Minimally Invasive Treatments

Laparoscopy, or minimally invasive surgery, involves the introduction and use of medical instruments and scopes through small (1/4 to 1/2 inch) incisions to perform surgery. In contrast, the typical flank incision for open surgery is about eight to 10 inches, extending into the ribcage area.

Quicker recovery times, magnified visualization by the surgeon using scopes and video, less pain medication, and smaller incisions and scars are just some of the many advantages of laparoscopic surgery.

At Emory, laparoscopic surgery for cancer, kidney stones, infections, and reconstruction have been performed routinely for the last several years. Laparoscopic kidney removal, adrenal gland removal, and kidney drainage tube reconstruction have almost entirely replaced their open surgical counterparts. Emory boasts two fellowship-trained laparoscopists, as well as a training program to educate community and resident physicians on laparoscopy.

Please see the headings below to learn more about each of the minimally invasive procedures offered at Emory. Not all patients are candidates for laparoscopic surgery.

Robotic Prostatectomy

Robotic prostatectomy is the latest minimally invasive surgical option for prostate cancer. Robotic prostatectomy includes complete removal of the prostate, lymph nodes (if necessary), and reconstruction. Robotic prostatectomy requires five to six small (1/4 inch) muscle-splitting incisions. Patients are less likely to need a blood transfusion, often require less pain medication, and are usually discharged one to two days after surgery.

Laparoscopic Nephrectomy (Kidney Removal)

Laparoscopic nephrectomy (kidney removal) is the most common laparoscopic urologic procedure performed at Emory. For benign cases of kidney removal (stones, infections, diseased or shrunken kidneys), the kidney can be broken up into smaller pieces and removed without enlarging any of the small incisions. For cancer, the kidney is placed in a bag prior to removal through a small incision lower in the abdomen away from the muscles for less pain and better cosmetic appearance. The hand-assisted method allows the surgeon to place one hand inside the patient's body for better tactile sense. Emory urologists also perform kidney surgery via transperitoneal (through the abdomen) or retroperitoneal (from the back, behind the bowel cavity) approaches for patients with multiple previous abdominal surgeries. A typical hospital stay can be as quick as overnight or up to three days.

Laparoscopic Partial Nephrectomy

Laparoscopic partial nephrectomy involves removing just the tumor rather than the whole kidney and sparing as much normal kidney tissue as possible. Partial nephrectomy for smaller tumors has been found to be just as effective as complete nephrectomy with the advantage of leaving the functional kidney behind. This is a more complicated and challenging operation and is limited to small well-placed tumors or diseased segments of the kidney.

Laparoscopic Kidney Tumor Ablation

Laparoscopic kidney tumor ablation, which includes cryosurgery and radiofrequency ablation, is also an option for smaller tumors that are not easily removed by laparoscopic partial nephrectomy. Both techniques are kidney-sparing surgeries designed to cause minimal damage to healthy kidney tissue.

Cryosurgery kidney tumor ablation involves small needles and the use of pressurized gas to freeze the kidney tumor to temperatures below -40 degrees Celsius. This is performed under laparoscopic guidance to visualize the tumor and ensure safety to the surrounding organs.
Radiofrequency kidney tumor ablation also involves the placement of an array of needles into the kidney tumor, which are then heated to 120 degrees Celsius to destroy the tumor cells.

Laparoscopic Pyeloplasty

Laparoscopic pyeloplasty is reconstructive surgery of the junction between the kidney and ureter (kidney drainage tube). Congenital blockages or scar tissue from kidney stones may cause a blockage of the kidney and drainage tube, which over time can lead to flank pain, kidney stone formation, severe infection and eventual destruction of the kidney. Laparoscopic pyeloplasty is a minimally invasive alternative to open surgery and has been found to be greater than 95 percent successful in curing these types of blockages. A typical hospital stay is overnight to two days.

Laparoscopic Adrenalectomy

Laparoscopic adrenalectomy is the surgical removal of the adrenal gland, which lies above the kidney. The most common reason for removal is benign growths of the adrenal that can cause high blood pressure, weight gain, unwanted hair growth, or electrolyte imbalances. Laparoscopic adrenalectomy can also be performed for cancer. The length of the hospital stay for laparoscopic adrenalectomy depends on the reason for surgery. Overnight stays are routine, but longer stays are required for more difficult tumors.

Laparoscopic Stone Surgery

Laparoscopic stone surgery is an uncommon approach to treating kidney stones. Other less invasive procedures for stones have lessened the need for open stone surgery to well below one percent. Laparoscopic stone surgery is reserved for rare cases when both reconstructive or cancer surgery and stone removal must be performed at the same time.