Complications after laparoscopic renal surgery

Laparoscopic renal surgery is a safe procedure, allowing a part or whole of the kidney to be removed or cancerous without the need for open surgery. However, there is still a small percentage of post-surgery accidents.

1. What is renal endoscopic surgery?

Laparoscopic renal remand surgery is a procedure to remove part of a damaged or cancerous kidney. When performed, the surgeon cuts 3 small cuts with a diameter of 1 – 1.5cm on the abdomen while the patient is given a full-body anesthesia. Then high-precision medical instruments are inserted into the abdomen for these small cuts. Under the instructions of the ultrasound images, the doctor will remove the damaged part of the kidneys from the patient's body.

With non-invasive properties, laparoscopic renal surgery is being widely used in the treatment of many diseases such as cancer, de-functioning kidney surgery, kidney transplantation. There are many conditions to consider before using endoscopic renal removal including: age, general health, general kidney function, number of tumors and patient selection. The advantage of this method is less invasive, less pain, faster recovery than regular open surgery.

Total kidney removal due to cancer

Photos of kidneys removed due to cancer

2. Laparoscopic renal cirlitar is introscopy in design

2.1 Treatment of malignant diseases

  • Extensive renal cutting in the treatment of kidney cancer:

Is the leading indent for laparoscopic renal rescopy. Contrainasing cases of coaking dysfunction, severe cardiopulmonary disease, abdominal wall infections, lower aortic thrombosis, lymph node metastatic, invasive cancer into neighboring agencies. Relative contraint index for large tumor size cases. Be careful of old cases of in-abdominal surgery and obesity;

  • Part kidney removal in the treatment of kidney cancer:

In addition to small-sized tumors, on the surface or peripheral of the kidneys. Contraincular to cases of deep tumors invading the renal navel, tumors located in the middle of the kidneys, tumors with a combination of renal vein thrombosis, patients with coaculation disorders and a history of old surgery on the kidneys. Contrain specifying the pair of renal stalks (arterial control) for cases of medium and severe increase in blood nitrogen. Be careful with cases of obesity;

  • Renal and ureteral cuts in high urinary tract hermuria:

Renal and ureteral cuts are in place for cariomas that no longer prescribe endoscopic removal, those that have not yet invaded the surrounding organization.

Urethral mesthral myality

Urethral mesthral myality

2.2 Treatment of benign diseases

  • In addition: Loss of renal function, chronic renal tank inflammation, dysenteritis in polycystic kidney disease, kidney disease caused by urine reflux, cause-in-the-cause arterial hypertension in the kidneys, progressive polycystic kidney disease,…
  • Contraincularity: Unsubstrained blood clot disorders, infection at the surgical site, heart failure, severe respiratory failure. Relative contraincularity for cases of sticking around the kidneys, especially cases of renal tuberculosis, purulent kidneys, achingitis, post-traumatic or post-embolic atrophy.

2.3. Cutting kidneys in living people for kidneys

The technique of renal transplantation by laparoscopic surgery in people who volunteer for the kidneys has many advantages such as less trauma, high aesthetic factors, increased labor rehabilitation. This technique requires high accuracy, avoiding kidney damage, especially the kidney stalk must be operated on, ensuring the requirement of renal blood vessels.

3. Contraint of renal laparoscopic surgery

  • Renal renal loss due to stones: Relative contrainture;
  • Old history of abdominal surgery: Patients with a history of old abdominal surgery can cause in-abdominal stickiness, making laparoscopic surgery difficult. This is relative contrain specifying;
  • Obesity: Makes it difficult for the surgeon;
  • Intestinal obstruction and intestinal paralysis: Increases the risk of bowel damage during surgery because it reduces the working space during laparoscopic surgery;
  • Blood clot dysfunction: Is absolute contrainttraincular;
  • Uns treated bacterial infections: Abdominal wall infections near the surgical location if not treated steadily are the main causes of bacteria entering the body, causing post-surgery infection;
  • Kidney disease – yellow-grained renal tank and renal tuberculosis can cause severe inflammation around the kidneys, increasing the risk of complications in laparoscopic surgery, so open surgery should be prioritized;
  • Cardiovascular disease or severe lung disease: May put patients at risk of complications from abdominal inflatables.

obesity

Obese people are contrained to renal laparoscopic surgery

4. Perform laparoscopic renal surgery

4.1 Preparation

  • Personnel performed: Experienced urologist and anesthesiologist;
  • Means: Endoscopic surgery system, ultrasonic knife, 5mm trocar, 10mm, automatic cutting pinper, clamp, endoscopic scissors, ,…;
  • Patients: Be tested to assess the offsetting of renal function, identify the cause of pathology through tests: ultrasound, intravenous urinary scan, computer ct scan of the urinary system, radiomodiography, renal anal scan,… In addition, elderly and depleted patients will be improved pre-surgery.

