Dr. Anup Ramani is one of the best Uro oncologist, Surgeon in Mumbai, India providing Robotic Surgery and Treatment for Prostate Cancer, Kidney Tumor Surgery/Stone Removal, Urinary Bladder Cancer and Adrenal Gland Treatment, Enlarged Prostate Surgery and treatment, Penis Cancer/Partial Penectomy/Robotic Pyeloplasty Surgery and Treatment.
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Enhancing Patient Comfort and Recovery Kidney Stone Removal: The Role of Spinal Anesthesia and Ureteral Stents in Ureteroscopy

04 Apr
By Dr. Anup Ramani

Kidney stones can be an excruciating experience, often causing intense pain and discomfort. However, with advancements in medical procedures, treatments like ureteroscopy have become a common and effective solution for removing stones from the kidney and ureter. In cities like Mumbai, these treatments are often performed using modern techniques that prioritize patient comfort and faster recovery.

Two important components of this process – spinal anesthesia and ureteral stents – play a crucial role in ensuring that patients remain comfortable during and after the procedure. This article will explore how spinal anesthesia enhances the patient experience and how ureteral stents support the healing process after kidney stone removal surgery.

Ureteroscopy for Kidney Stone Removal

Ureteroscopy is a procedure used to treat kidney stones that are located in the ureter. Unlike traditional surgery, ureteroscopy does not require large incisions. Instead, a small endoscope is inserted through the urethra and into the ureter. The scope allows the surgeon to visualize the stone and remove or break it down using a laser.

This procedure can be performed under local or spinal anesthesia, making it much more comfortable than open surgery. Patients can avoid the risks and complications associated with larger incisions, such as infections, excessive bleeding and long recovery periods.

Ureteroscopy for Kidney Stone Removal

The Role of Spinal Anesthesia in Ureteroscopy

Spinal anesthesia is a common anesthesia technique used in kidney stone treatment. Unlike general anesthesia, which makes the entire body unconscious, spinal anesthesia numbs only the lower half of the body. This technique is often preferred for kidney stone removal procedures for several reasons:

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Benefits of Spinal Anesthesia in Ureteroscopy:

  • Minimal Discomfort: Patients remain awake but do not feel any pain during the procedure. The lower part of the body is numbed, ensuring that the patient can comfortably undergo the entire process.
  • Faster Recovery: Since spinal anesthesia doesn’t require a lengthy recovery period like general anesthesia, patients can often walk around and resume light activities within hours of the procedure.
  • Avoidance of Cuts and Incisions: With spinal anesthesia, the procedure remains minimal invasive, as no cuts or incisions are required. The kidney stone ureteroscopy is performed using a small, flexible tube, which avoids the need for surgical openings.
  • Reduced Risks: Spinal anesthesia has fewer risks compared to general anesthesia. It does not affect the respiratory system, so patients are less likely to experience complications like nausea or vomiting after the procedure.

How Spinal Anesthesia is administered?

The anesthesia is typically administered through an injection into the lower back, providing rapid numbness from the waist down. The patient will feel relaxed and comfortable, allowing the surgeon to perform the procedure without the patient experiencing pain or discomfort.

Ureteral Stents: Supporting Healing and Preventing Complications

After the kidney stone removal surgery, a ureteral stent is often placed in the ureter. This is a small, flexible tube that keeps the ureter open and allows urine to flow from the kidney to the bladder without obstruction. The stent is essential for the healing process following ureteroscopy.

Why are Ureteral Stents Necessary?

  • Facilitating Urine Flow: The stent helps ensure that urine flows smoothly from the kidney to the bladder after the stone is removed or broken down. Without the stent, swelling and inflammation might block the ureter, leading to additional pain and complications.
  • Preventing Obstruction: The stent prevents the ureter from collapsing or becoming blocked due to swelling or tissue irritation. This is especially important after a procedure of kidney stone ureteroscopic stone removal, where the ureter may become irritated or inflamed.
  • Promoting Healing: By keeping the ureter open, the stent allows the body to heal more effectively. This can reduce the likelihood of complications such as infection or further stone formation.

Placement and Removal of Ureteral Stents:

  • Placement: During kidney stone ureteroscopy, the stent is placed inside the ureter, usually after the stone has been removed or fragmented with a laser. It is designed to stay in place for several weeks to allow proper healing.
  • Duration: The stent is generally left in place for about four to six weeks. It is a temporary measure to ensure the ureter remains open during recovery.
  • Removal: The stent is removed in a simple procedure that may be done in the doctor’s office or as a short outpatient procedure. Removal typically occurs six weeks after the initial surgery.

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Patient Comfort and Recovery in Kidney Stone Removal

The use of spinal anesthesia and ureteral stents not only ensures that patients are comfortable during kidney stone removal surgery but also accelerates the healing process. Here’s how these elements work together to enhance recovery:

Post-Procedure Comfort:

  • Spinal Anesthesia: Since the anesthesia wears off within a few hours, patients often experience minimal discomfort after surgery. They are usually able to get up and walk around the same evening of the procedure.
  • Ureteral Stents: Although stents may cause some mild discomfort, including the feeling of needing to urinate frequently, they are crucial for the healing process. Most patients find that any discomfort subsides after the stent is removed.

