Some patients have an inherited abnormality which causes cysts to form in many different organs, including the kidney, liver, pancreas, and brain. This is called Autosomal Dominant Polycystic Kidney Disease. The kidney cysts can increase in number and size over time and can cause abdominal pain and discomfort, as well as kidney failure requiring dialysis or kidney transplantation. Patients with extensive involvement of their kidneys by cysts may develop high blood pressure, bleeding into the cysts, which causes increased pain, infection of the cysts, and kidney failure necessitating dialysis or kidney transplantation.
If the cysts become very large and cause pain, they may be drained. This can be done by inserting a needle through the back into the cyst or by an operation to open and drain all of the cysts. When there are a large number of cysts it is more effective to perform the operation to drain the cysts. Recently, the operation to open and drain the cysts has been done laparoscopically. This operation is performed through four, 1/2-inch to 3/4-inch incisions made in the abdomen through which a telescope and dissecting instruments are inserted into the abdomen to remove and drain all of the cysts on the outside of the kidney. The operation is usually used in patients who have very large kidney cysts, which cause abdominal pain or discomfort. Most patients will have some or all of their pain relieved after the cyst decortication procedure. Some patients who have high blood pressure from this disease have had improvement in their blood pressure after the cyst decortication procedure. However, it is not known if draining the cysts will slow down the kidney failure caused by this disease, and ongoing clinical studies are being done to evaluate this question.
The laparoscopic cyst decortication operation has less pain after the operation compared to an open surgery to perform this same procedure. The hospital stay is usually 2 - 3 days. The recovery time and time to return to regular activities is quick, usually 2-3 weeks for complete recovery.