Laparoscopic Nephrectomy

Laparoscopic Nephrectomy in Iran

How long does it take to do a laparoscopic nephrectomy?

How long are you in the hospital after a nephrectomy?

How do they do laparoscopic kidney removal?

Is kidney surgery painful?

When can I go back to work after kidney removal?

Can kidney tumor be removed?

Laparoscopic nephrectomy (kidney removal) is a minimally invasive technique that provides the patients with less discomfort and equivalent results when compared to the larger incision required for the conventional open surgery. Compared to the traditional open surgery, the laparoscopic nephrectomy has resulted in significantly reduced post-operative pain, a short hospital stay, early return to work and daily activities, more favourable cosmetic results and an outcome identical to the open surgery. Hence, the laparoscopic nephrectomy is a safe and effective way to remove a diseased or cancerous kidney in the patients.

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Why do I need a Laparoscopic Nephrectomy?

Patients may need a laparoscopic nephrectomy for the following reasons:

The infections may have damaged the kidney and so it requires to be removed.
The kidney may not be working or only partially working, if left in place it can be a source of infection or pain.

A cancer arising in the kidney may have been diagnosed and the usual treatment for this is to remove the kidney.

If cancer is diagnosed in the kidney, it is sometimes essential to remove the adrenal gland that lies on the top of the kidney at the same time. Some kidney cancers have a higher risk of cancer recurrence in the ureter (a tube carrying urine from the kidney to the bladder). If this have been found, then the ureter will also be removed, which means that a small incision lower down on the abdominal wall as well as the other small incisions will be made. Your doctor will discuss the reason for removing your kidney.

Approximately 4000 people in the United States donate one of their two kidneys each year to a loved one for transplantation.

The standard surgery to remove a kidney requires a flank or abdominal incision of about 8 to 20 inches in length. Additionally, in most instances a rib has to be removed to allow enough exposure. Most of these procedures may be performed by laparoscopy with similar success rates using the “key hole” incisions.

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What affects the final cost of Nephrectomy?

  • Extent of surgery needed
  • The patient’s general health
  • Minimally invasive surgery or open surgery
  • The patient’s diagnosis

nephrectomy cost in Iran start from $980.

What are the advantages for a laparoscopic nephrectomy?

There are multiple advantages of a laparoscopic nephrectomy and it includes:

  • Smaller skin incision-about four 1cm incisions rather than a 30cm incision.
  • Less pain due to smaller incisions and the muscles are parted rather than cut.
  • Better view because of the magnification of the system.
  • Shorter hospital stay-about 3 to 5 days in hospitals as compared to a week or longer for the open surgery.
  • The ability to return to work in 2 to 4 weeks as compared to 6 or more weeks after the traditional open surgery.
  • Less blood loss and reduced need for a blood transfusion.
  • Low cost nephrectomy surgery in Iran
  • There are no differences in the chance of cancer cure whether the surgery is performed by conventional open or laparoscopic method.

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Laparoscopic Nephrectomy Risks

Long-term complications from a nephrectomy relate to potential problems of living with less than two complete, fully functioning kidneys. Although overall kidney function decreases following a nephrectomy, the remaining kidney tissue usually works well enough for a healthy life.

Problems that may occur with long-term decreased kidney function include:

High blood pressure (hypertension)

Chronic kidney disease

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Preparing for surgery

Medications to avoid prior to surgery

Aspirin, Motrin, ibuprofen, Advil, Alka-Seltzer, vitamin E, Ticlid, Coumadin, Lovenox, Celebrex, Voltaren, Vioxx, Plavix and some other arthritis medications can cause bleeding and should be avoided one week prior to the date of surgery. (Please contact your surgeon’s office if you are unsure about which medications to stop prior to surgery. Do not stop any medication without contacting the prescribing doctor to get their approval.)

Bowel preparation and clear liquid diet

Drink one bottle of magnesium citrate, which you can purchase at your local pharmacy, the evening before your surgery. Do not eat or drink anything after midnight.