4.2 Implementation

Patient position: Tilt 75° if laparoscopic surgery through the peritoneea; tilt 90° if post-iton endoscopic surgery;

  • Insymity: The patient is given in-administration anesthesia, pre-surgical urethral sonde is placed;
  • Trocar placement: Placement depends on laparoscopic surgery through the mesitoneea or post-iton endoscopic surgery;
  • Create a post-iton cavity;
  • Renal removal: The technique depends on laparoscopic surgery through theitone membrane, post-iton endoscopic surgery or renal removal for transplantation.

Bronchoscopy helps to check for problems with the throat, tracheeal, bronchi

In-administration anesthesia techniques

4.3 Patient monitoring

  • During surgery: Close monitoring of vessels, arterial blood pressure, central vein pressure, O2 and CO2 blood levels, blood loss, blood flow, duration of surgery;
  • After surgery:
    • Hemolysis, general condition, abdominal condition, post-surgery pain, urine volume, re-circulation, sub-skin gas overflow, drainage;
    • Water and electrolycage accretion according to results obtained from blood bio biomeding tests;
    • Combined use of antibiotics of the cephalosporins group and Metronidazol 3-5 days;
    • Re-examination after 1 month.

5. Complications and handling during and after laparoscopic renal surgery

5.1 Surgical accidents

  • Peritoneal tearing (in patients with post-peritoneal endoscopic renal removal) caused by trocar puncture or during surgery: Treatment by adding trocar to push the peritonea or suturing the torn peritonea. In case of extensive tearing of the mucous membranes, which cannot be stitched, they are enlarged, transformed into laparoscopic surgery of the kidneys through theitone membrane;
  • Pleural tearing, perforation of the diaphragm due to high trocar puncture close to the flank or during surgery can be handled by suturing the pleura and diaphragm through endoscopy, combining continuous suction pleural circulation. And if laparoscopic surgery cannot be continued, switch to open surgery;
  • Bleeding due to damage to the lower aortic vein, genital veins: If it is not handled through laparoscopic surgery, it is recommended to transfer open surgery to stitch up the bleeding;
  • Damage to other organs such as the duodenum, colon,... due to trocar puncture, surgery or electric combustion, it is recommended to transfer open surgery, handle according to the lesion;
  • Technical difficulties, abnormal vascular stalks, inflammation around the kidneys, widespread lesions that cannot be operated on through endoscopy should be transferred open surgery.

Trocar poke

Wrongly poking trocar can cause complications in laparoscopic surgery

5.2 Post-surgery accidents

  • Bleeding in the abdomen: Surgery is required immediately;
  • Residual capacitors or abs absss in the abdomen: It is necessary to determine the exact location, size of the outbreak or absss by ultrasound or computer cirr topecting and handling in each specific case. That is:
    • Volume capacitors, an oversentositors of less than 5cm, in shallow can poke under the instructions of ultrasound;
    • Condensation, deep-rooted anesthosis that needs to be stored or surgery to clean the anesthies.

Laparoscopic renal surgery is a highly safe, less invasive, simple and proactive technique that brings many benefits to patients during treatment and recovery, helping to preserve the kidneys, maintaining the quality of life for patients. Although it is considered safe, this technique still carries risks. Therefore, patients who are prescribed endoscopic renal removal need to follow the instructions of their doctor, re-examine in a timely manner to minimize the risk of complications.

For detailed advice on this method, please go directly to Share99 health system or book an online examination HERE.

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SEE MORE:

  • Advantages of laparoscopic renal rescopy surgery
  • Laparoscopic renal surgery for benign kidney disease
  • How is endoscopic renal removal performed?
SEE MORE:

  • Laparoscopic renal surgery for malignant kidney disease
  • How do I know if the cancer metalysed to the bone?
  • How is endoscopic renal removal performed?

About: Minh Quynh

b1ffdb54307529964874ff53a5c5de33?s=90&d=identicon&r=gI am the author of Share99.net. I had been working in Vinmec International General Hospital for over 10 years. I dedicate my passion on every post in this site.

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