Nephrectomy means the removal of a kidney, & where as ureterectomy was removal of the ureter. The main and major common reason for having a nephroureterectomy was a tumour of the inner lining of the kidney or the ureter, known as transitional cell cancer. The kidney & ureter will be removed by using either an open surgical approach or laparoscopic surgery. If a kidney needs to remove, most of the urologists may do laparoscopic surgery if possible because in open surgery it will involves by making a large cut on the side & front of the abdomen.
OPEN RADICAL NEPHROURETERECTOMY:
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Open nephroureterectomy was done under the general anaesthetic.
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A urinary catheter was always inserted or introduced & stays in the place till you are mobile after the surgery.
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Incision was required to lower down in abdomen, so that the entire length of ureter will be removed. Most frequently, an incision needs to be made in the bladder to make sure the whole ureter was removed.
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Operative time will be based on the complexity of the surgery but generally it will take 3 to 4 hours.
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A urinary catheter will be left inside for 7 to 10 days after the surgery, it was used to allow the bladder to heal.
LAPROSCOPIC RADICAL NEPHROURETERECTOMY:
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The patient must undergo general anesthesia for this method.
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First, the ureter where it enters the bladder was freed by the help of a specially designed cystoscope.
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4 to 5 small cylindrical tubes are called trocars were placed inside the abdominal cavity. The trocars will allow the entry of a video-telescope, known as laparoscope, to observe and view the entire abdominal cavity & kidney.
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The video-telescope will helps the doctor a magnified view of the surgery field & it allows identifying the vessels & structures with more clarity with what it was possible in the open surgery.
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With all the trocars & instruments were in place the vessels which are supplying blood to & from the kidney are need to be clipped.
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The kidney & ureter were now freed from all the surrounding structures.
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The ureter was dissected all the way down to the bladder. The kidney & ureter were then removed as one by extend one of the trocar cut or incisions 2 to 3 inches.