Drink only clear fluids for a 24-hour period prior to the date of your surgery. Clear liquids are liquids that you are able to see through. Please follow the diet below.

Clear liquid diet

Remember not to eat or drink anything after midnight the evening before your surgery.
Clear liquids are liquids that you are able to see through. Please follow the diet below.

  • Water
  • Clear broths (no cream soups, meat, noodles, etc.)
    • Chicken broth
    • Beef broth
  • Juices (no orange juice or tomato juice)
    • Apple juice or apple cider
    • Grape juice
    • Cranberry juice
    • Tang
    • Hawaiian punch
    • Lemonade
    • Kool-Aid
    • Gatorade
  • Tea (you may add sweetener but no cream or milk)
  • Coffee (you may add sweetener but no cream or milk)
  • Clear Jell-O (without fruit)
  • Popsicles (without fruit or cream)
  • Italian ices or snowballs (not marshmallow)

Planning for a donor nephrectomy If you’re planning to donate a kidney for a transplant, you’ll have thorough exams to determine if you’re a suitable candidate. Criteria for donating include:

18 years of age or older

Compatible blood type with kidney transplant recipient

Generally good health

Two well-functioning kidneys

No history of high blood pressure, kidney disease, diabetes, certain cancers or major

risk factors for heart and blood vessel (cardiovascular) disease
Stable mental health.

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During the procedure

The nephrectomy procedure varies, depending on how the surgery is performed and how much of the kidney is removed. Variations include:

Open surgery. In an open nephrectomy, the surgeon makes an incision about 10 to 20 inches (25 to 50 centimeters) long in either your side or your abdomen typically between the lower ribs on the side of the affected kidney. The surgeon may need to remove a lower rib to gain better access to the kidney.

Laparoscopic surgery. In this minimally invasive procedure, the surgeon makes a few small incisions in your abdomen to insert wand-like devices equipped with video cameras and small surgical tools. The surgeon makes a somewhat larger opening if your entire kidney needs to be removed.

Robot-assisted laparoscopic surgery. The surgeon may use a robotic system to perform a laparoscopic nephrectomy. Robotic tools require very small incisions, provide better imaging of the procedure and enable precise removal of diseased tissue. The surgeon controls the surgical instruments from a remote console a short distance from the operating table. The assisting surgical team inserts the instruments through the abdominal incisions and attaches the instruments to the system’s robotic arms.
Radical nephrectomy. In a radical nephrectomy, the surgeon removes the whole kidney, the fatty tissues surrounding the kidney and a portion of the tube connecting the kidney to the bladder (ureter). The surgeon may remove the adrenal gland that sits atop the kidney if a tumor is close to or involves the adrenal gland.
Partial nephrectomy. In a partial nephrectomy also called kidney-sparing surgery  the surgeon removes a cancerous tumor or diseased tissue and leaves in as much healthy kidney tissue as possible.

Robotic partial nephrectomy, laparoscopic partial nephrectomy and traditional open surgery yield similar long-term outcomes. However, the much smaller incisions in robotic and laparoscopic surgery usually mean you’ll have less postoperative pain and blood loss and a faster return to your normal activities.

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After the procedure

Recovery time and the length of your hospital stay depend on your overall health and the type of nephrectomy performed.

Depending in part on your ability to get out of bed and the type of procedure performed, the urinary catheter will likely be removed sometime during the first 24 to 48 hours after the surgery.

  • Pain control: You can expect to have some pain that may require pain medication for a few days after discharge. Afterward, 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 two weeks after surgery as this will soak your incisions and increase the risk of infection. You may have adhesive strips across your incision. These are not to be removed. They will fall off in approximately five to seven days. Sutures will dissolve in four to six weeks.
  • Activity: Taking daily walks is strongly advised. Prolonged sitting or lying in bed should be avoided. Climbing stairs is possible but should be taken slowly. Driving should be avoided for at least one to two weeks after surgery. Absolutely 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 on an average of three weeks after surgery. You can expect to return to work in approximately four weeks.
  • Diet: You should drink plenty of fluids and discuss with your doctor if you need to be on a salt- or protein-restricted diet.
  • 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.
  • Kidney function blood tests and X-rays: Patients are encouraged to have an annual blood test, called serum creatinine, performed by their primary care physician to follow their overall kidney function. 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.

