What is Endopyelotomy Surgery ?
This operation is done to open up a narrowing of the ureter. This is the tube that goes from patient's kidney to patient's bladder. A nephrostomy tube (a small drainage tube) is passed through an incision (cut) in patients back into patient's kidney. A ureteric stent (small hollow, plastic tube) is then passed through the nephrostomy tube into the ureter. This stent makes sure that urine (pee) drains from the kidney to bladder. The nephrostomy tube may be removed after patient's stent is in place. Patient's stent will stay in place for a few weeks.
Used for temporary internal drainage from the ureteropelvic junction (UPJ)to the bladder following incision of a stricture. The segment with no sideports prevents post operative narrowing of the ureteral lumen while preventing in growth of ureteral wall to the stent. Highly radiopaque and has low encrustation tendency
What does the procedure for Endopyelotomy Surgery involve ?
Two approaches are commonly used for Endopyelotomy; both these techniques are performed under general anesthesia.
Patient will be required to stay in the hospital for 2 days following the Endopyelotomy procedure : -
- Antegrade Endopyelotomy- In this procedure, the ureteropelvic junction of the kidney is approached from the side through the Nephrostomy tube. A blade is used to cut the UPJ and relieve the obstruction. The entire procedure takes about 2 - 3 hours. The nephrostomy tube is left in after Endopyelotomy.
- Retrograde Endopyelotomy - This procedure is performed by approaching the UPJ via the urethra. The Retrograde Endopyelotomy instrument contains a balloon that dilates and at the same time cuts to relieve the obstructed UPJ. This technique of Endopyelotomy is performed under general, regional or intravenous sedation. The entire procedure of Retrograde Endopyelotomy takes about 2 hours.
Benefits of Endopyelotomy Surgery : -
- Short hospital stay
- Quicker recovery
- Less pain during post-operative period following Endopyelotomy
- Less need for pain medication
- Quicker return to normal activity and work
- Smaller incisions and less scarring
- The advantage of this approach is two fold. Primary placement of the stent helps to define the appropriate site and direction for the endopyelotomy incision, allowing marsupialization of the proximal ureter into the renal pelvis. Use of this technique also obviates the need to pass a large-caliber stent after the endopyelotomy incision has been made, thereby avoiding a potential risk of ureteropelvic junction disruption.
Risks of Endopyelotomy Surgery : -
- Failure of the operation
- Excessive bleeding
- Infection (at the operation site or the urinary tract)
- Injury to other organs and tissues
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