Uretic stent removal alternative to General Anesthetic

[billysboy]

As title really Dad is 80 and has survived a major sigmoid colon cancer operation in January
He has a uretic stent fitted which now needs removal however we were told by the surgeon that he would not survive a local so they are looking at alternatives
He has already had one unsucessfull attempt at removal under a local

Has anyone had any experience of this ?

Presume you mean won't survive a GA rather than local....

If he managed major surgery under GA in Jan & nothing much has changed since then he'll most likely be fine with a GA for a quick stent removal. if things have changed drastically since Jan see if surgeon can refer him to anaesthetic pre-assessment clinic to see if anything can be optimised/discuss exactly what the risks are. Spinal anaesthetic may be an option if he really doesn't want a GA but it isn't necessarily less physiologically challenging. Best to discuss the options with an anaesthetist rather than the surgeon. (From an anaesthetist).

I was going to have stents put in when I was pregnant
I was told a GA for in and then they come out cystoscopic with a bit of Local??

Sorry I see that it was unsuccessful
Can they sedate for it or perhaps an epidural/ spinal block?

Have they calcified onto the ureters?

I think the epidural is what they are looking into they have not calcified but have stuck to the side of the ureter

Dad had a four hour op under GA and they called twice during the week after to say they couldnt do any more and placed him under palliative care which is why they advised they wouldnt operate again as they didnt think his heart was strong enough
I am just going out of my mind worrying about it and dont really seem to be able to find any answers .The urologist said it is not straightforward to remove

Walkingthroughawall
Do you have any more you can add about the epidural ie how long can it be used for and have you used it for anything similar ?

Haven't ever done a stent removal under epidural (in 11 years of regular urology lists...so it really isn't done commonly). Have done a few with spinal. Most are done with GA. Obviously I can't give specific advice for your Dad, but I'd strongly suggest he tries to speak to the anaesthetist rather than the surgeon (we specialise in getting people through anaesthetics not the surgeons!).

A repeat GA in Jan, by the sound of it, would have been extremely high risk if he was sick enough to be receiving palliative care input. However, it's now 6mths down the line and he's still alive and they obviously think he's going to survive long enough to justify removing the stent so things may be somewhat better.

Depending on exactly what the problem is with his heart a spinal/epidural may be possible but there are some heart problems for which they are contraindicated and as I alluded to in the other reply, they're not necessarily less physiologically challenging than a GA. Depending on exactly what the urological problem is making the stent removal difficult, you may not get quite such good surgical conditions with a spinal/epidural which would mean converting to a GA on the table. It sounds like his surgeon and anaesthetist need to talk to each other (hopefully they have done already if he's booked for theatre!) and then discuss the pros & cons of each option with your dad. Hope it all goes smoothly.

so we had a pre op meeting with the anesthetist today who gave Dad a 50 50 of surviving the anesthetic and thereafter , he cannot do a spinal tap because of the bedsore on his sacrum

The urologist has insisted that the stent be removed as it has been in for 6 months now

So stuck between the devil and the dark blue sea now

Operation tomoz at 11 am

Sending you all strength
Anaesthetists are by default the experts at keeping people alive
Have faith
X

How did it go

he survived the operation so far , he was out for about an hour and a half from what I can make out he is now recovering in HDU

I am going up in the morning to see him

How is he

Dad still going on ok , I saw him yesterday and he is only now starting to get fully over the effects of GA
Said he had stopped seeing bugs every where all over the wall !

GA seems a bit like alcohol and a hangover , when I was 18 I could shrug it off quite quickly , now nearer 50 if I went mad with wine it woud take a whole lot longer to get over