50290 Excision of perinephric cyst

Name of the Procedure:

Excision of Perinephric Cyst (Also known as Surgical Removal of Perinephric Cyst, Perinephric Cystectomy)

Summary

Excision of a perinephric cyst is a surgical procedure to remove fluid-filled sacs located around the kidneys. These cysts can cause pain or other symptoms if they become large or infected.

Purpose

The procedure addresses the presence of cysts around the kidney (perinephric cysts) that may cause discomfort, pain, or impair kidney function. The goal is to alleviate symptoms, prevent complications, and improve kidney function and the patient's overall well-being.

Indications

• Persistent or severe pain in the area around the kidneys
• Recurrent infections of the cyst
• Hemorrhage or bleeding within the cyst
• Significant growth of the cyst impacting kidney function or surrounding organs
• Presence of symptoms such as hypertension that may be related to the cyst

Preparation

• Patients are typically advised to fast for at least 8 hours before the procedure.
• Adjustments to medications, especially anticoagulants, may be necessary as per physician's direction.
• Pre-procedure imaging tests like ultrasound, CT scan, or MRI to evaluate the cyst.
• Blood tests to check kidney function and overall health status.

Procedure Description

1. The patient is administered general anesthesia to ensure they are asleep and pain-free.
2. An incision is made in the flank or abdominal area to access the kidney.
3. Surgical tools are used to carefully isolate and remove the perinephric cyst while preserving kidney function.
4. The area is examined for any signs of infection or remaining cyst tissue.
5. The incision is closed with sutures, and a drainage tube may be placed to prevent fluid accumulation.
6. The removed cyst is typically sent to a laboratory for pathological analysis.

Duration

The procedure usually takes between 1 to 3 hours, depending on the complexity and size of the cyst.

Setting

The excision of a perinephric cyst is performed in a hospital's surgical suite or an outpatient surgical center equipped for such procedures.

Personnel

• Urological surgeon or general surgeon
• Anesthesiologist
• Surgical nurses and technician assistants

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma formation
• Injury to nearby organs or structures
• Persistent pain
• Rarely, kidney function impairment
• Anesthesia-related complications

Benefits

• Relief from pain and discomfort
• Prevention of future infections or complications
• Improvement in kidney function
• Enhanced quality of life

Recovery

• The patient is usually monitored in a recovery room for a few hours post-surgery.
• Hospital stay may range from 1 to 2 days.
• Patients are typically advised to avoid heavy lifting or strenuous activity for several weeks.
• Pain management includes prescribed pain relievers and over-the-counter medications.
• Follow-up appointments to monitor healing and kidney function.

Alternatives

• Aspiration or drainage of the cyst, though this may not be a permanent solution.
• Monitoring and observation of asymptomatic cysts with regular imaging.
• Sclerotherapy, a less invasive procedure where a sclerosing agent is injected into the cyst.

Pros of alternatives include less invasive approaches with shorter recovery times. Cons may include potential recurrence of the cyst or incomplete resolution of symptoms.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel pain. Postoperatively, there may be discomfort at the incision site, which can be managed with pain medications. Patients may experience some fatigue and restrictions on activities as they recover but can usually return to normal activities within a few weeks. Regular follow-up care ensures optimal recovery and monitoring of kidney health.