Augusta University Medical Center's Department of Urology is one of few in the Southeast to offer laparoscopic procedures to treat cancers of the prostate, kidney bladder, testicle and adrenal gland. We have performed laparoscopic surgeries since 2002. A complex, advanced technique, laparoscopic surgery is a minimally invasive procedure that requires specially trained surgeons and the most precise equipment. As a result, few centers worldwide provide this alternative.
Laparoscopy reduces pain, blood loss, scars and recovery time. During the procedure, a thin needle is placed into the abdomen through which carbon dioxide gas is introduced to inflate the abdominal cavity, giving the surgeon visibility and space to work. Surgeons make two to five dime-sized incisions into which they inserting hollow tubes called trocars. A specialized fiberoptic telescope with a video camera, called a laparoscope, is inserted through one of the trocars, allowing the surgeon to see inside the abdomen via a television monitor. The trocars are also used as paths for slender surgical instruments, and aid in the removal of cancerous growths and organs. In hand-assisted laparoscopy, a slightly larger incision allows the surgeon to insert a hand inside the abdomen to perform more complex surgery.
Our surgeons also use minimally invasive surgery for urologic abnormalities such as ureteropelvic junction obstruction and retroperitoneal fibrosis.
Nephrectomy and partial nephrectomy: The complete or partial removal of a kidney may be necessary due to cancer, infection or kidney disease. During laparoscopic nephrectomy, a kidney without cancer can be diced into smaller pieces that are removed through the trocars. A cancer-containing kidney must be removed in one piece to prevent spilling cancer cells. Removing it in one piece also makes it easy to diagnose the extent of the cancer under a microscope.
Prostatectomy: We offer laparoscopic removal of the prostate gland to treat prostate cancer, resulting in less blood loss, less pain and quicker recovery. This technique also allows more exact placement of sutures than traditional radical prostatectomy, thanks to magnification provided by the laparoscope.
Renal cyst unroofing: When cysts form on the kidney, they’re usually benign; however, they can become painful and/or infected, or affect kidney function. When this happens, it’s necessary to remove the outer lining of the cyst to release fluid and pressure, a procedure known as unroofing. During laparoscopic renal cyst unroofing, we place an ultrasound probe through a trocar to examine the kidney for additional cysts beneath the surface.
Adrenalectomy: The adrenal gland sits just above the kidney. Both benign tumors (which can cause high blood pressure and other hormonal imbalances) and cancers may require removal of the adrenal gland. Laparoscopic adrenalectomy is quickly becoming the standard treatment for adrenal masses.
Cystectomy and partial cystectomy: We offer laparoscopic removal of the bladder, known as a cystectomy, or part of the bladder, known as a partial cystectomy, to treat bladder cancer. Our surgeons are also skilled at laparoscopically constructing alternative means of urine drainage.
Lymph node dissection: The removal of the pelvic and retroperitoneal lymph nodes is an important diagnostic tool that allows us to determine the extent of urological cancer, and assess the necessity of further surgery. We also use lymph node dissection to effectively treat urologic malignancies such as testicular and bladder cancer. Laparoscopic removal of lymph nodes was one of the first laparoscopic procedures performed in urology.
Pyeloplasty: A birth defect or scar where the kidney connects to the ureter (the tube connecting the kidney to the bladder) is called a ureteropelvic junction obstruction, or UPJ obstruction. Repair of a UPJ obstruction is necessary to prevent kidney damage. Surgeons remove the scar or blockage laparoscopically, then carefully reconnect the ureter to the kidney by fashioning it into a funnel shape. If necessary, kidney stones are also removed simultaneously.
Ureterolysis: Ureters obstructed by retroperitoneal fibrosis may require surgery to free them from surrounding scar-like tissue. Laparoscopy allows a magnified view of this delicate process.