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Laparoscopic Partial Nephrectomy

Laparoscopic Partial Nephrectomy

Laparoscopic partial nephrectomy is surgery to remove a part of your kidney. When the part of your kidney that is diseased or damaged is removed, healthy parts of your kidney are able to keep working. The kidneys are two bean-shaped organs found under the ribs on each side of the upper abdomen. Their job is to remove wastes and other unwanted chemicals from the body. These wastes are flushed from your body in your urine. On top of each kidney is an adrenal gland, which is an organ that makes hormones. Hormones are special substances that control some functions of your body. The adrenal gland and other tissues may be removed during this surgery.

You may need a laparoscopic partial nephrectomy when your kidney is damaged. This may be caused by blocked blood vessels, kidney stones, infection, or kidney cancer. These conditions decrease your kidney's ability to control blood pressure and remove wastes from your body. With this surgery, your kidney problem may be treated, preventing more kidney damage.

After your surgery:

Activity: You may need to walk around the same day of surgery, or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.

Food and drink after surgery: You will be able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.

Drains: These are thin rubber tubes put into your skin to drain fluid from around your incision. The drains are taken out when the incision stops draining.

Medicines: You may be given the following medicines:

  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
  • Anti-nausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.
  • Stool softeners: This medicine makes it easier for you to have a bowel movement. You may need this medicine to treat or prevent constipation.

Laparoscopic Pyeloplasty:

Laparoscopic Pyeloplasty

A laparoscopic pyeloplasty is an operation where a narrowing or scarring at the junction of the kidney with the ureter is repaired using keyhole surgery.

which can cut, diathermy and stitch the blood vessels and organs inside. A stent will then be inserted into the ureter (pipe connecting kidney to bladder) to prevent any blockage of the ureter due to swelling from the wound site and aid healing. This will allow the easy passage of urine into the bladder. This will be removed at a later date and this is usually performed under a local anaesthetic. (Please see information leaflet on 'having a ureteric stent'). At the end of the operation a catheter tube is often placed into the bladder through your water pipe, a wound drain will sometimes be inserted.

What happens afterwards?

After your operation you will be taken back to the ward, and you will be able to drink sips of later. A light diet may be taken the day after your surgery. You will have a drip in your arm to keep you hydrated, which will be stopped when you are eating and drinking normally. To control any discomfort or pain you may have a pump which will administer a pain-killing drug automatically. If not, strong pain-killing injections or suppositories will be given. You may experience pain in the shoulder and have a bloated feeling in the abdomen. These are both temporary and will resolve over the first few days. The catheter tube will monitor your urine output and will be removed when you are up and mobile. The wound drain will be removed when the drainage is minimal, usually after 48 hours. The wound sites will be covered with a light dressing and any stitches to these sites will dissolve in 2-3 weeks, alternatively you may have steric strips over these sites and these can be removed after 5-7 days.

What are the possible complications?

Occasionally infection and pain may occur at the wound site. A hernia of the incision site may occur which would require further treatment. There is a rare chance that the surgeon may have to proceed to open repair should he encounter problems such as bleeding during surgery. A blood transfusion may also be very rarely required. Very rare complications include injury to organs/blood vessels near the kidney, which then require conversion to open surgery.

At Home

It may take 6 weeks for you to fully recover from this surgery. It is important to avoid heavy lifting and strenuous exercise during this period. We recommend that you should avoid driving for 2 weeks. You will be given an appointment to have your stent removed in 6 weeks time. You will be seen in out patients approximately 3 months after surgery.