Minimally Invasive Urological Surgery

What is minimally invasive urological surgery?

In minimally invasive urological surgery, urologists use techniques that let them treat certain conditions without doing open surgery that requires large cuts (incisions) in your body. Minimally invasive surgery uses small incisions — cuts about the size of a dime — that do less damage to healthy tissue and reduce blood loss during surgery.

Urologists may use minimally invasive surgery to correct issues that affect your urinary system, female reproductive system and male reproductive system (genitourinary systems).

Urologists can perform minimally invasive urological surgery in different ways, including:

• Laparoscopically.
• Robotically.
• Through a single port.
• Endoscopically. During endoscopic surgery, they’ll insert a long, thin, flexible tube with a small video camera at the end and channels for surgical instruments (endoscope) to pass through the urethra into your urinary bladder, ureter (pee tube) and kidney to treat a variety of conditions.

In some cases, urologists may use high-energy shock (pressure) waves or lasers instead of surgery.

What is laparoscopic urological surgery?

In laparoscopic urological surgery, urologists use a laparoscope to see inside a small incision in your body. A laparoscope is a thin rod with a camera at the end that can zoom in and enhance images.

Laparoscopic urological surgery typically involves two to four incisions, or keyholes. The laparoscope goes into one keyhole while the surgical tools go into the other keyholes.

What is robotic urological surgery?

In robotic urological surgery, urologists use mechanical arms that they control with a surgical console. The arms contain small surgical instruments with “wrists” at the tip, allowing for a greater range of motion and finesse. There’s also a special camera that surgeons use in robotic surgery. It creates 3D images that enable the urologist and the rest of the surgical team to see the affected areas.

What is single-port surgery?

Single-port surgery means a urologist only makes one small incision in your abdomen or belly button (navel) — the location depends on the type of surgery. In this surgery, your urologist first blows carbon dioxide into your belly to inflate it. Inflating (insufflating) your belly creates space to work and makes it easier for your urologist to see your organs. It also gives your urologist room to insert a camera and any needed surgical tools into your belly.

What does minimally invasive urological surgery treat?

Minimally invasive urological surgery treats a wide range of conditions, including:

• Bladder cancer.
• Kidney cancer.
• Prostate cancer.
• Kidney stones.
• Kidney cysts.
• Pelvic organ prolapse.
• Undescended testicles.
• Testicular torsion.
• Chronic kidney disease.
• Benign prostatic hyperplasia (BPH).

What are some of the most common minimally invasive urological procedures?

Some common minimally invasive urological procedures include:

• Vaginal prolapse repair. A vaginal prolapse repair fixes your vaginal wall after it falls from its normal location in your body. A urologist will use a variety of techniques to restore support.
• Orchiopexy. An orchiopexy is a procedure to move an undescended testicle into your scrotum (the pouch of skin behind your penis that typically contains your testes) and permanently fix it there. Urologists also use orchiopexy to treat testicular torsion.
• Partial nephrectomy. During a partial nephrectomy, a urologist will remove part of your kidney. They may use a surgical robot if you have a small kidney tumor. The robot has small arms that can make precise movements in hard-to-reach areas in your body. Using a surgical robot means you don’t have to have open surgery.
• Radical nephrectomy. During a radical nephrectomy, a urologist will remove your entire kidney. They may completely remove your kidney if you have kidney tumors or kidneys that don’t work (nonfunctioning), don’t drain very well or cause symptoms.
• Radical cystectomy. A urologist may use a laparoscope or robot to remove your entire urinary bladder.
• Simple prostatectomy. BPH can cause your prostate to become very large and obstruct your pee flow. During this procedure, a urologist removes the inner portion of the prostate to improve your pee flow. They may perform a simple prostatectomy robotically or laparoscopically.
• Radical prostatectomy. In this surgery, your urologist treats prostate cancer by removing your prostate gland. Urologists do this surgery when you have prostate cancer that hasn’t spread (metastasized) to other areas of your body. They can perform the procedure laparoscopically or robotically.
• Pyeloplasty. During a robotic or laparoscopic pyeloplasty, a urologist will cut out (excise) a narrowed and/or poorly draining section of your ureter (pee tube). They then reconstruct the ureter to allow for better drainage.
• Shock wave lithotripsy. This procedure uses shock waves to break up kidney stones, making it easier for the stones to move from your kidneys or ureter (pee tube) into your bladder and then out of your body.

What should I expect during minimally invasive urological surgery?

Your urologist will explain how they’ll use a specific, minimally invasive surgery to treat your condition. They’ll perform a physical examination to ensure you’re healthy enough for surgery. They’ll also ask questions about your:

• Health history.
• Any medications you’re taking.
• Any allergies you have.

They’ll also give you specific directions on when to eat and drink the day before your surgery.

Minimally invasive urological surgeries require anesthesia. For many of them, you won’t be awake and won’t feel any pain. However, you may be awake but drowsy during shock wave or laser surgeries that don’t require incisions.

After your procedure, healthcare providers will track your overall health, treat your pain and give you instructions on how to recover best. Once they determine you’re healthy enough, they’ll let you go home.

What are the benefits of minimally invasive urological surgery?

The primary benefits of minimally invasive urological surgery include:

• Less blood loss.
• Shorter hospital stay.
• Lower risk of infection.
• Less pain while you recover.
• Faster recovery time.
• Less pain medication.
• Smaller scars.
• High success rates.

What are the risks or complications of minimally invasive urological surgery?

All surgeries come with general risks. These include:

• Anesthesia risks.
• Infection.
• Organ damage.
• Healing problems.
• Fluid buildup at surgical sites (seroma).

Talk to your urologist about additional risks for specific surgeries.

What is the recovery time after minimally invasive urological surgery?

The different types of minimally invasive urological surgery have different recovery times. Your urologist will give you a better estimate of your recovery time according to your procedure.

When should I call my healthcare provider?

After minimally invasive urological surgery, contact your healthcare provider right away if you notice any of the following:

• Signs of infection, such as fever or chills.
• Long-lasting nausea and vomiting.
• Heavy bleeding at your incisions.
• Increasing discoloration, swelling, pain or pus around your incisions.
• Pain that you can’t manage with prescribed medications.

What is the difference between minimally invasive urological surgery and open urological surgery?

Minimally invasive urological surgery uses very small incisions and a laparoscope or surgical robot to help perform the surgery. These tools allow your surgical team to see your affected areas and perform the surgery without damaging much of the surrounding areas. You usually spend less time recovering at the hospital, and your overall recovery is faster.

Open urological surgery is a more traditional surgical approach. Your urologist makes a large incision in your body with a sharp knife (scalpel). The incision is at least 3 inches long, but it may be as long as 12 inches or more, depending on the type of procedure. Your urologist looks at your affected areas and performs the procedure through the incision. Open surgery usually requires you to spend more time recovering at a hospital. Your overall recovery usually takes longer than minimally invasive urological surgery.

A note from Cleveland Clinic

Minimally invasive urological surgery uses medical technologies and techniques to make surgery easier on your body. It’s less invasive, which means you spend less time at the hospital, and your recovery time is faster. It can also make surgery less intimidating because there are fewer risks than open surgery. Talk to your urologist about how they’ll use minimally invasive urological surgery to treat your condition. They can answer any questions you may have about a specific approach.