What is Laparoscopic Nephrectomy

Laparoscopic nephrectomy is a surgical procedure to remove a kidney. This procedure is done through several small incisions in your abdomen. In this procedure, you may have your entire kidney and some surrounding structures removed (radical nephrectomy), or you may have only the damaged or diseased part of your kidney removed (partial nephrectomy).

You may need this surgery if your kidney is severely damaged from kidney disease, infection, or cancer. You may also need this procedure if you were born with an abnormal kidney or if you are donating a healthy kidney.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Bleeding.
• Infection.
• Pneumonia.
• Damage to other body structures near the kidney.
• Allergic reactions to medicines.

A bone or additional tissue may need to be removed so the surgeon can get to your kidney. If this happens, the laparoscopic procedure may need to be changed to an open procedure.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Medicines

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• You may be given antibiotic medicine to help prevent infection.

General instructions

• Plan to have someone take you home after the procedure.
• Do not use tobacco products, including cigarettes, chewing tobacco, or e-cigarettes. If you need help quitting, ask your health care provider.
• Ask your health care provider how your surgical site will be marked or identified.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
  • Hair may be removed from the surgical area.
• An IV tube will be inserted into one of your veins.
• You will be given a medicine that makes you fall asleep (general anesthetic).
• A tube will be inserted to drain urine (urinary catheter).
• A small incision will be made in your abdomen to insert a thin telescope with a camera (laparoscope). This lets your surgeon see your kidney during the procedure.
• More small incisions will be made to insert laparoscopic operating tools.
• If you are having a partial nephrectomy, only the diseased part of your kidney will be removed.
• If you are having a radical nephrectomy:
  • All of the blood vessels that attach to your kidney will be separated and tied off.
  • Part of the tube that carries urine from your kidney to your bladder (ureter) will be removed.
  • Your kidney will be removed.
• One incision may be slightly larger to remove your kidney.
• Bleeding in the surgical area will be controlled.
• A small tube (drain) may be placed near one of the incisions to drain extra fluid from the surgical area.
• The incisions will be closed with stitches (sutures) or another type of closure.
• A bandage (dressing) will be placed over the incision.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• Your IV will stay in place until you can drink fluids on your own. Your urine output will be checked.
• Your urinary catheter may be removed.
• You will be encouraged to walk as soon as possible.
• You will be shown how to do breathing exercises, such as coughing and breathing deeply. These help prevent pneumonia.

Laparoscopic Nephrectomy, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information on caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• Pain.
• Soreness and numbness in your incision areas.

Follow these instructions at home:

Activity

• Return to your normal activities as told by your health care provider. Ask what activities are safe for you.
• Do not lift anything that is heavier than 10 lb (4.5 kg) until your health care provider approves.

Bathing

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths for bathing.
• Keep the bandage (dressing) dry until your health care provider says it can be removed.

Incision care

• Follow instructions from your health care provider about how to take care of your incisions. Make sure you:
  • Wash your hands with soap and water before you change your dressing. If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to be in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Watch for:
  • Redness, swelling, or pain.
  • Fluid, blood, or pus.

General instructions

• Take medicines only as directed by your health care provider.
• Do not drive or operate heavy machinery while taking prescription pain medicine.
• Keep all follow-up visits as told by your health care provider. This is important.
• Drink enough fluid to keep your urine clear or pale yellow.
• If you have a drain, follow instructions from your health care provider about how to care for it.

Contact a health care provider if:

• Your pain is worse.
• You have redness, swelling, or pain at your incision site.
• You have a bad smell coming from the wound or dressing.

Get help right away if:

• You have a rash.
• You have trouble breathing or feel short of breath.
• You feel light-headed or dizzy.
• You have blood in your urine.
• You have fluid, blood, or pus coming from your incision.
• You have a fever.