Laparoscopic surgery

Laparoscopic surgery

After initial training in General surgery at Royal North Shore hospital urology training began in 2006 at Port Macquarie Hospital, Westmead and then Prince of Wales Hospital.

During this time Dr Arianayagam had significant exposure to laparoscopic surgery (also known as keyhole surgery) and was soon able to perform many laparoscopic procedures. In particular he trained under Professor Howard Lau at Westmead. Being a kidney transplant surgeon, Dr Lau trained Dr Arianayagam in laparoscopic live donor nephrectomy, where laparoscopic surgery is used to harvest a kidney for transplantation.

While completing his Urologic Oncology fellowship at the University of Miami Miller School of Medicine there was also significant exposure to more laparoscopic surgery and it was during this time that Dr Arianayagam also honed his skills in teaching.

In particular, Dr Arianayagam specializes in laparoscopic partial nephrectomy, which is a challenging operation where a diseased portion of the kidney is removed leaving the rest of the organ intact. It has many advantages over the traditional operation, which requires a very large incision, which is very painful and has a long recovery time. He also performs zero ischaemia partial nephrectomy, where the artery to the kidney is not clamped. This has the advantage of having no ischaemia to the kidney and hence improved function. It is even more challenging than the traditional laparoscopic approach due to the risk of increased bleeding. Results of this technique was presented at the recent Urological Society of Australia and New Zealand in 2014.

Currently, Dr Arianayagam has been practicing in Sydney since 2011 and has developed the reputation of being a skilled laparoscopic surgeon and excellent teacher. He routinely performs the entire breadth of laparoscopic surgery ranging from total to partial kidney removal as well as all aspects of adrenal surgery.

Laparoscopic procedures performed include:

  • radical nephrectomy (removal of entire kidney)
  • partial nephrectomy (removal of part of the kidney)
  • pyeloplasty (repair of a kidney when it does not drain properly)
  • adrenalectomy (removal of abnormal or cancerous adrenal gland)
  • ureteric reimplantation (the ureter is reattached to the bladder after an injury, usually after a hysterectomy)


CT scan showing image of tumour on right side of the image.
This small tumour can be removed using key hole surgery.


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