Laparoscopic reconstruction of the pelvis of the kidney

What is this?

This involves repair of the narrowing or scarring at the junction of the ureter with the kidney pelvis to improve the drainage of the kidney. It is performed through keyhole incisions and involves insertion of a temporary ureteric stent to aid healing with cystoscopy and x-ray screening

What alternatives are there?

Observation, telescopic incision, dilatation of the narrowed area, temporary placement of a plastic splint through the narrowing, open surgery

What to expect before procedure

You will usually be admitted on the same day as your surgery. You will normally receive an appointment for pre-assessment, approximately 14 days before your admission, 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 need to wear anti-thrombosis stockings during your hospital stay; these help prevent blood clots forming in the veins of your legs during and after surgery.

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. A ureteric stent is normally inserted to allow healing of the suture line in the pelvis of the kidney. A bladder catheter is also inserted during the operation to monitor urine output and a drainage tube is placed through the skin near the newly-formed anastomosis.

After the procedure

You will be given fluids to drink from an early stage after the operation and you will be encouraged to mobilise as soon as you are comfortable to prevent blood clots forming in your legs. The wound drain and catheter are normally removed after 24-48 hours. The average hospital stay is 5 days.

Potential side effects