Laparoscopic Radical Nephrectomy (Removal of the Kidney)

What does the procedure involve?

This involves removal of the kidney through several keyhole incisions. It requires the placement of a telescope and operating instruments into your abdominal cavity using 4-5 small incisions. The adrenal gland may also be removed and one incision will need to be enlarged to remove the kidney

What are the alternatives to this procedure?

Observation, embolisation, chemotherapy, immunotherapy, open surgery.

What should I expect before the procedure?

Please be sure to inform Professor Vale in advance of your surgery if you have any of the following:

  • an artificial heart valve
  • a coronary artery stent
  • a heart pacemaker or defibrillator
  • an artificial joint
  • an artificial blood vessel graft
  • a neurosurgical shunt
  • any other implanted foreign body
  • a regular prescription for Warfarin, Aspirin or Clopidogrel (Plavix®) (blood thinners)
  • a previous or current MRSA infection

What happens during the procedure?

Normally, a full general anaesthetic will be used and you will be asleep throughout the procedure. In some patients, the anaesthetist may also use an epidural or spinal anaesthetic which minimises pain post-operatively.

A bladder catheter is normally inserted during the operation to monitor urine output, and a drainage tube is usually placed through the skin into the bed of the kidney.

What happens immediately after the procedure?

You will be given fluids to drink from an early stage after the operation and you will be encouraged to mobilise early to prevent blood clots.

The wound drain and catheter are normally removed after 24-48 hours. The average hospital stay is 2-3 days.

Are there any side-effects?

Common (greater than 1 in 10)

  • Temporary shoulder tip pain
  • Temporary abdominal bloating

Occasional (between 1 in 10 and 1 in 50)

  • Bleeding, infection, pain or hernia at the incision site requiring further treatment

Rare (less than 1 in 50)

  • Bleeding requiring conversion to open surgery or requiring blood transfusion
  • Entry into lung cavity requiring insertion of a temporary drain
  • The histological abnormality may eventually turn out not to be cancer
  • Recognised (or unrecognised) injury to organs/blood vessels requiring conversion to open surgery (or deferred open surgery)
  • Involvement or injury to nearby local structures (blood vessels, spleen, liver, kidney, lung, pancreas, bowel) requiring more extensive surgery
  • Anaesthetic or cardiovascular problems possibly requiring intensive care admission (including chest infection, pulmonary embolus, stroke, deep vein thrombosis, heart attack and death)
  • Dialysis may be required to stabilise your kidney function if your other kidney functions poorly

What should I expect when I get home?

There may be some discomfort from the small incisions in your abdomen but this can normally be controlled with simple painkillers. All the wounds are closed with absorbable stitches which do not require removal.

It will take 10-14 days to recover fully from the procedure and most people can return to normal activities after 2-6 weeks. However you should refrain from heavy lifting and abdominal exercises for a minimum of 6 weeks to allow the muscle layers to heal fully.