Laparoscopic Deroofing Renal Cyst

Laparoscopic deroofing of renal cyst is undertaken when a renal cyst causes compression of the kidneys and other organs. If there is malignancy, then such laproscopic deroofing should not be performed.
For most benign renal cysts, usually such a treatment is not necessary until they are not too large in size and disturb the normal functioning of other organs. Also in case of polycystic syndrome of the kidneys, laparoscopic deroofing provides the much needed relief.

Safety:

As safe as traditional open surgeries. Minimal blood loss, pain, blood transfusion, only overnight hospital stay. Minimally invasive procedure.

Length Of The Surgery:

1 hour

When to approach your Urologist?:

  • Blood passing through urine.
  • Constant fevers without any known source of infection.
  • Frequent pain in the lower back, waist or abdomen.
  • Sudden weight loss.
  • Early fatigue.
  • Formation of abdominal lumps.
  • Loss of appetite.
  • Pertaining swelling of ankles and legs.
  • At later stage of cancer:
  • Shortness of breath
  • Coughing up blood
  • Bone pain

Diagnosis Tests:

  • Physical examination
  • Urine tests
  • Blood test
  • Intravenous Pyelogram (IVP)
  • CT scan
  • Ultrasound test:
  • Biopsy
  • Surgery

Preparation:

Certain medications to be specifically avoided pre surgery:

  • Aspirin.
  • Ibuprofen Motrin.
  • Voltaren, Plavix, Lovenox, Vioxx, Celebrex.
  • Advil, Ticlid, Alka Seltzer, Coumadin, Vitamin E.
  • Arthritis medications: avoided since before a week of the surgery otherwise it can cause bleeding during the surgery.
  • The urine culture analysis should be negative.
  • In case of UTI Urinary Tract Infection, it should be treated before the surgery by prescribed antibiotics.
  • In case of severe lung/ heart conditions, it is advisable not to perform PCNL on the patient.

Procedure:

  • Local anasthetia is injected to the patient.
  • They can be drained by radiological means with ultrasound under the CT guidance.
  • But this can cause them to reoccur, hence, deroofing is performed.
  • Three small incisions are made, 2 for instruments and 1 for the camera.
  • The incisions are usually made in the abdomen.
  • After the identification of the cyst, the surrounding tissue is separated from the cyst.
  • The cyst is then punctured and the cyst wall, excised which may be stitched back or removed.

Risks:

The PCNL potential risks include:

  • Common:
  • Pain
  • Abdominal bloating
  • Nausea
  • Occasional:
  • Bleeding, infection of incisions
  • Lower body aches.
  • Drainage from incision.
  • Reoccurrence of cysts.
  • Fever
  • Rare:
  • Blood transfusion requirement
  • Very Rare:
  • Injury to the blood vessels or surrounding organs during the procedure
  • Need for open surgery arises
  • A lung cavity may be repaired during the same procedure.

Follow- up:

It’s usually recommended that someone stays with you for the first 24 hours after surgery. This is in case you experience any symptoms that suggest there could be a problem, such as:

  • 24 to 48 hour surveillance.
  • Visit doctor:
  • Have light healthy diet with limited salt intake
  • Avoid high protein diet, alcohol and caffeine
  • Avoid strenuous activity and exercise for several weeks.
  • Walk as much as you can
  • Emergency Follow up:
  • Chest pain/ breathing difficulty.
  • Vomiting/ nausea
  • Blood pressure

All above, treatments are finalized taking into consideration the overall health, severity, age and other ailments of the patient. Only a well experienced urologist should perform the above treatment