PYELOPLASTY
Surgery of the renal pelvis due to a urine drainage disorder (robot-assisted pyeloplasty)
Robot-assisted pyeloplasty is a surgery which removes obstructions to urinary drainage from the renal pelvis in the ureter, in the area of the so-called ureteropelvic junction (UPJ). In this surgery the UPJ is removed and the ureter is reattached to the renal pelvis in order to create a wide opening. The advantages are similar to other mini-invasive surgeries, i.e. the approach to the operated area through small cuts, the careful preparation of the renal pelvis and ureter under a magnified 3D image and a precise suture of anastomosis between the renal pelvis and ureter.
Robot-assisted pyeloplasty is also performed on young patients, from the age of about 8-10, with the decisive factor being the overall stature of a patient.
Typical hospital stay procedure
Patients are usually admitted to the Urology Clinic one day before surgery. Besides the usual pre-operative examination, urine analysis is needed to eliminate potential infection of the urinary tract in order to ensure seamless reconstruction surgery. Patients are administered a glycerine suppository for bowel movement before their surgery. Food, drinks and cigarettes are prohibited from midnight before the surgery. Patients lock their belongings in a personal locker on the day of the surgery. Diazepam („premedication“) is usually administered before leaving the ward during the preparation for anesthesia. Patients are transported to the operating room by a nurse and handed over to an anesthesiologist. They have a brief check / interview which is followed by the administration of anesthesia. After the surgery, patients are transported to the sleep-in room for about 2 hours to fully wake up and they are given an overall check after the anesthesia. They are then transferred back to their bed in the Urology Clinic. A urinary catheter is inserted in the urethra during the surgery and removed about a week after the surgery. A drain may be inserted in the abdominal cavity for 1-2 days. A so-called DJ stent is also inserted during the surgery. It is an internal drainage tube leading from the renal pelvis to the bladder. This helps maintain good urine flow from the kidneys during the healing of the pelvis – ureter anastomosis. If a DJ stent has been inserted some time before the surgery (especially due to pain), it may need to be replaced one day before the surgery, especially if it has been present in the urinary tract for a longer time. The stent is left in place for about 4-6 weeks after the surgery, then it is removed during a day patient visit. There are usually 4 small scars on the abdomen after the surgery. The patient is discharged from the hospital on the 5th or 6th day.