New procedure for kidney removal
- February 2002
L-R: Urologists, Drs. K. Reddy, I. Brown and T. Song perform a laparoscopic nephrectomy
Over the past several years, a new type of surgery has begun to replace conventional surgery in Niagara. This new minimally invasive surgery, called laparoscopy, is drastically changing the way surgery is performed, as well as decreasing recovery time and reducing post-surgical complications for patients.
Laparoscopy uses digital video and fibre optic technology to allow surgeons to remove diseased organs and perform procedures using small incisions, rather than large ones.
Rather than the conventional surgery of a large incision with a scalpel, which causes bleeding and is a much more traumatic recovery, many surgeons today are performing laparoscopic surgery, which involves making a one centimetre incision in the patient, to insert a tiny camera. The surgical team can now view what they are doing internally on a television screen. They make two or three other small incisions, and through these small ports, they insert and manipulate the surgical instruments.
The latest laparoscopic surgery to come to Niagara is kidney removal, also called a nephrectomy. Niagara's seven urologists each perform six to seven nephrectomies every year and until recently, used the conventional method of making a large incision and removing the kidney. This is done because the kidney either contains a cancer or is no longer functioning and is causing problems like infections, pain or bleeding. Now, Niagara Falls urologist Ian Brown with the help of his fellow Niagara urologists are making laparoscopic nephrectomies available region-wide.
"I took the training course about one year ago, and went through a mentoring program with Dr. Kapoor from Hamilton," Dr. Brown said. "Through the Greater Niagara General Hospital Foundation, we were able to add the laparoscopic equipment we needed, and we began doing the procedure in Niagara Falls."
"One of the real benefits of laparoscopic surgery is that there is less blood loss for the patient during surgery, and even though the surgery now takes longer, the recovery time is far quicker." Using conventional surgery, a patient would be in hospital five to eight days, and would spend six to eight weeks at home recovering. Now, using the minimally invasive procedure, patients are in hospital two to three days, and are fully recovered in three weeks. "Data shows that there is no reduction in the success of the procedure provided the patients are properly selected."
"The actual procedure is difficult to conceptualize, so I usually describe it as cutting a one centimetre hole in a cardboard box through which you put a tiny camera, putting chopsticks through two other small holes, and moving things around in the box while you watch it all on TV," Dr. Brown remarks. "It really allows the surgeons to do a number of surgeries such as bowl surgery, hysterectomies and other gynaecological procedures, shoulder surgery, gall bladder removal, adrenal glands, and even sinuses."
"I am now mentoring with Drs. Diane Heritz and Tom Song in St. Catharines and Welland, who have already completed their training courses," Dr. Brown said. "They are assisting me in surgery and will soon be able to carry out their own surgeries, with other Niagara urologists assisting."
Key to this is having the most up-to-date equipment in our surgical suites. The equipment, including camera system and laparoscopic instrumentation, costs more than $60,000. It also costs about $500 for disposable items used for each procedure.