Progress of laparoscopic surgery
Through punctures in the abdominal wall or lumbar region (retroperitoneoscopy), the surgeon approaches the kidney, exposes the cyst, punctures and empties it, then uses an ultrasonic scalpel to excise the free wall along the border with the kidney tissue, leaving the bottom of the cyst, which coagulates. The wall is sent for histology. In case of multiple cysts, all large ones are excised in one operation. The drainage is removed the next day, discharge on the 2-3rd day, back to work after 7-10 days. The cosmetic result is excellent, relapses are rare.
When should a kidney cyst be treated?
- cyst more than 5 cm or rapidly growing;
- lower back pain, feeling of heaviness;
- compression of the pelvis or ureter with impaired urine outflow;
- increased blood pressure associated with the cyst;
- suppuration or hemorrhage into the cyst;
- complex cyst (Bosniak III–IV) - excision with histology to exclude cancer.
Simple cysts up to 4-5 cm without symptoms do not require treatment - an ultrasound scan once a year is enough.
Puncture or laparoscopy
Puncture with sclerotherapy is an outpatient procedure under local anesthesia with an effectiveness of 70–85%; Suitable for simple cysts with easy access. Laparoscopic excision of the cyst wall gives a lasting result of 95% and allows the wall to be examined histologically; indicated for large, recurrent, parapelvic and complex cysts. For polycystic cysts, puncture or laparoscopic decortication of several of the largest cysts is performed to reduce pressure and pain.
