Remarkable developments in technology, surgical instruments and expertise have enabled surgeons to perform many operations by inserting endoscopes and surgical tools through incisions that are usually less than an inch. Endoscopes are small tubes with cameras that let surgeons see inside organs and body cavities and to perform procedures. These minimally invasive approaches have revolutionized the practice of surgery in the past 20 years, and the revolution is still underway as surgeons develop more minimally invasive treatments.

Urological surgeons can use various types and sizes of endoscopes to operate on kidneys, bladders and other parts of the urinary system. Loyola has the largest endourology practice in the Chicago area and offers minimally invasive treatments that are not performed at most area hospitals. Urologists Thomas M. T. Turk, M.D., and Kent T. Perry Jr., M.D., treat hundreds of patients per year with endoscopic techniques. They also offer the only Chicago-area fellowship program in endourology to train urologists in the art and science of minimally invasive surgery.

The smallest endoscope they use is the 2-millimeter ureterscope, which can be fed through the urinary tract - without any incisions - to destroy kidney stones or repair a narrowed ureter (the duct that carries urine from the kidney to the bladder).

One of the larger endoscopes called a laparoscope is about the width of a finger. Turk and Perry are among the leaders in their field in using laparoscopy to remove large kidney stones, tumors and cysts in the urinary system. They currently perform laparoscopic nephrectomy (kidney removal) to treat cancer and to remove a kidney for donation and partial nephrectomy (partial kidney removal) to control cancer. The traditional method for these operations is through one large, open incision on the side of the patient's abdomen. Considerable pain and discomfort are associated with "flank incisions," which involve cutting through muscle and sometimes
even ribs.

"Operating on the kidney laparoscopically is a world apart from doing open surgery," said Perry. "The differences to the patient are huge." Research has shown that minimally invasive procedures are just as effective at treating disease, but offer significant benefits to patients, including less need for pain medications, fewer days in the hospital, a much shorter recovery time and fewer post-operative complications.
One of the newest minimally invasive techniques that Perry and Turk are using is laparoscopic cryosurgery to treat kidney tumors. This experimental treatment may be appropriate for patients who have small, malignant kidney tumors and who are not good candidates for more aggressive surgery. A cryosurgery probe is used to freeze and kill the tumor cells and closely surrounding tissue. The procedure is a promising new approach to kidney cancer.

Another minimally invasive treatment, microwave therapy, is a new alternative to the standard treatments for enlarged prostates. Through a catheter placed in the urethra, microwave-generated heat is used to destroy enlarged prostate tissue. Only a local anesthetic is used, and the patient can return home after the procedure. Loyola is one of the few medical centers in the Chicago area that offers microwave therapy as an office-based procedure.

To make an appointment with an urologist at Loyola, call (708) 216-8563.

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