Overview
Laparoscopic Assisted Stone Removal (laparoscopic cystotomy) is a minimally invasive procedure to remove your pet’s bladder or urethral stones. As opposed to traditional surgical approaches, laparoscopy allows for stone removal through the use of cameras with a single 1” surgical incision. Not every patient with bladder or urethral stones is an appropriate candidate for this procedure and careful selection is required.
Why it’s done
Your veterinarian may recommend a laparoscopic cystotomy if your pet has:
- Radiographic or ultrasound evidence of stones in your pets urinary system
How to prepare for your pet’s procedure
Before your pet’s laparoscopic cystotomy, you will meet with one of our specialists to talk about the procedure and what to expect.
When you meet with our team, please bring a list of all medications that your pet is currently taking, including over the counter medications, vitamins, and herbal supplements. Before your pet’s procedure, you may be asked to discontinue giving certain medications that can increase the risk of bleeding.
This is a good time to ask questions about the procedure and make sure you understand the risks and benefits.
Preoperative diagnostics and tests
Before your pet’s laparoscopic cystotomy procedure the following may be indicated:
- Abdominal ultrasound
- Abdominal radiographs (x-rays)
- Comprehensive blood tests
- Urinalysis and urine culture
General Instructions for the Day of Surgery
- Give your pet nothing by mouth after midnight the night before. This means that all food and water should be withheld.
- Please arrive for pet’s admission promptly at your scheduled arrival time.
- You will be asked to sign both a Surgical Consent Form as well as an Estimate, indicating your understanding of the procedure, risks, and associated costs.
What happens during the laparoscopic assisted stone removal?
Your pet will be given a general anesthetic. A 1” incision is made into the abdomen and the bladder is visualized. A second small incision is made into the bladder and a lighted instrument with a camera on the end, called a cystoscope, is used to help locate the stones in the urinary system. The stones are then removed with specialized graspers or baskets. Small stones can be removed with suction.
Risks
Complications associated with a laparoscopic cystotomy can include the following:
- Bleeding
- Leakage of urine
- Infection
- More frequent urinations
After the procedure
- Following the procedure, you will be given a phone call with an update on your pet’s recovery. A scheduled discharge will be coordinated at that time.
- Please remove the bandage from your pet’s intravenous catheter site 10 to 15 minutes after arriving home.
- Some abdominal tenderness is common for 3-5 days following laparoscopic surgery.
- It is important to restrict your pet’s activity for the next 3-5 days while the incision is healing. Walks should be short and your pet should always be on a leash. Please do not let your pet rough house with other animals during this time.
- Many patients will not eat the night following anesthesia. If your pet has not eaten after 24 hours of returning home, please call Salt River.After the procedure (continued)
- Some patients will vomit or have diarrhea following anesthesia. If the vomiting or diarrhea persists more than 24 hours, please call Salt River. In contrast, some patients may be constipated or may not have a bowel movement for up to 72 hours following anesthesia. If your pet is straining to defecate after 72 hours, please call Salt River.
- Suture removal is generally not necessary, as internal dissolving stitches will be placed.
- Please monitor the incision for any signs of heat, pain, swelling, or discharge. Should you notice any of these signs, it may be an indication of infection. Please call Salt River if you notice a problem.
- Licking or scratching at the incision will dramatically increase the chances of an infection or that the incision will open up. To prevent this from happening, please watch your pet closely for scratching or licking at the incision. If this occurs, an e-collar should be placed.
Results
The samples are submitted to a number of specialized laboratories for evaluation including the following tests:
- Stone analysis
- Bacterial cultures
The final stone results can take up to 3-4 weeks. Once the final results have returned and a treatment plan has been devised, our specialists will call you to discuss the findings and recommendations.
Follow up
A recheck appointment is required 1 month following the procedure.