CYST deroofing surgery


Kidney Cysts:  


A cyst is a collection of fluid. Kidney cysts are very common (approximately 50% of people over 50 years have one) and usually cause no problems. Occasionally, a cyst can increase in size and produce pain and a high blood pressure due to compression of the rest of the kidney. The first-line treatment of such a cyst is to drain it under a local anaesthetic to relieve symptoms, and also confirm that the cyst is responsible for the pain.  At the same time a chemical, called a ‘sclerosant’ can be injected into the cyst to stop it re-forming.  If the cyst re-fills and continues to cause symptoms it is best dealt with by an operation.  

The kidneys lie high in the abdomen, below the diaphragm and as a result can only be reached by traditional surgery through a large incision. The laparoscopic operation is performed through four 5-10 mm cuts near the rib cage.  Although laparoscopy is called keyhole surgery, the view obtained is much better than looking through a keyhole. Modern equipment produces a wide, bright, clear and magnified view of the operation. The gas used to distend the abdomen during laparoscopy also greatly reduces bleeding during surgery.


Laparoscopic cyst ‘de-roofing’

After insertion of the four laparoscopic ports, the camera and instruments are inserted and a workspace is created.  The kidney and kidney cyst(s) is located and the top of the cyst is removed, releasing all the fluid.  Fat around the kidney is placed into the cyst cavity to prevent re-filling, and the ports are removed.  The operation usually takes round 1 hour.   


After the operation  


You should expect some discomfort but this should easily be controlled using the pain-killers you will be prescribed.  Most patients are able to get out of bed and recommence eating/drinking the day following the operation, and leave hospital after 2-3 days.  Be sensible when you are at home – you have had a major operation inside even though the cuts are small and the pain may be minimal.  You should therefore not undertake strenuous physical exercise until at least 3 weeks, and not drive until you are capable of braking hard or swerving quickly to avoid an accident (typically around 2 weeks).    


Follow-up 

Follow-up may vary from patient to patient and will be discussed with you before discharge.

 

© 2009 Australian Urology Associates