You will be given a general anesthetic, so you will be asleep for the surgery. A small incision is made on the side of your abdomen and gas (carbon dioxide) is put into your abdomen to make space for the laparoscope. Then the laparoscope goes through the incision. Small incisions (3 to 5 of them), 5 to 10 mm in size, are made for the passage of the laparoscope. One of them will be larger to allow for removal of the kidney. Most patients will have dissolvable stitches and dressing tapes (steri strips) over their incisions. There is a small chance during your surgery that your surgeon may have to make a larger incision to complete the operation (open nephrectomy). This will only be done if it is considered safer or more effective in your situation.
After the Operation
After the operation you will be in the post-operative recovery area for 1- 2hrs then you will be taken upstairs to the 3 West surgical ward. In order to avoid complications (listed below), I will want you to move around as soon as possible after surgery. On the day of surgery when you are on the ward I have the Nurse assist you to stand at the bedside. On the day after surgery I will want you to walk around the ward. You will find that moving from lying down to sitting can be painful without assistance at first but once you are standing the discomfort is much better. Also by walking your bowels with start to function sooner and relive the bloating that is common after surgery. Once you are passing flatus you will be allowed to go home to complete your recovery. You will be discharged home on the second day after surgery if you are passing flatus, and your pain is controlled with oral pain medications. It is better to be at home for the remainder of your recovery as there are fewer chances for contracting an infection at home.
What to Expect at Home
May experience pain or discomfort around incision sites especially with coughing or sitting up. You may feel tired and need to nap during the day.
Reasons to See a Doctor:
- Redness, foul-smelling drainage or separation of incision site
- Fever over 38.5 C.
- Severe pain unrelieved by medication.
- Leg pain or swelling.
- Nausea or vomiting which persists.
Advance your diet slowly at home. Stick to foods that are simple and easy to digest. Try to drink 6-8 glasses of water per day.
Get up and about as soon as possible after surgery. Walk as tolerated. Avoid lifting more than 20 lbs for 6 wks. Avoid pressure on your incisions. You may start showering 24-36 hrs after surgery. Avoid water stream directly on incisions by applying clear plastic wrap over them when showering. You may sponge bathe. Do not submerge in a tub bath for 3-4 weeks.
Use prescription pain medication as needed. Do not apply ointments or creams to incisions until the steristrips have been removed. You may then apply polysporin or other antibiotic ointment 2-3 times per day until healed. Take a stool softener (obtain over the counter at local pharmacy) starting the night of your surgery. Stop taking stool softeners once having soft bowel movements. Do not take stool softeners if diarrhea occurs. If you have not had a bowel movement by the 3rd day after your surgery, take a laxative (obtain at your local pharmacy over the counter).
You may begin your regular medications when you leave the hospital unless instructed otherwise.If you take blood thinners (ASA, plavix, warfarin), I will advise when you can start them again.
Adapted from Campbell-Walsh Urology Tenth Edition
Michelle Strovski, Maple Ridge Urology, Serving Maple Ridge, Coquitlam, Mission, Abbotsford, Langley, and Vancouver.