PYELOPLASTY

Pyeloplasty was the surgical treatment to reconstruct or revision of renal pelvis to drain & decompress the kidney. Most commonly it was done to treat the uretero-pelvic junction obstruction if the residual renal function was adequate. This revision of the renal pelvis will able to treat the obstruction by excising the stenotic area of uretero-pelvic junction or the renal pelvis & build a more large conduit with the help of tissue in the left over renal pelvis & ureter.

There were different kinds of pyeloplasty based on the surgical technique & patterns of the incision used. A pyeloplasty may be either be done by the open, robotic or laparoscopic route.

OPEN PYELOPLASTY:

  • In conventional open surgery, the doctor will perform a cut or incision in her or his side above the kidneys. This incision will be closed by using a dissolvable stitch & was covered with Steri-strips.

  • Whichever procedure was used, the doctor will locate the blockage in the ureter, discard the affected part & join the cut ends of ureter again.

  • They are inserted on either a blue stent or a JJ stent inside the ureter to keep that stable while it was healing. Both kinds of the stent are needs to be removed after some weeks when the operation was done. The blue stent was detached on the ward 1 week after the surgery. The JJ stent was removed in a short method under the anesthetic around 6 weeks after the operation was done.

LAPAROSCOPIC PYELOPLASTY:

  • Laparoscopic pyeloplasty was done under the general anesthetic. The time taken for the whole operation was 3-4 hours.

  • The surgery was done by 3 small (1cm) incisions or cuts were made in the abdomen. A telescope & small instruments were inserted into the abdomen by these keyhole incisions or cut, which allow the doctor to repair the blockage/narrowing without placing his hands into the abdomen.

  • A small plastic tube called as ureteral stent was left inside the ureter at the end of the surgery to bridge the pyeloplasty repair & help drain the kidney. This stent may remain in that place for 4 weeks & was generally removed in the doctor’s office.

  • A small drain was also left exiting the flank to drain away if there was any fluid nearby the kidney & pyeloplasty repair.