A laparoscopic pyeloplasty is a minimally-invasive surgical procedure used to correct an obstruction at the base of a kidney. Patients who suffer from frequent urinary tract infections, abdominal pain, urination problems, and kidney stones may be assessed for blockages and scheduled for pyeloplasty operations. The procedure involves using an endoscopic camera, surgical tools, and a stent, which are inserted through three or more tiny incisions in the abdomen to repair damaged tissue. In most cases, laparoscopic pyeloplasty can be completed in less than three hours, and patients can expect full recoveries in about one month.
The base of the kidney meets the ureter at the ureteropelvic junction (UPJ). Blockages in the UPJ or a narrowing of the uppermost part of the ureter tube can cause urine to back up into the kidney and lead to potentially serious health complications. A doctor may decide to schedule a laparoscopic pyeloplasty after imaging scans and physical exams confirm the presence of a UPJ obstruction. Before the procedure, the risks and benefits are discussed in detail to ensure the patient is comfortable going through with it.
Patients are usually instructed to avoid consuming food and liquids the night before laparoscopic pyeloplasty surgeries. On the day of the procedure, a general anesthetic is given, and the lower abdomen is shaved and sterilized. A small incision is made to provide access for the endoscope, a fiber optic camera that transmits a real-time feed to a monitor in the operating room. The surgeon uses the endoscope to inspect the UPJ and guide the placement of surgical tools. A stent is usually placed between the kidney and one of the abdominal incisions to drain excess blood and urine during the operation.
Once the stent and endoscope are in place, the surgeon carefully cuts away the UPJ obstruction and removes the damaged tissue through one of the incisions. The base of the kidney is reattached to the healthy portion of the ureter using specialized sutures. The tools and endoscope are then retracted and the surgical wounds are bandaged.
A patient is typically kept in the hospital for at least one day following a laparoscopic pyeloplasty. The stent and a urinary catheter are kept in place for two to five days to drain the kidney as the reconstructed UPJ starts to heal. If internal bleeding or other complications do not arise, the patient is allowed to go home with special instructions about diet and activity. Most people are able to fully recover in a matter of weeks.