Ureters are the tubes connecting the kidney to the bladder and urine from kidney travel to bladder through ureters. The connection through which one or both of the ureters are attached to the bladder may not be properly developed in a child. This is referred by the medical term vesicoureteral reflux (VUR). This results in the flow of urine back from bladder to kidney. Even though it may not be causing any pain it can lead to urinary infection and damage to your child’s kidney. In Ureteral reimplantation surgery either one or both of the ureters are connected to the bladder in new positions so that they are stronger.
Preparing for the surgery
Inform your doctor regarding all the medicines that are now taken by your child. He will have to stop some of them for a few days based on the advice of the doctor. Your child will have to fast for a few hours before the scheduled time of the surgery. Usually the time period for fasting can be six hours. The anesthetist will inform the hours of fasting required based on your child’s health and other factors. Follow the instructions completely and if you feel any doubt call him and clarify it immediately.
The day of surgery
The surgery usually takes 3 to 4 hours for completion and the child will be required to stay in the hospital for one or two days after the surgery. A catheter will be inserted to the bladder to facilitate the passage of the urine.
Laparoscopic procedure
Laparoscopic procedures are minimally invasive procedures which are carried out with three or four small incisions of the size 10 to 3mm. A laparoscope and specialized tools required for carrying out the surgery are inserted through these holes. The surgeon carefully guides the tools through the abdomen so that they reach the correct surgical spot without causing any damage to the interior organs. Laparoscope is an instrument with a camera. The camera is used to take the video of the internal organs and the surgery being carried out. This video is magnified about 20 times and is made available near the surgeon. By viewing these videos and remotely controlling the special instruments using its controls which are available near the surgeon, he carries out the surgery. Number of incisions and stitches are made to change the connection of the ureter to a better position in the bladder. Once the procedure is completed the special instruments and laparoscope are withdrawn and with the help of stitches the incisions on the abdomen are closed.
Postoperative care
After the surgery the patient will be removed to the recovery room where he will be under intensive care till the recovery is complete. After the completion of the recovery the patient will be brought to his room. The patient will be given medicines and food through the IV line provided. Urine will be drained through a catheter into a bag provided for this purpose for usually a day. The urine may contain blood during the first few days. The patient will be discharged within two days after the surgery. Drink lot of fluids and follow the doctor’s advice regarding the cleaning of the incisions. Doctor will advise when you can take bath and start normal activities.
