Laparoscopy of the kidney: cyst resection, removal of stones
Laparoscopic methods of treatment of diseases of the internal organs are becoming more popular types of surgery. Urology is no exception in this medical trends. To date, a large number of diseases of the kidney (cysts of the kidney, urolithiasis, etc.) can be identified and cured with the help of nephroscope (laparoscopy). The postoperative period after laparoscopy of the kidney is characterized by short duration and low risk of complications that qualitatively distinguishes this method of surgical treatment in comparison with the classical wide operations.
Endoscopic surgeries are minimally invasive operative treatment of diseases of the internal organs. Access to the affected organ through a small puncture in the abdominal wall, the average number of which is 3-4. Through these punctures in laparoscopy introduced into the abdominal cavity endoscope (laparoscope, nephroscope, etc.) and special tools to perform direct surgical intervention. The endoscope is a flexible probe of small diameter with a camera and a light source at the end. Such a device allows the surgeon to visually monitor the progress of the operation, preventing the development of complications.
Despite the presence of negative aspects, laparoscopy cysts, kidney resection or excision of parts of tissue with an endoscope are used more often.
Indications and contraindications
The use of nephroscopy for the treatment of kidney diseases has the following indications:
- Pain syndrome, characterized by sharp or aching pain in the projection of the kidneys on the lower back.
- The identification of stones or cysts in the kidney.
- Detection of benign or malignant neoplasms with kidney damage.
But to this procedure there are contraindications that restrict the use of the method:
- Decompensated diseases of the respiratory and cardiovascular systems.
- Adhesions in the abdominal cavity, associated with the previously performed surgery.
- Pregnancy in the later stages.
- Infectious diseases in acute form.
- Unexpressed clinical picture of the disease.
In each individual case the Clinician should review existing patient indications and contraindications to nephroscope.
The following indications and contraindications for surgical intervention should be followed in every case of a laparoscopy.
Preparation of the patient for surgery
Reducing the risk of complications and improving the efficiency of operations is possible due to the observance of certain rules of preparation of patient to the carrying out of a laparoscopy:
- A person needs to avoid hypothermia and contact with sick people to prevent the development of infectious diseases.
- Pass the required minimum tests: clinical analysis of blood, urine, ECG and ultrasound of the urinary system.
- When taking medications that reduce blood clotting, you should consult with your doctor about the possibility of their temporary abolition.
- 2-3 day before the laparoscopy, the patient requires a special diet, aimed at reducing bloating. It is recommended to iskluchit from fatty foods, fried foods, bread and pastries, and foods with a high content of fiber: vegetables, fruits, legumes, etc.
- The night before carry out the cleansing of the bowel, usually with the help of special medicines (Fortrans, etc.).
- On the eve in the area of the surgical field is carried out shaving the hair on the skin.
Observance of these rules allows to ease the progress of the operation and the postoperative period.
The course of nephroscope
Laparoscopy for kidney stones or cysts can be performed in two different ways with the use of flexible endoscopes:
- The flexible probe can be inserted through the urethra and move up the urinary tract.
- Nephroscope introduced through a puncture in the lumbar region, or through the abdominal wall.
In both cases the most important stage of the operation is adequate analgesia, which is achieved spinal anaesthesia or by General anaesthesia. The technique of removal of cysts and stones, in General, similar.
Compliance with technique of laparoscopy to reduce the risk of operative and postoperative complications.
After adequate anesthesia, the patient side of the abdominal wall produce a few small incisions for insertion of instruments. Also with a special needle introduced into the abdominal cavity carbonic gas, the tensile cavity and to increase its volume for better inspection. Through the holes injected Nevrokop for visual observation and the surgical manipulators. Runs directly surgery, involves the removal of the stones, the bonding of the walls of the cyst or resection of the kidney. After the procedure is finished, the instruments are removed, and the abdominal cavity leave drainage tubes for fluid removal. All holes are sewn with a carefully.
The average duration of renal laparoscopy is 3-4 hours, depending on the purpose and extent of surgery.
Complications of the procedure
As with any surgery, laparoscopy may be a number of complications:
- Bleeding from the vessels of the anterior abdominal wall.
- Damage to internal organs like kidney and loops of small and large intestine.
- Intestinal perforation manipulators.
- Purulent-inflammatory diseases.
- After such intervention increases the risk of developing hernias of the anterior abdominal wall.
However, compliance with the rules of preparation of patient and technique of execution of laparoscopy avoids these complications.
The postoperative period
After any laparoscopic operation, the patient recovering very fast, which is associated with low invasiveness of the procedure. As a rule, on the second day after the operation the patient is allowed to move around the room, and 3-4 days of a person being discharged from medical hospital.
The major point of the postoperative period, is the diet after laparoscopy:
- From the diet should exclude fatty, fried and spicy food.
- Closely monitor fluid intake and protein foods, to reduce the load on the kidneys.
- Salty foods should be consumed with caution or even discard them. Salt promotes water retention in the body and increases the load on the kidneys, which can lead to relapse of the disease, or even renal failure.
Similar requirements for the postoperative period should be observed even when the minimum volume of transactions, as the risk of complications always remains.
Nephroscope kidney disease is a modern and minimally invasive method of surgical treatment. Quick patient recovery, lower risk of complications and high performance ensure a wide dissemination of the technique of surgical interventions.