Laparoscopic Nephrectomy

 

Indications

Patients who are found to have kidney cancer have their kidneys removed to treat cancer. Patients with recurrent kidney infections, severe blockage and long-term kidney stones disease may develop persistent pain or lose the diseased kidney, so nephrectomy justified. More than 4,000 people each year in the United States to give one of their two kidneys to the end of the transplant. Standard surgery to remove a kidney requires a skirt or abdominal incision 8 to 20 inches in length. In addition, in many cases, the fins must be removed to allow adequate exposure. Most of these procedures can be performed laparoscopically with similar success rates using small incisions "keyhole"

Operative Procedure

Laparoscopic nephrectomy was performed under general anesthesia. The typical length of work is 3-4 hours. The surgery is performed for 3 small incisions (1 cm) in the stomach. The telescope and small instruments inserted into the abdomen through incisions that allow the surgeon completely free and dissect the kidney, without having to get their hands on abdomen. The kidney and then placed in a plastic bag and removed intact through the extension of one of the sites of existing cuts.

Potential Risks and Complications

Although this procedure has proven to be very safe, as with any surgery, the possible risks and complications. Safety Speed and similar complications compared with open surgery.

The risks includes:

• Infections: Patients were cured with intravenous antibiotics earlier surgery to reduce the risk of infection after surgery phenomena. If signs or symptoms of infection after surgery (fever, discharge from the incisions, frequency / urinary discomfort, pain or May you be concerned) please contact us at once.

• Bleeding Blood loss: During this process is usually smaller (less than 100 cc) and the blood transfusions in less than 5% of patients need. If you are interested in autologous blood transfusion (donating their own blood) before surgery, you should consider a surgeon. When the information package by mail or delivered to you about your surgery, you will receive the authorization form for you to get to the Red Cross in your area.

• Damage to tissue / organ: The Although rare, injury to tissues and organs, including the intestine, vascular structures, spleen, liver, pancreas and gall bladder may require new surrounds operation. Injury may occur in the nerves or muscles that are related to positioning.

• Hernia: Hernia at the incision sites rarely occurs because all incisions closed lock around the end of the operation.

• Conversion to open surgery: An operation requiring conversion to standard open surgery if difficulties during laparoscopic procedures. This can lead to greater and perhaps a longer period of recovery standard open cut.

Immediately after surgery patient will be taken to the recovery room, and then transferred to his hospital room, after fully awake and your vital signs are stable.

• Post-operative pain: Pain medication can be controlled and delivered to the patient through a catheter or epidural or intravenous injection (pain), which is managed by nurses. You may feel pain in the shoulder mild transient (1-2 days) compared to the carbon dioxide gas used to inflate the abdomen during laparoscopic surgery.

• Nausea: You May experience nausea related to anesthesia. There are medications to treat persistent nausea.

• Urinary Catheter: You can presume to require a urinary catheter to empty the bladder (placed in the operating room while the patient is asleep), about a day after the operation. It is not uncommon to have blood stained urine for several days after surgery.

• Power: You can expect to have an intravenous in 1-2 days. A small tube placed in a vein in order to obtain the necessary fluids and stay hydrated. It also provides a way to receive medication. Most patients are able to tolerate ice chips and sip of fluids the day of surgery and the next day regular food. Once in a typical diet, medication pain taken orally before intravenously or by injection.

• Fatigue: Fatigue is a common and should begin to disappear for a few weeks after surgery.

• Spirometry: You will be asked to do some simple breathing exercises to prevent respiratory infections by using incentive spirometry device (such exercises are explained by nurses during hospital stay). Deep breath and Coughing is an important part of your recovery and helps prevent pneumonia and other pulmonary complications.

• Ambulation: The day of the operation, it is very important to get out of bed and start walking with the supervision of a care-giver or family member to prevent blood clots in the legs. You can expect to get a (sequential compression devices) SCD with tight white low in order to avoid the formation of clots in the legs.

• Hospital Stay: The length of hospital stay for most patients is approximately 2 days.

• Constipation/Gas Cramps: You may experience sluggish bowels for several days following surgery as a result of the anesthesia. Suppositories and stool softeners are usually given to help with this problem. Taking a teaspoon of mineral oil daily at home will also help to prevent constipation. Narcotic pain medication can also cause constipation and therefore patients are encouraged to discontinue any narcotic pain medication as soon after surgery as tolerated.

What to expect after discharge from the hospital?

• Pain Control: You can expect to have some incisional discomfort that may require pain medication for a few days after discharge, and then Tylenol should be sufficient to control your pain.

• Showering: You may shower after returning home from the hospital. Your wound sites can get wet, but must be padded dry immediately after showering. Tub baths are not recommended in the first 2 weeks after surgery as this will soak your incisions and increase the risk of infection. You will have adhesive strips across your incisions. They will fall off in approximately 5-7 days on their own. Sutures underneath the skin will dissolve in 4-6 weeks.

• Activity: Taking walks is advised. Long sitting or staying in bed should be avoided. Climbing stairs is possible but should be taken slowly. Driving must be shunned for 1- 2 weeks after surgery at least. Totally no heavy lifting (greater than 20 pounds) or exercising (jogging, swimming, treadmill, biking) for six weeks or until instructed by your doctor. Most patients return to full activity at home on an average of 3 weeks later operation. You can guess to resume work in approximately 4 weeks.

• Diet: You should be on a no added salt diet and always avoid high protein diets as both can cause potential damage to your remaining kidney. It is best to discuss methods and guidelines to protect your remaining kidney with your primary care physician after fully recovering from surgery.

• Follow-up Appointment: After your surgery date to schedule a follow up appointment as instructed by your surgeon.

• Pathology Results: The pathology results from your surgery are usually available in one week following surgery. You may discuss these results with your surgeon by contacting him by phone or in your follow up appointment in the office.

• Liver/Kidney Function Blood Tests and X-rays: The Patients are encouraged to have an annual blood test to include a serum creatinine (to follow the function of the remaining kidney) and liver function tests, performed by their primary care physician. Your surgeon will also review these results in the office during follow up visits. In patients with kidney tumors, follow up X-ray tests (e.g. CT, MRI, sonograms) may be periodically required to follow the appearance of your remaining kidney.