Open Pyeloplasty surgery is a direct surgical procedure done to clear Ureteropelvic junction (UPJ) obstruction. It is performed to repair the ureter( a tube that attaches the kidney and bladder)
This procedure is designed to clear a blockage or narrowing in the ureter. For open surgery pyeloplasty in a small baby or infant, a single incision of 2 to 3 inches is required. In the case of a slightly bigger child, there might be multiple incisions of about 1 centimetre.
An Open Pyeloplasty surgical procedure may be required, in both adults and children. Adults, teenager
How is Open Pyeloplasty performed – Before, during, and after
Before surgery: The patient is asked to get admitted to the hospital a day prior or on the same day. The doctor will conduct a thorough body examination and laboratory investigations before surgery. Since it is an open surgery, the patient would be kept for observation, dressing, and cleaning of the wounds even after the surgery.
Since it involves a direct incision on the body, Open Pyeloplasty surgical procedure is performed under general anaesthesia conditions only..
During surgery:Â An appropriate set of multiple incisions on the flank (side of the body), each about 1cm long, are used for traditional open surgery for pyeloplasty. The abdomen is filled with CO2 for better visibility. The incisions are used to ensure that the stricture may be localised, removed, and two remaining ends of the stricture can be stitched together. The procedure usually takes three to four hours to complete.Â
A wound drain is sewn in place during the surgery. The wound drain is attached to a drainage bag. As the name suggests, the wound drain assists with the drainage of any urine or blood from the kidney that may ooze from the area
After surgery: Apart from this wound drain, a ureteric stent is inserted. This ureteric stent is referred to as a Blue stent or JJ stent. The ureteric stent promotes healing and aids the draining of urine from the kidneys. In addition to these, a catheter is also inserted into the urethra. This catheter further helps to drain the urine. Such a catheter drains into a bag and is left in place till the patient is ready to resume activities. The incisions are sutured using dissolvable stitches after the surgery. The entire procedure can take 2 to 4 hours. After a Open Pyeloplasty surgery, it is recommended to be kept under observation in the hospital for another night.
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Risk factors
Although this surgery is safe, there are risk factors and potential complications of the surgical procedure. Following are some of the possible complications:
- Bleeding: Blood loss is usually modest (less than 100 cc) during this treatment, and a blood transfusion is rarely necessary.Â
- Infection: All patients are given broad-spectrum intravenous antibiotics before surgery to reduce the risk of infection.
Hernia: Hernias at incision sites are uncommon because all keyhole incisions are meticulously closed at the end of the procedure.