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 Is having a kidney removed a major operation?

Nephrectomy is generally a safe procedure. But as with any surgery, nephrectomy carries a potential risk of complications. A nephrectomy is a major surgery to remove all or part of your kidney. The kidneys are two small, bean-shaped organs in the abdomen. They filter water and waste products from your blood.

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How long does it take to do a laparoscopic nephrectomy?

Laparoscopic nephrectomy surgery takes approximately 2 to 2-1/2 hours, and the hospital stay is usually just overnight, even for large tumors.

How long are you in the hospital after a nephrectomy?

You will probably remain in the hospital for 1 to 7 days, depending on the method of surgery used. You will be encouraged to return to light activities as soon as you feel up to it. Strenuous activity and heavy lifting should be avoided for 6 weeks following the procedure.

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How do they do laparoscopic kidney removal?

The urologic surgeon may perform a nephrectomy through a single incision in the abdomen or side (open nephrectomy) or through a series of small incisions in the abdomen using a camera and small instruments (laparoscopic nephrectomy). In some cases, these laparoscopic procedures are performed using a robotic system.

Is kidney surgery painful?

The surgeon will cut the ureter, place a bag around the kidney, and pull it through the larger cut. This surgery may take longer than an open kidney removal. However, most people recover faster and feel less pain after this type of surgery when compared to the pain and recovery period following open surgery.

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When can I go back to work after kidney removal?

Every person recovers differently and has different needs. Some people find that they are well enough to return to work 2 weeks after surgery, though most people take 4 weeks to get back to work.

Can kidney tumor be removed?

Surgery is the main treatment for most kidney cancers. Depending on the stage and location of the cancer and other factors, surgery might be done to remove either the cancer along with some of the surrounding kidney tissue (known as a partial nephrectomy), or the entire kidney (known as a radical nephrectomy).

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How long does pain last after kidney removal?

The incision will leave a scar that will fade with time. Your belly will feel sore after the surgery. This usually lasts about 1 to 2 weeks. Your doctor will give you pain medicine for this.

What are the side effects of living with one kidney?

There may also be a chance of having high blood pressure later in life. However, the loss in kidney function is usually very mild, and life span is normal. Most people with one kidney live healthy, normal lives with few problems. In other words, one healthy kidney can work as well as two.

Why do they not remove the bad kidney?

In most cases, even for patients with polycystic kidney disease, which is a genetic disorder that causes the formation and growth of cysts in the kidneys, surgeons don’t remove the person’s own (native) kidneys during kidney transplantation. Instead, the surgeon usually places the new kidney in the lower abdomen.

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Can you drink alcohol after kidney removal?

About Drinking Alcohol. The amount of alcohol you drink can affect you during and after your surgery. It’s important that you talk with your healthcare providers about your alcohol intake so that we can plan your care. Stopping alcohol suddenly can cause seizures, delirium, and death.

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What happens when one kidney is removed?

You are born with two kidneys, but you really only need one. A single healthy kidney can work as well as two kidneys, but if both kidneys are removed, dialysis or a transplant is necessary to maintain life.

Most people with a single kidney live a normal life without developing any long- or short-term problems. However, some long term problems have been seen in some people.

In some people who were born with a single kidney, or had a kidney removed during childhood, there is a chance of some slight loss in kidney function later in life. This usually takes 25 years or more to happen. There may also be a chance of having high blood pressure later in life. However, the loss in kidney function is usually very mild, and life span is normal. Most people with one kidney live healthy, normal lives with few problems.

In other words, one healthy kidney can work as well as two.

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