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Laparoscopic Pyeloplasty Lecture By Dr R K Mishra
For Surgeon / Aug 22nd, 2020 11:44 am     A+ | a-


This video demonstrates Pyeloplasty is the surgical reconstruction of the renal pelvis (a part of the kidney) to drain and decompress the kidney. In nearly all cases, the goal of the surgery is to relieve a uretero-pelvic junction (UPJ) obstruction.

Laparoscopic pyeloplasty is a minimally invasive surgical procedure that is performed to correct a blockage or obstruction in the ureteropelvic junction (UPJ) that causes urine to back up into the kidney, leading to kidney damage and other complications. The UPJ is the junction where the kidney pelvis meets the ureter, the tube that carries urine from the kidney to the bladder.

During a laparoscopic pyeloplasty, the surgeon makes several small incisions in the abdomen and inserts a laparoscope (a thin, flexible tube with a camera and light) and other specialized surgical instruments. The surgeon then removes the blockage or obstruction and reconstructs the UPJ using sutures or stents.


 

Laparoscopic pyeloplasty offers several advantages over traditional open surgery, including smaller incisions, less pain and scarring, shorter hospital stays, and faster recovery times. However, it is a complex procedure that requires a skilled and experienced surgeon.

Overall, laparoscopic pyeloplasty is a safe and effective treatment for UPJ obstruction, with high success rates and low complication rates. As with any surgical procedure, there are risks and potential complications, which should be discussed with the surgeon prior to the surgery.

Laparoscopic pyeloplasty offers several advantages over traditional open surgery for the treatment of ureteropelvic junction (UPJ) obstruction, including:

  1. Less invasive:
    Laparoscopic pyeloplasty involves making small incisions in the abdomen, which results in less trauma to the surrounding tissues and organs compared to open surgery. This leads to less pain, scarring, and blood loss, and a quicker return to normal activities.

  2. Shorter hospital stay:
    The recovery period after laparoscopic pyeloplasty is shorter compared to open surgery. Patients usually spend only 1-2 days in the hospital before being discharged.

  3. Faster recovery:
    Laparoscopic pyeloplasty allows for a quicker return to normal activities, with patients typically able to resume work and other regular activities within a week or two.

  4. Reduced risk of complications:
    Because laparoscopic pyeloplasty is less invasive than open surgery, there is a lower risk of postoperative complications such as infection, bleeding, and hernia.

  5. Improved cosmetic outcome:
    The small incisions made during laparoscopic pyeloplasty are less noticeable than the larger incision required for open surgery, resulting in a better cosmetic outcome.

  6. Better visualization:
    Laparoscopic pyeloplasty allows the surgeon to see the surgical field in greater detail with the help of a camera inserted through one of the small incisions. This enhances the precision and accuracy of the procedure.

  7. Reduced postoperative pain:
    Because laparoscopic pyeloplasty is less invasive than open surgery, patients experience less postoperative pain, which can be managed with oral pain medications.

    In summary, laparoscopic pyeloplasty offers several advantages over traditional open surgery for the treatment of UPJ obstruction, including less invasive, shorter hospital stay, faster recovery, reduced risk of complications, improved visualization, reduced postoperative pain, lower risk of adhesions and incisional hernia, and improved patient satisfaction. However, the procedure requires specialized training and expertise, and not all patients may be suitable candidates for laparoscopic pyeloplasty.

    Although laparoscopic pyeloplasty is generally considered a safe and effective procedure for the treatment of UPJ obstruction, there are potential risks and complications that patients should be aware of. These may include:

    Bleeding:
    There is a risk of bleeding during the surgery or in the postoperative period, which may require a blood transfusion or additional surgery.

    Infection:
    Any surgical procedure carries a risk of infection, which may require antibiotics or further treatment.

    Injury to surrounding organs:
    During laparoscopic pyeloplasty, the surgeon may inadvertently damage surrounding organs, such as the bowel or blood vessels.

    Urine leak:
    A urine leak may occur at the site where the UPJ was reconstructed, which may require further surgery or prolonged catheterization.

    Recurrence of UPJ obstruction:
    In some cases, the UPJ obstruction may recur after the surgery, requiring further treatment.

    Conversion to open surgery:
    In some cases, laparoscopic pyeloplasty may need to be converted to open surgery if the surgeon is unable to complete the procedure laparoscopically.

    Anesthesia complications:
    General anesthesia carries a small risk of complications, such as allergic reactions or respiratory problems.

    Thrombosis:
    Patients undergoing laparoscopic pyeloplasty are at risk of developing blood clots in the legs or lungs, which may require further treatment.

    Nausea and vomiting:
    Patients may experience nausea and vomiting after the surgery, which can be managed with medications.

    Adverse reactions to medications:
    Patients may have an adverse reaction to medications used during the surgery or in the postoperative period, such as pain medications or antibiotics.

    Incisional hernia:
    Although laparoscopic pyeloplasty involves smaller incisions compared to open surgery, there is still a risk of incisional hernia formation.

    Prolonged recovery:
    In rare cases, patients may experience a prolonged recovery period or develop chronic pain after the surgery.

    It is important for patients to follow their surgeon's instructions before and after the surgery to reduce the risk of complications. This may include stopping certain medications or dietary supplements before the surgery, avoiding certain foods or activities after the surgery, and attending follow-up appointments as scheduled. Patients should also notify their surgeon if they experience any unusual symptoms, such as fever, persistent pain, or difficulty urinating, after the surgery.

2 COMMENTS
Vinit kumar
#2
Mar 22nd, 2021 11:10 am
Awesome videos lecture of Laparoscopic Pyeloplasty Lecture By Dr R K Mishra
Dr. Junaid Alam
#1
Aug 27th, 2020 11:25 am
Awesome videos lecture of Laparoscopic Pyeloplasty. why i am so late to watch these video..thank u. keep uploading.
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