What is Pyeloplasty?
Pyeloplasty is a custom procedure to treat and remove Uretero Pelvic Junction (UPJ) obstruction.
A kidney is made up of millions of small units known as nephrons, where the blood from the body is filtered and urine is formed. Kidney excretes the collected urine from all the nephrons in to a trilateral structure called renal pelvis. Ureters, the thin tubes of both the kidneys carry Urine from the renal pelvis to the bladder. Generally the intersection point of pelvis and the ureter, called the Ureteropelvic Junction (UPJ) constricts or crimps and so the urine flow is hindered. These results in the accumulation of urine in nephrons, inducing the expansion of renal pelvis and this state is known as hydronephrosis. This state can be congenital. This abnormal condition is named as ureteropelvic junction (UPJ) obstruction which leads to poor and sluggish drainage of urine from the kidney. UPJ obstruction can cause stones, abdominal pain, flank pain, infection, high blood pressure and failure of kidney function. This UPJ Obstruction can be repaired and smooth flow of urine ensured with the help of Pyeloplasty.
Congenital abnormalities like horseshoe kidney, fibrous scarring because of stone or former operations, a blood vessel that may cause it to kink or an impacted stone in the upper part of ureter can also cause Ureteropelvic junction Obstruction, which leads to the damage of kidney tissues and ultimately lead deterioration of kidney function and kidney failure. Laparoscopic Pyeloplasty helps to relieve all these symptoms
Laparoscopic Pyeloplasty Procedure:
Subsequent to general anaesthesia, a telescope is placed in the bladder through the urethra. Ureter, the tube that connects the kidney to the bladder is set with a small tube (stent). Later the sides of the abdomen are incised. Normally, 3 to 4 incisions are made between 0.5cm and 2 cm right below the ribs on the problematic side. The junction between the renal pelvis and the ureter is excised on its narrow part. A new join between the ureter and the kidney is built. 2 to 3 hours is the surgical time on normal conditions. The Operation takes a longer time to complete, when there’s a crossing vessel and if the join is to be made on the other side of the crossing vessel. The stent that is initially kept internally in-between the kidney and the bladder remains after the operation and will be removed after 6 weeks of the surgery under local anaesthesia.
Advantages of Laparoscopic Pyeloplasty:
Large Incisions on open pyeloplasty are replaced with small cuts and microscopic instruments. Laparoscopic procedure is as same as traditional open Pyeloplasty. A laparoscopic pyeloplasty is considered as a minimal invasive surgical procedure. It comparatively reduces hospital stay and assures speedy recovery, also less pain and less medication after the operation. Faster return to work and regular activity, and less scarring due to smaller incisions.