Laparoscopy in Urology
Instead of large incisions on the body, small 10 mm and 5 mm puncture wounds are made through which special telescopes and instruments are passed into the abdomen. The telescope will show the operative field on the monitor screen and watching this, the surgeon is able to use instruments through small key holes to perform many types of surgery.
The creation of small keyholes as against large wounds for surgery, decreases the stress on the body and facilitates early recovery. There is less trauma to the internal organs and the magnification produced by the equipment, greatly facilitates precision of surgery. The patient remains less number of days in hospital and can return to work earlier than open surgery. The small incision of laparoscopy, decreases postoperative pain around 20 times less than open surgery. Even though the surgical expense of Laparoscopic surgery is more, the total cost of the treatment of the disease is usually 20% less than open surgery.
Kidney removal surgery is usually done when the kidney is not functioning or when there is a tumour. A non-functioning kidney should be removed as it will affect the functioning of the opposite good kidney. It can also produce problems like high BP, recurrent urinary tract infections etc.
When compared to open surgery, there are several advantages for laparoscopic kidney surgery.
- At the time of surgery, the image obtained is magnified 10 to 15 times, increasing the accuracy of the surgery performed.
- The internal wound is correspondingly small and therefore, postoperative recovery is very short.
- As the external wounds are small, post operative pain is less.
- The person does not have to stay away from work for more than 2 weeks as compared to 6 to 8 weeks for open surgery.
- Open surgery scar for the kidney is very long and ugly. The 0.5 and 1cm scars after laparoscopy, are hardly noticeable.
The urine formed in the kidney collects in the kidney pelvis. This pelvis is connected to the bladder by a tube called the ureter. Sometimes there is obstruction at the junction of the kidney's pelvis and ureter. If the obstruction is complete, the function of the kidney will be seriously affected. The obstruction can be present at the time of birth or later, at any age. The commonest age of presentation is early in adult life.
The treatment is by surgery. This can be done either by open surgery, with its accompanying morbidity of a 15 cm wound or in some cases, by endoscopic techniques ( endopyelotomy).
Large stones in the ureter have to be removed by open surgery. However instead, the same surgery can be performed using key holes. Instead of making large wounds, small keyholes are made to pass instruments into the body and perform surgery inside. When compared to open surgery, there is remarkably less pain and faster healing, enabling early discharge home..