Nephrectomy is a procedure used to treat Kidney Cancer, the cancerous growth in the kidney.
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Understanding Laparoscopic Nephrectomy
Laparoscopic nephrectomy is performed to laparoscopically remove the tumour in the kidneys.
The tumor clot in the renal vein is milked backwards and removed from it.
Clearance of the affected lymph nodes is also done.
Although the laparoscopic operation takes much longer than open surgery, there are considerable reductions in the length of postoperative hospital stay and the time taken to return to normal activities and to full recovery.
How is Laparoscopic Nephrectomy Performed?
In this procedure 3 to 5 to small incisions are made into the abdomen, through which laparoscopic instruments are sent.
the kidney is approached in the abdomen within the peritoneum. The large intestine is pushed down to expose the kidneys.
The artery supplying the kidneys (renal artery) is identified and clipped. The kidneys are then accessed laparoscopically.
The (ureters tube carrying urine from kidneys to the bladder) are identified and separated from the surrounding structures.
The hilum (entry point of ureters and blood vessels) is then dissected of its structures. The bleeding is controlled.
Hence the kidney becomes free. This kidney is then placed in a plastic bag within the abdomen and is removed through the incision.
The absolute reason to remove the kidney is the cancer of the kidney. Cancer not removed at the earliest is not a wise thing to do, it might cost the life of the patient. The earlier it is removed, the better it is.
Life after LAPAROSCOPIC NEPHRECTOMY
- If one kidney is removed, there is only left. At most care should be taken to avoid any injury or disease to it.
- Keep a record of urine output, and seek medical help if there is a significant reduction.
- Be aware of any urinary complaints, any infection should immediately treated with antibiotics.
laparoscopic nephrectomy FAQ’s
The chances are you will not, because a single kidney is enough for a good, long and healthy life. As long as you are not unfortunate enough to have the remaining kidney damaged, you will not be affected significantly.
No, you should eat and drink like everyone else, and you should be able to flush out as much urine as you are doing right now before the surgery.
No. Laparoscopic nephrectomies are completely blood less.
It is true, that for whatever reason (bleeding, difficult anatomy, etc. surgeons will sometimes choose to open up. Generally speaking, Laparoscopic nephrectomy is very successful.
Technically it is a little demanding and requires some extra instrumentation like staplers, but over all it’s a very pleasing operation to do both for the surgeon as well as the patient.
It’s a bit more expensive than the open surgery because of intra operative staplers, energy devices etc. These staplers are expensive but they can cut down bleeding tremendously and render the operation much more successful through the keyhole technique.
It takes anything between one to two hours. Very rarely it can take up to 3 hours. Sometimes simple kidneys are out in half an hour or so. However, the time it takes shouldn’t be a major criterion. The completeness of the surgical procedure should be the most important thing.
Dr. Ilamparuthi Chennakrishnan
GENITO- URINARY SURGEON
M.B.B.S., M.S. (General surgery), M.Ch. (Urology), D.N.B. (GUS), F.I.C.S.