Minimally Invasive Urological Surgery

Laparoscopic Procedures

Laparoscopic Adrenalectomy
Tumors growing on the adrenal glands, and one or both adrenal glands can cause production of excess hormones and may need to be removed surgically. Also, large adrenal masses may need to be removed if cancer is suspected. Cooper surgeons routinely use laraposcopy for this procedure. Traditional surgery may be necessary, however, to remove adrenal glands that are very large or produce volatile hormones.

Hand-Assisted Laparoscopy
In hand-assisted laparoscopy (HAL), used in various urological procedures, a Cooper surgeon uses a special sleeve to insert his hand into the body through a small incision (cut). HAL provides improved control and sensation and enables the surgeon perform certain advanced laparoscopic procedures more quickly and safely than with standard laparoscopic techniques. Surgeons can remove affected organs intact through the same small incision made to insert the hand; this allows the sample to be more accurate evaluated, especially when cancer is suspected. One of the most common conditions treated with this approach is kidney cancer.

Laparoscopic Surgery of the Kidney

Laparoscopic Nephrectomy
Kidney removal (nephrectomy) may be necessary in patients with kidney cancer, recurrent kidney infection, severe stone disease, or long-term obstruction of the kidney. Also, a kidney may be removed from a healthy donor for transplantation into a patient with kidney disease. Cooper surgeons use a variety of laraposcopic techniques to remove a kidney. Laparoscopy enables surgeons to see the kidney better during surgery and results in a much smaller scar—about 3”—than traditional surgery, which requires a 10-20” scar and, sometimes, the removal of a rib.

Laparoscopic Partial Nephrectomy
Currently, when kidney cancer is often diagnosed before it is of a large size or spreads to other parts of the body, in the majority of patients, removing the part of the kidney with the tumor is all that is needed (partial nephrectomy.) The technique for partial nephrectomy is similar to complete removal of the kidney; however, additional reconstruction is needed to repair the damaged tissue and to restore kidney function. Cooper surgeons use advanced laparoscopic techniques to perform this procedure. Laparoscopy enables surgeons to see the kidneys better during surgery and results in a much smaller scar—about 3”—than traditional surgery, which requires a 10-20” scar and, in some cases, the removal of a rib.

Laparoscopic Nephroureterectomy
Transitional cell carcinoma is a type of cancer that can occur in the renal pelvis and/or the ureter. Surgical removal of the kidney and the ureter (nephroureterectomy) may be necessary if cancer has formed in the lining of these structures or in cases where there is a long history of reflux within the kidney, or if the kidney is non-functioning. Cooper surgeons use laraposcopy to remove the kidney and ureter, resulting in a much smaller scar—about 3”—than traditional surgery, which requires a larger incision or sometimes two.

Laparoscopic Pyleoplasty
Obstructions can occur where the kidney and ureter meet (called ureteral pelvic junction obstruction), due to stone disease, infection, or trauma, or they may be present from birth (congenital). Some people with a ureteral pelvic junction obstruction have no symptoms; others have pain, an infection, or blood in the urine. Ureteral pelvic junction obstruction can cause urine to build up in the renal pelvis, which could damage the kidney. Cooper surgeons use laparoscopic pyleoplasty to repair the ureteral pelvic junction obstruction surgically by removing the obstruction from the ureter and reconstructing the ureter and renal pelvis to improve urine drainage.

Laparoscopic Removal of Renal Cysts
While most kidney cysts are non-cancerous (benign) and require no treatment, some cysts grow large enough to cause pain, obstruct the kidney, or cause high blood pressure. Kidney cysts that produce serious symptoms need to be drained and removed. Cooper surgeons use laraposcopy to remove kidney cysts.

Laparoscopic Surgery for Prostate Cancer

Laparoscopic Lymph Node Removal
This procedure is used to determine if prostate cancer has spread (metastasized) to the lymph nodes in the pelvis. Patients with a significantly elevated prostate-specific antigen (PSA) blood test, a high tumor grading (Gleason score), and/or disease on both sides of the prostate (bilateral) are more likely to have cancer that has spread to the pelvic lymph nodes. Since treatment options are different for patients with metastatic prostate cancer, determining if the cancer has reached the pelvic lymph nodes before surgery or radiation therapy is very important. Cooper surgeons use laraposcopy to take a sample of the lymph nodes for analysis, in patients at risk for lymph node metastasis.

Percutaneous Renal Surgery
Stones can form in the kidney and cause pain or an infection. Cooper surgeons use percutaneous kidney surgery on large, complex, or infectious stones and sometimes for transitional cell carcinoma of the kidney. During percutaneous renal surgery the surgeon uses x-ray to guide a needle into the patient’s back and kidney. He then places a special scope (nephroscope) and instruments into the kidney to evaluate and repair the defect.

Shock-Wave Lithotripsy
Although very small kidney stones may pass through the body with little pain, a larger stone can get stuck in the kidney or ureter and cause severe pain. Extracorporeal shock wave lithotripsy is the standard treatment for small to moderate stones without infection or blockage. The procedure does not require any instromentation and is usually done as an outpatient procedure.

Ureteroscopy
Ureteral stones can form in the kidney and get lodged in the ureter, where they can block the flow of urine and cause pain or an infection. Narrowings or strictures can also form in the ureter as a result of previous surgery, radiation therapy, or passage of stones, or be present from birth (congenital). Cancer within the lining of the urinary system, known as transitional cell carcinoma, can also occur within the ureter. Cooper surgeons use ureteroscopy to evaluate, remove and treat ureteral stones, strictures, or tumors without an incision.