Minimally Invasive Urological Surgery

Overview

Minimally invasive urological surgery is a type of surgery used to treat problems in the urinary system, female reproductive system, and male reproductive system. This method avoids large cuts, reducing recovery time and allowing a quicker return to daily activities.

Minimally invasive surgery uses tiny cuts, about the size of a dime, to minimize damage to healthy tissue and reduce blood loss. Various technologies and techniques are available, and they continue to improve over time.

Types

Minimally invasive urological surgery is performed in several ways.

Common methods include:

• Endoscopically: To treat various conditions, a long, thin tube with a camera and channels for surgical instruments is inserted through the urethra into the bladder, ureter, and kidney. 
• Laparoscopically: This surgery usually involves two to four small cuts, with a thin rod with a camera, called a laparoscope, inserted into one and the surgical tools into the others.
• Single port: The procedure begins with making one small incision, either in the abdomen or belly button, depending on the type of surgery. In this procedure, the belly is inflated with carbon dioxide to create space and improve visibility. This inflation allows the healthcare provider to insert a camera and any necessary surgical tools into the belly. 
• Robotically: In this method, a special camera provides 3D images, allowing healthcare providers to see the affected areas clearly. It involves the use of mechanical arms controlled from a console. These arms feature small, wrist-like instruments that allow for precise movements.

In certain cases, high-energy shock waves or lasers may be used instead of surgery.

Common minimally invasive urological procedures include:

• Radical cystectomy: Removing the entire urinary bladder using a laparoscope or robotic tools.
• Simple prostatectomy: Removing part of the prostate to improve urine flow, done laparoscopically or robotically.
• Radical prostatectomy: Removing the prostate gland to treat localized prostate cancer, performed laparoscopically or robotically.
• Pyeloplasty: A healthcare provider removes and repairs a narrowed section of the ureter to improve drainage.
• Shock wave lithotripsy: This procedure uses shock waves to break up kidney stones so they can pass more easily through the urinary tract.
• Vaginal prolapse repair: This surgery restores the vaginal wall to its proper position using various techniques.
• Orchiopexy: This procedure moves an undescended testicle into the scrotum and fixes it there and can also treat testicular torsion.
• Partial nephrectomy: Part of the kidney is removed, often using a surgical robot for precision if there’s a small tumor, avoiding open surgery.
• Radical nephrectomy: The entire kidney is removed, typically due to tumors or if the kidney is nonfunctional or problematic.

Reasons for undergoing the procedure

There are several types of cancer that can be treated with minimally invasive urological surgery, such as kidney cancer, prostate cancer, and bladder cancer.

Minimally invasive urological surgery may also be recommended for the following conditions:

• BPH, or benign prostatic hyperplasia
• Chronic kidney disease
• Kidney stones
• Kidney cysts
• Pelvic organ prolapse
• Undescended testicles
• Testicular torsion

Risks

Minimally invasive urological surgery, similar to any medical procedure may have risks, such as:

• Complications with anesthesia
• Infection
• Healing issues
• Injury to the organs
• Seroma, or fluid accumulation at surgical sites

Before the procedure

Before a minimally invasive urological surgery the healthcare provider may do the following:

• Explain the details of the surgery
• Assess the patient’s overall health to ensure suitability for the procedure
• Review one’s medical history, current medications, and any allergies
• Provide specific instructions regarding food and drink intake prior to the surgery

During the procedure

During the surgery, anesthesia is administered to ensure a pain-free experience. However, in some procedures like shock wave or laser treatments patients might be awake but drowsy. These procedure do not usually involve incisions.

After the procedure

After the procedure, one may expect:

• Overall health will be closely monitored, and instructions are provided for recovery
• Instructions to manage pain
• Once the patient is deemed healthy enough, they will be discharged to go home 

Outcome

Overall, minimally invasive urological surgeries offer several benefits, including reduced blood loss, shorter hospital stays, lower infection risk, less pain during recovery, faster healing, decreased need for pain medication, smaller scars, and high success rates.

Recovery times for minimally invasive urological surgeries can vary based on the specific procedure performed. For an accurate estimate of recovery time, it’s best to consult with your healthcare provider.

Post-procedure, it’s important to monitor for potential complications, such as:

• Unmanageable pain despite prescribed medications
• Increasing discoloration, swelling, pain, or pus around the incisions
• Symptoms of infection, such as fever or chills
• Persistent nausea or vomiting
• Excessive bleeding from the incisions