Speedy Recovery:

  • Quick Mobility: With spinal anesthesia, patients can often move around soon after the procedure. Most are able to leave the hospital within one to two days.
  • Return to Normal Activities: Patients can generally return to office work or light activities within a week. More strenuous activities, like lifting or running, should be avoided until the stent is removed, typically after about six weeks.

FAQs About Kidney Stone Removal

Spinal anesthesia numbs the lower half of the body, making the procedure painless without putting the patient to sleep. It’s commonly used in kidney stone removal surgery for comfort and safety.

The stent helps keep the ureter open, ensuring smooth urine flow and promoting healing by preventing obstruction or infection after the procedure.

The stent is typically removed 4 to 6 weeks after the kidney stone ureteroscopy procedure, often during a simple follow-up visit.

Most patients can return to office work within a week. However, strenuous activities like running and weightlifting should be avoided for at least a month.

Conclusion

The use of spinal anesthesia and ureteral stents significantly enhances both comfort and recovery in kidney stone ureteroscopy. Patients can enjoy a nearly pain-free procedure with minimal disruption to their daily lives. If you are considering kidney stone treatment in Mumbai, Dr. Anup Ramani ensures that your treatment experience is smooth and efficient.

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Dr. Anup Ramani is one of the best Uro oncologist, Surgeon in Mumbai, India providing Robotic Surgery and Treatment for Prostate Cancer, Kidney Tumor Surgery/Stone Removal, Urinary Bladder Cancer and Adrenal Gland Treatment, Enlarged Prostate Surgery and treatment, Penis Cancer/Partial Penectomy/Robotic Pyeloplasty Surgery and Treatment.

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PARTIAL PENECTOMY
  • Partial penectomy is done in cases where glans and distal penis is involved with carcinoma. 
  • Partial penectomy is a type of organ-preserving surgery. Preservation of sexual and micturational function depends on the surgical dissection and reconstruction of residual urethra.
Kidney Stone Removal
  • Patients who develop stones in the kidney or ureter, often experience severe pain.
  • This condition usually needs a procedure to remove the kidney stones.
  • This procedure is called ureteroscopy and is performed very commonly.
  • It does not require any cuts and hence it is painless.
  • The procedure is performed with an endoscope inserted through the penis under spinal anesthesia.
  • The scope is inserted through the penis into the kidney and stones are dissolved with a laser.
  • The procedure takes about 40-50 minutes. 
  • A catheter (urine pipe) is kept after the procedure to drain the bladder. A stent is kept in the kidney at the same time.
  • Patient is mobile and walking in the room the same evening.
  • Hospital stay is one night and patient is discharged the next day after removal of the catheter.
  • Patient has to come back after six weeks to remove the stent in the kidney.
  • Patients can resume office a week after surgery and heavy activities like running, weight lifting, a month after the procedure.
  • We offer fixed packages for this procedure which can be obtained by calling our helpline +91 9967666060.
  • Men with an enlarged prostate, which is a normal ageing changes, often experiencing difficulty passing urine. This condition usually needs a procedure to trim the prostate and relieve the blockage.
  • This procedure is called TURP and is performed very commonly.
  • It does not require any cuts and hence it is painless.
  • The procedure is performed with an endoscope inserted through the penis under spinal anaesthesia.
  • The overgrown prostate is dissolved with a laser bloodlessly.
  • The procedure takes about 40 minutes.
  • A catheter (urine pipe) is kept after the procedure to drain the bladder.
  • Patient is mobile and walking in the room the same evening.
  • Hospital stay is two nights and patient is discharged with the catheter, which is removed after 4 days.
  • Patients can resume office a week after surgery and heavy activities like running, weight lifting, a month after the procedure.
  • We offer fixed packages for this procedure which can be obtained by calling our helpline +91 9967666060.
ROBOTIC ADRENALECTOMY FOR ADRENAL GLAND TUMOUR

  • Robotic adrenalectomy is a sophisticated, complex surgery and it is very important that an experienced surgeon performs this surgery to avoid major complications.

  • Once the anesthesia is done, and patient positioned, three micro cuts (3mm each) are made in the patient’s abdomen.

  • The arms of the Da Vinci robot are connected to the cuts via ports (tubes).

  • Dr. Ramani then sits in the controlling console to perform the surgery.

  • On an average, a robotic adrenalectomy takes one hour.

  • The surgery is almost completely bloodless and there has never been any need to transfuse blood after surgery.

  • A urine catheter and bag to drain the bladder is inserted during surgery.

  • A tiny drain pipe may be inserted in the surgical side of the abdomen, connected to a bag.

  • Patient is kept nil-by-mouth the day of the surgery, with IV fluids. Sips of water are started the next day and solid food by day three.

  • The drain pipe, if kept, is removed in the room on day 2 after surgery.

