Dr. Shaw is proud to be one a few Urologists in Central Texas to offer expertise in da Vinci (robotic) repair of obstructed, or blocked kidneys. Where this was once a major procedure with an incision from the front to back under the ribs, we replace this with 4 tiny incisions the width of your thumb.
Laparoscopic da Vinci Robotic Pyeloplasty & UPJ Repair Information
What happens under normal conditions?
What is ureteropelvic junction (UPJ) obstruction?
Although encountered less frequently in adults, UPJ obstruction may occur as a result of kidney stones, previous
What are the symptoms of ureteropelvic junction (UPJ) obstruction?
How is ureteropelvic junction (UPJ) obstruction diagnosed?
How is ureteropelvic junction (UPJ) obstruction treated?
Dr. Shaw is proud to offer the latest technology for management of urologic disorders with robotics. Dr. Shaw was amongst the first surgeons in the area to offer this option to patients, and began his training in robotics in 2000 while in residency at Tulane, the first robotics program in the Gulf Coast region.
Dr. Shaw has been chosen since 2004 to be one a select group of surgeons from Intuitive Surgical, to be a nationwide proctor of da Vinci Robotic Surgery. Dr. Shaw routinely participates in national and international events for robotic surgery, keeping with the latest technology in this rapidly expanding area of Urology.
The classic treatment of UPJ obstruction is an open operation to remove the UPJ and to reattach the ureter to the pelvis of the kidney creating a wide junction between the two. This operation, called a pyeloplasty, allows rapid and easy drainage of urine produced by the kidney and relieves symptoms and the risk of infection. The procedure usually has a success rate in excess of 95 percent with one operation. Hospitalization after surgery depends on age of the patient.
Newer treatment of UPJ obstruction involves minimally invasive surgery. Dr. Shaw is able to replicate the same procedure that is done with a large (open) incision with the latest technology. Dr. Shaw is proud to offer da Vinci laparoscopic, robotic repair of UPJ obstruction.
What is da Vinci Robotic Surgery? Simply put, the reason why we used to make large incisions for major surgeries was so we could put our hands inside the body. With the the advent of robotics, we perform the same surgery, arguably better, with smaller incisions, because instead of the surgeon’s hands, we only need to make a few small 1/2 inch incisions to insert the robotic hands. From there, we use 3-D vision, High Definition (HD) Cameras and the latest technology to translate the surgeons hand movements to the robotics. Think Wii for robotic surgeons! All this technology translates to more precise movements, vision that is magnified in 3-D and other benefits. Results? My patients rarely require blood transfusions, have less pain and smaller incisions than open surgery, and return home in 24-48 hours.
What can be expected after treatment for ureteropelvic junction (UPJ) obstruction?
The day before your procedure, we ask that you take only a clear liquid diet (soups, broths, etc). However, do not take anything by mouth after 12:00 midnight the night before surgery. Wear comfortable, loose-fitting clothing like a jogging suit on the day of your procedure. Bring a list of all the prescription and nonprescription medications that you take regularly with you on the day of the procedure.
Please plan to arrive two hours prior to your treatment.
The procedure usually takes 3 hours, and Dr. Shaw will come and speak to your family afterwards.
Upon wakening from the procedure, you will have a catheter draining your bladder. I have yet to meet a person who likes having a catheter, but relax, the catheter typically will remain for just a few days and removed. Because we have effectively removed a small part the urine tube (ureter), this needs to heal, or seal back up. A catheter for a few days accomplishes this.
It is common for the catheter to drain pink or red urine. Just as Kool-Aid can turn water red with just a small amount of coloring, just a small amount of blood turns the urine red. This will clear up in a few days.
You will be given full instructions from our nurse on how to manage, and drain the foley catheter bag when it gets full.
It is not unusual to have a sensation of wanting to urinate, or to have bladder spasms after surgery. This usually goes away within 1-2 days.
The ureter (urine tube connecting kidney and bladder) is about the dimension of a soft-drink straw. The ureter is reconnected over a stent, which is a temporary plastic tube that is placed internally, and goes from the kidney to the bladder. This stent is about as wide as coffee stirrer straw, and helps to keep the ureter from closing shut after surgery.
Most patients tolerate the stent just fine, although some patients may have discomfort between the kidney and bladder, or an urge to urinate frequently, because of the stent. Luckily, the stent is just temporary, usually in place for just a few weeks while the ureter heals, and is removed in a 30 second brief procedure with lidocaine (numbing) jelly in the office.
A foley catheter draining the bladder is usually removed 48-72 hours after the procedure.
A drain is also placed near the surgery site to remove postoperative fluid. This is also removed a few days after surgery.
Advice After da Vinci Robotic Pyeloplasty
For pain, if it is OK to take, advil, motrin or prescription Toradol is great. These are non-narcotic, so you don’t get sleepy, constipated or have other issues; however they are great anti-inflammatories. Take them on a regular basis the first 2-3 days after the procedure. For pain not relieved by these medications, use the prescription Tylenol with Codeine or Vicodin that was prescribed for you.