Mininally Invasive Urologic Surgery at Mayo Clinic

By Mayo Clinic Staff

Mayo Clinic urologists perform hundreds of less invasive (minimally invasive) operations each year for a variety of urologic problems. Patients with kidney disease or with an upper urinary tract disorder used to face a major operation that required major incisions, long hospital stays and long recovery periods.

These new types of minimally invasive surgical procedures produce excellent results, and patients often have shorter hospital stays, less discomfort and bleeding, and a shorter recovery period including less time away from work and regular activities.

Two types of minimally invasive surgery that Mayo Clinic urologists are well known for are:

  • laparoscopic kidney operations
  • endoscopic procedures used to diagnose and treat upper urinary tract disorders.

Laparoscopic Kidney Procedures

Most people with kidney disease are canidates for laparoscopy. In the past, obesity, previous abdominal surgery and pulmonary disease were considered barriers to laparoscopic operations. But in the experience of Mayo Clinic urologists, patients in these situations enjoy the same success and recovery rates as other patients.

Description

In a laparscopic procedures, surgical tools and a tiny video camera are inserted into the patient's abdomen through several small incisions (less than one-half inch in length). The camera transmits video images that allow the surgeon to see the kidney in great detail. The surgeon then inserts surgcial instrument through two or three other small incisions and perfoms the operation.

Laparoscopic kidney procedures are performed under general anesthesia and last 2 to 4 hours. Following the procedure, the incisions are closed with a stitch or two or with surgical tape; within a few months, they are barely visible. Complications are minimal and success rates are comparable to those of conventional kidney surgery.

Procedures that can be performed laparoscopically include:

  • nephrectomy (removal of a kidney)
  • partial nephrectomy (removal of part of a kidney)
  • donor nephrectomy (removal of a kidney from a healthy person to transplant in a recipient; also see kidney transplantation)
  • pyeloplasty (removing a blockage between the ureter and the kidney)
  • cyst unroofing or decortication (opening cysts to drain them)

Endoscopic kidney procedures

Urologists at Mayo Clinic have been using endoscopy for more than a quarter of a century for diagnosis and treatment of upper urinary tract disorders. Over the past decade, the Mayo Clinic urologists have seen a significant rise in hte success of these procedures, thanks to the development of ever smaller and more flexible endoscopic equipment.

Mayo Clinic urologists perform over 200 percutaneous kidney procedures and more than 300 ureteroscopies for diagnosis and treatment each year, making Mayo Clinic a major endourology center. There are no age restrictions for endoscopic procedures. However, people who have had previous bladder operations or who have marked enlargement of the prostate require a different type of treatment.

Description

An endoscope is a small, flexible tube with an attached optical system that is inserted into the body through an opening (like a urethra) or through a small incision. The optical system allows doctors to see the insides of organs and body cavities, and to perform surgery by inserting and manipulating equipment through the tube. Because they require little or no incision, endoscopic surgeries cause minimal scarring and allow rapid recovery times.

Mayo Clinic urologists use endoscopic procedures to:

  • diagnose and treat a wide variety of upper urinary tract disorders
  • find sources of bleeding or infection
  • determine the nature of lumps found in the upper urinary tract
  • biopsy tumors in carefully selected cases
  • treat stones in the ureters and kidney
  • treat strictures in the upper urinary tract
  • treat certain types of benign tumors and lesions in the upper urinary tract