laparoscopic procedure
Laparoscopic Surgical Techniques:
Dr Schoenfeld has performed 25 successful laparoscopic procedures to date.
Laparoscopic Nephropexy and Nephroectomy
People with kidney troubles already have plenty of problems. It adds insult to injury that surgery to remove part or all of a kidney can put someone to bed for several weeks.
But contrast that to the recent experience of an 81-year-old man who had a cancerous kidney removed. A week later, he felt well enough to walk around his yard.
The secret of this quick recovery is the use of laparoscopic surgery: instruments that enter the body in narrow tubes, instead of the surgeon's own hands. That means far less intrusion into the patient's body.
The use of laparoscopic surgery can dramatically reduce the recovery time for our patients. It normally takes several weeks to recover from a kidney operation or "nephrectomy," if you want to sound like a surgeon. Laparoscopic nephrectomy relies on a small fiber-optic tube, along with other narrow instruments, that enter the body through half-inch incisions and can be maneuvered to reach the kidney. Carbon dioxide is pumped into the body to give the surgeon room to work.
The surgeon can then remove the kidney in a couple of different ways. If the kidney needs to come out whole for testing, the surgeon can pull it through an incision of 3 to 4 inches, or less. If the kidney does not need to come out whole, the surgeon can dissect the organ and remove it through the original half-inch incision.
Laparoscopic surgery has been around for a number of years. It has only been in the last few years that doctors in some parts of the country have used it to remove kidneys. Laparoscopic surgery is not appropriate in all cases, Porter says. But when it can be used, patients report they're pleased with how quickly they are up and about.
In a conventional nephrectomy, the surgeon must make a 12- to 18-inch cut nearly from the belly button to the spine, slicing through three muscle groups to get to the kidney. Sometimes, the surgeon must remove a rib to get enough space.
The laparoscopic technique involves a quarter of the blood loss, or less, compared to a conventional surgery. It also means a hospital stay of 2 1/2 to three days, instead of six. And the patient can often return to work in three weeks instead of seven.
Dr. Schoenfeld uses the laparoscopic device for many other surgeries. One surgery is called laparoscopic nephropexy: the surgeon fixes kidneys that otherwise "drop" when the person stands, causing considerable pain.
The laparoscope can take a biopsy of a kidney tissue to check for disease. Another laparoscopic procedure removes the kidney and ureter the tube that drains urine into the bladder to battle one form of cancer. In young men with testicular cancer, the surgeon may use the device to remove lymphatic tissue and determine the extent of the disease. As with other procedures, the alternative to the laparoscopic procedure is more painful.
