Laparoscopic Radical Nephrectomy

For patients diagnosed with a large (i.e., > 4 cm) kidney tumor, laparoscopic radical nephrectomy provides patients with a safe and minimally invasive technique for complete removal of the affected kidney and tumor.
This minimally invasive approach has the advantage of improved cosmesis, reduced pain, blood loss, and hospital stay, as compared to conventional open surgery with similar cure rates.

Surgery

Laparoscopic radical nephrectomy requires that patients undergo general anesthesia. While operative time varies from one individual to another, the average operating time is approximately 3-4 hours.
During laparoscopic radical nephrectomy, approximately 3 to 4 small keyhole (< 1cm) incisions are made in the abdomen, which allow the surgeon to insert a telescope (called laparoscope) and hand-held surgical instruments into the abdomen through portals called trocars.

Potential Risks and Complications

As with any major surgery, complications, although rare, may occur with laparoscopic radical nephrectomy. Potential risks and complications with this operation include, but are not limited to, the following:

• Bleeding
• Infection
• Adjacent Tissue/Organ Injury
• Incisional Hernia
• Conversion to Open Surgery

What to Expect After Discharge from the Hospital

• Pain Control:  For the majority of patients, one to two days of oral narcotic pain medication may be necessary after which Extra Strength Tylenol is usually sufficient to manage their pain.  Again, narcotics should be minimized to avoid constipation and over sedation.
• Showering:  Patients can shower immediately upon discharge from the hospital allowing their incisions to get wet. Once out of the shower, pad your incision sites dry and avoid any heavy creams or lotions. Tub baths or hot tubs in the first 2 weeks are discouraged as this will allow for prolonged soaking of your incisions and increase the risk of infection. The sutures underneath the skin will dissolve in 4-6 weeks.
• Activity:  Walking 6 times a day for the first two weeks after surgery on a level surface is strongly encouraged as prolong sitting or lying can increase your risk of pneumonia and deep vein thrombosis. It is permissible to climb stairs. No heavy lifting or exertion for up to 4 weeks following surgery.  Patients may begin driving once they are off of narcotic pain medication and have full range of motion at their waist. Most patients can return to full activity including work on an average 3-4 weeks after surgery.
• Diet:  Patients may resume a regular diet once they begin to pass flatus and their appetite improves.