  • The catheter is removed on day two after surgery.

  • Total hospital stay for robotic adrenalectomy is 4 nights (including night before surgery).

  • Post discharge, a doctor from the surgical team visits the patient at home/ hotel room once every day.

RETURN TO ACTIVITY

  • On the day of discharge, patient is totally self-sufficient. They are able to walk freely without any pain, dress themselves, shower, toilet and they do not need to hire any nurse or help at home. Almost all patients are back to work within 2 weeks of surgery.

  • Heavy activities like running, weight lifting can be resumed after a month

FOLLOW UP AFTER SURGERY

  • Follow up after an adrenalectomy is in the form of CT scans, once a year for 5 years.
    Local patients usually meet Dr. Ramani after two weeks to discuss report.

  • Outstation patients are counselled on a phone consultation.

ROBOTIC SURGERY FOR BLADDER CANCER
  • Dr. Ramani is one of the very few surgeons in India who has the expertise to perform a robotic surgery for bladder cancer, which includes removing the urinary bladder and reconstructing a new bladder robotically.
  • Robotic radical cystectomy is an extremely sophisticated, complex surgery and it is very important that an experienced surgeon performs this surgery to avoid major complications.
  • Once the anaesthesia is done, and patient positioned, six micro cuts (3mm each) are made in the patient’s abdomen.
  • The arms of the Da Vinci robot are connected to the cuts via ports (tubes).
  • Dr. Ramani then sits in the controlling console to perform the surgery.
  • On an average, a robotic radical cystectomy with an ileal conduit takes 3-4 hours.
  • The surgery is almost completely bloodless and there has never been any need to transfuse blood after surgery.
  • A urine catheter and bag to drain the new bladder is inserted during surgery.
  • Two tiny drain pipe in inserted in the surgical side of the abdomen, connected to a bag.
  • Patient is kept nil-by-mouth for 4 days after surgery with IV supplementation of patient’s daily requirements of calories, fats, carbohydrates, proteins and electrolytes.
  • The drain pipes are removed in the room on day 3-5 after surgery.
  • Total hospital stay for radical cystectomy is 8 nights (including night before surgery).
  • Post discharge, a doctor from the surgical team visits the patient at home/ hotel room once every day.
RETURN TO ACTIVITY
  • On the day of discharge, patient is totally self-sufficient. They are able to walk freely without any pain, dress themselves, shower, toilet and they do not need to hire any nurse or help at home.
  • Almost all patients are back to work within 6 weeks of surgery. Heavy activities like running, weight lifting can be resumed after two months.
FOLLOW UP AFTER SURGERY

  • Follow up after a radical a cystectomy is in the form of CT scans, once a year for 5 years.

  • Histopathology report: Local patients usually meet Dr. Ramani after two weeks to discuss report.

  • Outstation patients are counselled on a phone consult. Depending on the report, patient may or may not need chemotherapy after surgery.

  • If chemo is needed, patients may choose to get it done with a medical oncologist of their choice or avail the services of one of the four medical oncologists on our team.

ROBOTIC RADICAL/PARTIAL NEPHRECTOMY FOR KIDNEY CANCER
  • Robotic partial nephrectomy is a sophisticated, complex surgery and it is very important that an experienced surgeon performs this surgery to avoid major complications. Robotic radical (total) nephrectomy is
  • relatively easier but still requires significant experience to consistently deliver results.
  • Once the anaesthesia is done, and patient positioned, five micro cuts (3mm each) are made in the patient’s abdomen.
  • The arms of the Da Vinci robot are connected to the cuts via ports (tubes).
  • Dr. Ramani then sits in the controlling console to perform the surgery.
  • On an average, a robotic radical nephrectomy takes one hour and a robotic partial nephrectomy takes about an hour and half.
  • The surgery is almost completely bloodless and there has never been any need to transfuse blood after surgery.
  • A urine catheter and bag to drain the bladder is inserted during surgery.
  • A tiny drain pipe in inserted in the surgical side of the abdomen, connected to a bag.
  • Patient is kept nil-by-mouth the day of the surgery, with IV fluids. Sips of water are started the next day and solid food by day three.
  • The drain pipe is removed in the room on day 3 after surgery. The catheter is removed on day two after surgery.
  • Total hospital stay for radical/partial nephrectomy is 4 nights (including night before surgery).
  • Post discharge, a doctor from the surgical team visits the patient at home/ hotel room once every day.
RETURN TO ACTIVITY
  • On the day of discharge, patient is totally self- sufficient. 
  • They are able to walk freely without any pain, dress themselves, shower, toilet and they do not need to hire any nurse or help at home. 
  • Almost all patients are back to work within 2-3 weeks of surgery.
  • Heavy activities like running, weight lifting can be resumed after a month.
FOLLOW UP AFTER SURGERY
  • Follow up after a radical/partial Nephrectomy is in the form of CT scans, once a year for 5 years.
  • Local patients usually meet Dr. Ramani after two weeks to discuss report. 
  • Outstation patients are counselled on a phone consultation.