Department of Surgery

Faculty:
Ronald Lewis MD
Bao-Ling Adam PhD
Ann Young Becker MD
James A. Brown MD
Jeffrey Donohoe MD
Vijay Kumar PhD
Kenneth Lennox MD
Yulin Ma, PhD
Thomas M. Mills, PhD
Donald Mode MD
Arthur Smith MD
Martha K. Terris MD
R. Clinton Webb, PhD

Residency Program in Urology

Urology Academic Calendar

Contact Us

Considering a career in urology? See "Information for Students".

Laparoscopic Urologic Surgery Available At MCG

Dr. James Brown has been performing laparoscopic procedures to treat cancers of the prostate, kidney bladder, testicle and adrenal gland at MCG since April of 2002. This complex, advanced technique, also know as “minimally invasive” surgery, requires specially trained surgeons and very specific surgical equipment. As a result, few centers worldwide, and no other hospitals in the CSRA, are able to provide this alternative to patients who need urologic surgery. Dr Brown’s special training in laparoscopic urology was made possible by the financial support of the Medical College of Georgia and the Georgia Cancer Coalition.

The benefits of laparoscopy compared to standard open surgery include less pain, less blood loss, faster healing time, less scarring, and less time off work.  During laparoscopic procedures, a thin needle is placed into the abdomen through which carbon dioxide gas is introduced to inflate the abdominal cavity to give the surgeon visibility and space to work. Two to five dime-sized incisions are made in the skin through which hollow tubes, called trocars, are inserted. A specialized fiberoptic telescope with a video camera, called a laparoscope, is inserted through one of the trocars, allowing the surgeon to watch a television monitor to see inside the abdomen. The trocars are also used as paths for slender surgical instruments. Also, cancerous growths and organs can be removed through these trocars. A similar procedure is hand-assisted laparoscopy, in which one of the incisions is made slightly larger so that the surgeon can insert a hand inside the abdomen to assist during more complicated surgery.

In addition to patients with cancers of the kidney, prostate, bladder, testicle and adrenal gland benefiting from laparoscopy, other urologic abnormalities, such as ureteropelvic junction obstruction and retroperitoneal fibrosis, can be treated with minimally invasive surgery.   

LAPAROSCOPIC PROCEDURES PERFORMED AT MCG INCLUDE:   

Nephrectomy and partial nephrectomy. The complete or partial removal of a kidney may be necessary due to cancer, infection, or kidney disease. During laparoscopic nephrectomy, a kidney without cancer can be diced into smaller pieces, which can be removed through the trocars. A cancer-containing kidney must be removed in one piece in order to prevent spilling cancer cells and avoid making it difficult to tell the extent of the cancer when inspecting it under a microscope; this requires a slightly larger incision.

Prostatectomy. Laparoscopic removal of the prostate gland to treat prostate cancer offers less blood loss, less pain, quicker recovery, and allows more exact placement of sutures than a traditional radical prostatectomy due to the magnification provided by the laparoscope. 

Renal cyst unroofing. When cysts form on the kidney, they are usually benign, but they can become painful, become infected or effect kidney function making it necessary to remove the outer lining of the cyst, known as unroofing, to release the fluid and pressure. During laparoscopic renal cyst unroofing, an ultrasound probe may placed through a trocar to examine the kidney for additional cysts beneath the surface. 

Adrenalectomy. The adrenal gland sits just above the kidney. Both benign tumors (which can cause high blood pressure and other hormonal imbalances) and cancers may require removal of the adrenal gland. Laparoscopic adrenalectomy is quickly becoming the standard treatment of adrenal masses.

Cystectomy and partial cystectomy. The removal of the bladder, known as a cystectomy, or part of the bladder, known as a partial cystectomy, due to bladder cancer as well as construction of an alternative means of urine drainage can be preformed laparoscopically. 

Lymph node dissection. The removal of the pelvic and retroperitoneal lymph nodes is an important diagnostic tool to determine the extent of urological cancer and assess the necessity of further surgery.  Lymph node dissection is also an effective treatment for some urologic malignancies, such as testicular and bladder cancer. Laparoscopic removal of lymph nodes was one of the first laparoscopic procedures performed in urology.

Pyeloplasty. A birth defect or scar where the kidney connects to the ureter (the tube connecting the kidney to the bladder) is called a ureteropelvic junction obstruction or UPJ obstruction. Repair of a UPJ obstruction is necessary to prevent kidney damage. The scar or blockage can be removed laparoscopically and the ureter carefully re-connected to the kidney by fashioning it into a funnel shape. Kidney stones may be also removed simultaneously if necessary.

Ureterolysis. Ureters obstructed by retroperitoneal fibrosis may require surgery to free them from the surrounding scar-like tissue. Laparoscopy allows a magnified view of this delicate procedure.  
 

MCG Department of Surgery  |  Medical College of Georgia

Please email comments, suggestions or questions concerning 
this web page to: Valinsa Gainey, vgainey@mcg.edu

April 12, 2004