Minimally Invasive Urological Procedures

Physicians at Baptist may use minimally invasive surgical techniques to treat a number of urological conditions, including:

• Prostate cancer
• Bladder cancer
• Enlarged Prostate (benign prostate hyperplasia or BPH)
• Kidney cancer: For patients diagnosed with kidney cancer-as well as for those who experience recurrent kidney infections, severe kidney stone disease, or long-term obstruction of the kidney-nephrectomy (complete kidney removal) may be indicated. This procedure is also performed for those patients who choose to be kidney donors.
• Kidney stones: While most kidney stones can be passed through the body without treatment, in some cases larger stones can become lodged in the kidney or ureter, causing severe pain.
• Female incontinence: For females experiencing the uncontrolled loss of urine, surgeons may perform a trans-obuturator sling. This procedure corrects stress incontinence by supporting the bladder neck and urethra in their correct position. The sling is laced through an incision in your thigh and vagina. The procedure does require an overnight stay in the hospital. 
• Urethral stricutres

In many cases, minimally invasive urological surgeries are performed laparoscopically. For this technique, physicians use a device called a laparoscope, a slender illuminated optical or fiber-optic instrument that is inserted through an incision in the abdominal wall. It is used to visually examine the interior of the peritoneal cavity. Laparoscopic surgery eliminates the need for a long incision in the abdominal muscles, making post-operative care and recovery much easier. Many patients are able to go home the day of surgery.

For certain urological surgeries, physicians may choose to use the daVinci Surgical System,™ technology that enhances the surgeon's ability to perform a number of minimally invasive procedures.

During a procedure, the surgeon operates while seated comfortably at a console in the operating room where he views a 3-D image of the surgical field, while grasping master controls that convey his hand, wrist and finger movements into precise, real-time movements performed by the robotic surgical instruments inside the patient. The instruments are designed with seven degrees of motion that mimic the dexterity of the human hand and wrist. The surgeon sees the surgical field on a monitor that provides 10x magnification and 3D imagery. This system allows physicians to perform technically demanding procedures with great precision. 

At Baptist, physicians perform the following minimally invasive urological surgeries.

• palladium seed implantations for prostate cancer
• cryotherapy: This technolgoy allows surgeons to freeze tumors. Currently, urologists are treating prostate cancer and small penal tumors with the state-of-the-art SeedNet™ Cryotherapy system. This procedure can be performed on an outpatient basis.
• laparascopic nephrectomy: In this procedure, the kidney is surgically removed using laparascopic equipment. This technique produces a much smaller scar-usually around three inches long-as compared to the 10-20 inch scar typical of traditional open surgery. Open surgery may also at times require the removal of a rib.
• laparascopic partial nephrectomy: In certain cases-such as when kidney cancer is diagnosed before it has grown very large-only a portion of the kidney is needed to be removed. As in a total nephrectomy, laparascopic techniques may be used to remove the diseased portion of the kidney, to repair the remaining tissue and restore function. Laparascopic equipment provides the surgeon with enhanced visualization of the surgical field. It also produces a much smaller scar.
• radical prostatectomy (robot assisted)
• photoselective vaporization of the prostate (GreenLight PVP™)
• percutaneous renal surgery: In this procedure, surgeons uses X-ray imagery to guide a needle through the patient's back into the kidney. There, he places a scope and other surgical equipment to repair damage caused by conditions such as large, complex or infected kidney stones. This technique may also be used to treat a type of kidney cancer called transitional cell carcinoma.
• shock-wave lithotripsy: Usually done on an outpatient basis, this technique is done without surgical instruments of any kind. Lithotripsy uses shock-waves to crush kidney stones into pieces small enough to be voided. It is the usual treatment for kidney stones that are small, not infected and not causing blockage.
• ureteroscopy: In this procedure, surgeons visually examine the interior of the ureter. This technique may be used to evaluate and/or treat kidney stones that have entered the ureter; structural changes within the ureter caused by previous surgeries, radiation therapy or as a result of a birth defect. It may also be used to treat a certain kind of cancer of the ureter called transitional cell carcinoma.
• Laser DVIU (direct visual internal urethotomy) for urethral stricures
• bladder biopsy
• transurethral resection of bladder tumor

Learn more about Urology Services at Baptist.