About Endoscopic Surgery
Endoscopic surgery is a minimally invasive approach in which urologic surgeons use a tiny video camera (the endoscope) and specialized surgical instruments attached to the endoscope to operate on the bladder, ureters, and kidneys. The endoscope is designed to pass through an existing space in the body such as the urethra (or the mouth or anus in other types of surgery). In some procedures surgeons pass the endoscope through a very small incision in the skin (percutaneously) to the organ or area to be treated.
Endoscopic Surgery for Urinary Stones
We here at Saint Gabriel General Hospital treat urinary stones using endoscopic techniques called cystoscopy, ureteroscopy, and percutaneous endoscopy. The ureteroscope is a specialized, very long, thin endoscope that carries a tiny telescopic camera and specialized surgical tools. To treat stones, doctors insert the endoscope up through the urethra to the bladder to get a clear view of the ureters, the channels that connect each kidney to the bladder. Doctors can remove kidney stones that have entered the ureter with a tiny basket. They can also extend a flexible laser-equipped fiber from the ureteroscope to fragment the stone into pieces that can leave the body in urine. If patients’ stones are large or their medical condition complex, surgeons may pass the endoscope through an incision on the back and enter the ureter through the kidney.
Endoscopic Surgery for Bladder Cancer
Urology surgeons treat a form of bladder cancer called superficial transitional cell carcinoma with an endoscopic surgery called a transurethral resection. Using a type of endoscope called a cystoscope, surgeons locate the tumor inside the bladder and remove it with a small wire loop that is attached to the cystoscope. This form of bladder cancer tends to recur, so Urology surgeons follow patients closely with periodic cystoscopies (a follow-up approach called surveillance) to be sure that we catch future cancers early.
Endoscopic Surgery for Ureteropelvic Junction Obstruction
Each kidney is attached to the bladder by a long, thin tubular channel called a ureter. Urine is made in the kidney and flows through this channel to the bladder. The kidney and ureter attach at a spot called the ureteropelvic junction (UPJ). The UPJ sometimes becomes obstructed because of scarring from urinary stones, surgery, or infection; or from blood vessel compression, gradual narrowing, or other causes. When obstructions develop at the UPJ urine cannot flow freely through the ureter, and pressure builds up in the kidney. Surgeons reach the UPJ using an instrument called a ureteroscope, a long thin endoscope that is equipped with a tiny camera and surgical tools such as lasers. They insert the ureteroscope through the urethra to reach the UPJ. They may also access the UPJ through an opening in the skin (percutaneously), which gives them access for larger endoscopes. Surgeons then open the obstructed junction and remove the cause of the blockage with an endoscopic procedure called an endopyelotomy.