Keyhole Surgery, laparoscopy and Kidney Stones
The kidneys and their functions
The kidneys are two bean-shaped organs, each about the size of a fist. They are located in the back of the upper abdomen on either side of the spine. The kidneys have a number of essential roles within the body – they cleanse the blood of waste products by producing urine. They also balance essential elements, such as sodium and potassium, while providing hormones necessary to regulate blood pressure and red blood cell production.
Keyhole surgery, or laparoscopic surgery as it is also known, is a method of carrying out an operation without having to make large cuts into the body. Many different types of operations can now be carried out using keyhole surgery. These operations include keyhole surgery to remove the prostate, the kidney and keyhole surgery to remove kidney stones. Keyhole surgery has many benefits for patients, because it reduces the time taken to recover from the operation, which means a shorter stay in hospital, less time off work and there will be less scarring.
What are kidney stones?
Kidney stones are hardened mineral deposits, normally of calcium, that form in the kidney. They begin as tiny particles and develop into stones over time. The kidneys filter waste products from the blood and add them to the urine that the kidneys produce. When waste materials in the urine do not dissolve completely, crystals and kidney stones are likely to form. Kidney stones are very common. About 3 in 20 men and 1 in 20 women in the UK develop a kidney stone at some stage in their life. It can occur at any age, but most commonly in middle age. About half of people who develop a kidney stone will have at least one recurrence at some stage in the future.
Small stones can cause some discomfort as they pass out of the body. However, stones can become lodged in the tube which carries urine from the kidney to the urethra. When this happens, the patient is likely to experience severe pain which begins in the lower back and radiates to the side or the groin. A lodged stone can also block the flow of urine, causing pressure to build up around the kidneys and hence severe pain.
Tests for kidney stones and to rule out other problems
Kidney stones are common and in most cases they are not caused by a known underlying disease. However, some routine tests may be advised to rule out underlying problems. In particular, tests are more likely to be advised if you have recurring kidney stones, or have symptoms of an underlying condition, or have a family history of a particular condition.
- X rays, ultrasound scan and computerized scans (CT scan).
- A blood test to check that the kidney is working properly.
- Blood tests to check the level of certain chemicals such as calcium.
- Urine tests to check for infection and for certain crystals.
- An analysis of the stone if you pass it out.
Treatment of kidney stones
Most stones pass spontaneously but some require treatment. Depending upon the size and location of the kidney stones treatment is usually with minimally invasive procedures and key hole surgery as in:
Shock wave therapy (lithotripsy).
Endoscopic procedures (ureteroscopy) and Keyhole surgery (PCNL).
Recently, Laser stone surgery is proving to be very effective.
Laser Treatment for kidney stones
Laser (directed at the stone using a special telescope) is used for breaking up kidney stones. The benefits for patients from this procedure is that only takes approximately 45 minutes, does not involve any cuts and is highly effective.
A holmium laser is considered to be the state-of-the art technology for carrying out this procedure. A small instrument is inserted into the urethra and guided into the area containing the stone. When the laser is activated, the laser beam vaporizes the stone. The laser beams can be precisely controlled and directed at very specific areas.
Mr Almallah is one of the leading specialists in laser stone surgery in the Midlands and he would be happy to give advice on the suitability of this new treatment for patients with kidney stones.