Mr Thyer offers specialist management of prostate cancer.
Mr Thyer has a special interest in robotic and laparoscopic surgery for prostate and kidney cancer but also performs surgery for many other urological conditions.
The kidney is a paired organ in the upper abdomen that filters the blood of waste then excretes this filtered waste in the form of urine. The urine is transported from the kidney via the ureter to the bladder in the pelvis where it is stored.
When a high grade or large tumour develops on the internal lining of the kidney or ureter then a Laparoscopic Nephro-ureterectomy is required to remove the entire kidney and ureter. If the tumour is in one section of the ureter only then a robotic segmental ureterectomy can be performed in selected circumstances so that the kidney can be spared (this operation is described in a separate information sheet).
Ten days prior to the procedure you should:
On arrival at hospital you will be prepared for theatre by nursing staff. Mr Thyer will see you just prior to being taken into the operating theatre. You will require a general anaesthetic of approximately 3 hours. Mr Thyer will make a series of 4 small incisions in the abdomen to allow the passage of the laparoscopic instruments. The kidney and ureter will be dissected free from its surrounding structures and the blood vessels to the kidney clipped and divided. The kidney and ureter as well as a cuff of bladder at the distal end of the ureter will be removed via a small incision in the lower abdomen and sent to a pathologist for microscopic examination (you may incur a pathologist fee). The defect in the bladder will be closed with sutures and a catheter will be placed in the bladder to remain for 10 days. After the operation a drain will be left in the abdomen. Most people are in hospital 2 nights then discharged home after Mr Thyer’s review.
Nephro-uretectomy: open surgical incision vs laparoscopic incision
You will require a CT cystogram at 2 weeks to ensure the bladder has healed. If the CT is satisfactory then the catheter can be removed from the bladder usually the same day. Mr Thyer’s rooms will contact you to arrange follow up to check your progress, wounds and pathology 3 weeks following the operation. You should take laxatives, wear compression stockings, drink plenty of water and avoid heavy lifting for 3 weeks following the procedure. You should not drive a motor vehicle until seen by Mr Thyer at the follow up appointment. Mr Thyer will perform flexible cystoscopy every 6 months to ensure there is no recurrence of cancer in the bladder.
Following the procedure, you should contact Mr Thyer if you: