complications

 

Some operations such as cyst de-roofing or laparoscopic guided cryotherapy can be performed as a day case although most other procedures require a 1 or 2 night post operatively in hospital.

 

 
Laparoscopic nephrectomy

 

Removal of the whole kidney may be necessary due to cancer, infection, stones or long term obstruction. This procedure can be performed via a laparoscopic or minimally invasive technique. Three small incisions are required to insert a camera and operating instruments into the abdominal cavity. The kidney is then either morcellated (broken up) and removed through a 2 cm incision, or if cancer is suspected one of the incisions is enlarged to remove the specimen intact which is then sent for analysis.

 

 

Laparoscopic partial nephrectomy

 

Some suspected tumours of the kidney are small and removal of the whole kidney is not necessary. The tumour can be removed with a small margin of normal kidney. This preserves renal function which is particularly important in patients with chronic renal failure, diabetes or cardio-vascular disease. This technique can also be performed through a laparoscopic approach.

 

 

 
Laparoscopic guided renal cryotherapy

 

Some patients with a suspected small renal tumour are not suitable for a partial nephrectomy. These patients can be treated with a freezing technique called cryotherapy. This involves a probe being placed under laparoscopic guidance into the tumour and destroying it by freezing it to -40C with liquid helium and argon.

 

 
 
Laparoscopic pyeloplasty

 

Patients with loin pain due to a condition called pelvi-ureteric junction obstruction (PUJO) can be treated with a laparoscopic pyeloplasty. This is a congenital condition (you are born with it) where the drainage of the kidney is poor due to an abnormal area at the exit of the kidney’s drainage system (PUJ). This can cause loin pain particularly after a fluid load or drinking alcohol. A pyeloplasty involves removal of the PUJO and reconstructing the junction with healthy functioning tissue.

 

 
Laparoscopic renal cyst de-roofing

 

Renal cysts are common and most don’t require any treatment. Some large cysts that cause pain can be treated with a de-roofing procedure. This involves removal of part of the cyst wall and plugging the defect in the kidney with fat from inside the abdomen to prevent it from coming back.

 

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