Is Removal Of Feeding Tube Necessary Post Robotic Assisted Surgery Of Hysterectomy?

Posted on Mon, 1 Dec 2014

Question: laparoscopic cholecystectomy and radical hysterectomy of my mother( 67 years old) was done 18 days back, post surgery after 1-2 days she started complaining of watery discharge from urninary area and her lower started getting wet, watery discharge keep on increasing then we thought to get done ultra sound and then only we got to know that inside body there is some thin tabular pipe. we went to doctor(who did surgery) next day and he examined, he did soemthing and said we have fixed it. now urine is not coming out automatically but still area gets wet and daily one pad is required to soack the watery discharge, situation is not bad as it was for 10 days. But we are now worried about what this thin pipe is inside body? is this permamnet? has doctor puncture the uretra and that is why they have put this pipe, if you refer discharge summary in section operative steps doctor has talked about some injury accidently in urtera.

Answered by Dr. Dr. P. T. Patil (6 hours later)

Brief Answer:
Nothing to be worried about.

Detailed Answer:
Hello
Thanks for your query,based on the facts and reports of your mother that you have posted it appears that she has Adenocarcina of the Endometrium for which she has undergone robotic assisted surgery of Hysterectomy .

During surgery there was accidental transaction of the left ureter which was rectified and repair was done by anastomosis of both the severed ends of ureter and continuety of Ureter was established.

Normally when we do end to end anastomosis of the ureter we put either DJ stent or Infant Feeding tube across the site of repair to prevent the urine leak in peritoneal cavity from the site of anastomosis.This also helps to heal up quickly.

This tube is not left in body permanently and removed after 3-4 weeks by which time healing is complete .

Please do not worry Dr will remove the tube and she will be free from leak .

Hope I have answered your query. Please feel free to write if you have more questions I shall be happy to help you .
Thanks and Regards .
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (31 hours later)

Thanks for your reply doctor sir, appreciated!!

Please help to understand how could you make out that Ureter has been repaired by surgeon and the rubber pipe inside the body will be removed once ureter gets healed up,. Has doctor in discharge summary mentioned about this specifics that they have repaired the ureter as well.

Is there a way (test or some xray) I should get done to see the ureter's healing progress. Any name of the test?

My mother has been still complaining of watery discharge, and she need to change 2-3 pads in a day even now. I am not sure whether this watery discharge is a leak from that pipe in the body or its common with ladies post these kind of surgeries. Though as per doctor advise she has taken medicines Disperzyme – for 12-13 days TDS and I think levoflox 500 mg for 5 days one in a day. But it has not helped to control watery discharge. Any suggestion/recommendation-

Regards,

Answered by Dr. Dr. P. T. Patil (1 hour later)

Brief Answer:
Read detail Answer below

Detailed Answer:
Hello
Thanks for follow up.
Your surgeon has honestly mentioned in discharge summary about injury to the Ureter during surgery.Please note that no surgeon in the world would leave it without repair if injury is rectified on table during surgery.Injured ureter if left unrepaired would lead to disaster complications like peritonitis ,urine leak in retro peritoneum and subsequently to death of the patient.

The tube in the ureter and bladder causes spasms of the bladder leading to involuntary mild contractions of the bladder that causes leak of the urine keeping patent wet and need for changing pads 3-4 times in a day.

As regards healing of the ureter it is bound to heal .You can get this confirmed by a radiological test called Intra Venous Pyelography.(IVP).

Please have a patience. I can say with confidence and my experience that it will heal up and she will have normal life in near future

Thanks and Regards.
Dr.Patil.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar