Open de-roofing of simple renal cyst (Rovsing’s operation)

What is this?

Surgical removal of one or more kidney cysts by open surgery; this is only indicated after earlier cyst aspiration has confirmed that the cyst is responsible for pain

What alternatives are there?

Percutaneous aspiration, aspiration & sclerotherapy, laparoscopic de-roofing, observation

What to expect before procedure

You will usually be admitted on the day before your surgery. A pre-clerking appointment will normally be sent to you to assess your general fitness, to screen for the carriage of MRSA and to perform some baseline investigations. After admission, you will be seen by members of the medical team which may include the Consultant, Specialist Registrar, House Officer and your named nurse. You will be asked not to eat or drink for 6 hours before surgery and, immediately before the operation, you may be given a pre-medication by the anaesthetist which will make you dry-mouthed and pleasantly sleepy. You will be given an injection under the skin of a drug (Clexane), that, along with the help of elasticated stockings provided by the ward, will help prevent thrombosis (clots) in the veins.

What happens during the procedure?

Normally, a full general anaesthetic will be used and you will be asleep throughout the procedure. In some patients, the anaesthetist may also use an epidural anaesthetic which improves or minimises pain post-operatively. You will usually be given an injectable antibiotic before the procedure after checking for any drug allergies. The incision is usually made in your loin, just below the rib cage. The kidney is mobilised and the cyst identified. The top of the cyst is removed (like taking the top off a soft-boiled egg); the inner and outer walls are stitched together to prevent the cyst from re-forming. Occasionally, a plug of fat from the fatty envelope within your abdomen (the omentum) is used to plug the centre of the cyst and prevent fluid from re-forming. A wound drain is usually inserted at the end of the procedure, together with a bladder catheter to monitor urine output.

After the procedure

Absorbable stitches are usually used and do not require removal; If the stitches used are not absorbable, we will arrange for them to be removed either on the ward or by your District Nurse after 7-10 days. The catheter is normally removed once you are mobile enough to get yourself to the toilet. The drain is removed after 3-4 days. The average hospital stay is 7 days.

Potential side effects