Product Summary: AMA rates
Laparoscopic radical nephrectomy, with para-aortic, or para-caval nodes
Item Number: 10cm 36528, 105; 10cm 36529, 105
For renal cancers contained in the kidney. This is a intended curative procedure, depending on staging.
Also for symptomatic, non-functional kidneys. Least invasive procedure with quick recovery.
Why is it done?
- Incidental finding of a solid renal mass larger than 3cm suspicious of a renal cancer.
- A symptomatic non-functioning kidney.
- Usually asymptomatic.
- Late symptoms include:
- Palpable Mass.
- Flank pain.
- Curative process for Renal Cell Carcinoma.
- Staging should be negative ie. No spread of tumour.
- Staging with:
- CT abdomen and chest.
- MRI if in Renal Failure or Contrast.
- Risk for post-operative dialysis will have been discussed prior to your surgery by means a referral; to a Nephrologist.
The correct side for surgery should be checked:
- CT scan present.
- Your approval.
- Prior to anaesthesia being.
How is it done?
- Patients will receive a general anaesthesia, unless contra-indicated.
- Prophylactic anti-biotics is given.
- An indwelling catheter is placed.
- The correct kidney is identified and marked while you are a.
- Depending on the side of the tumour 3-4 incisions will be made: 1 for the hand-port of approximately 8cm depending on the amount of sub-cutaneous fat present 1 for the camera-port 1 for the working-port (1 for the liver retractor on the right)
- The colon is reflected to reveal the retro-peritoneal space
- The ureter is identified and cleared up to the hilum
- The arteries are identified and tied off and cut first. More than 1 can be present
- Then the vein/ viens are tied and cut.
- The rest of the kidney is mobilized with its surrounding fat and removed.
- The adrenal gland is also removed in large tumours and upper pole tumours.
- Lymphnodes surrounding the blood supply to the kidney will be removed if the tumour is larger than 4 cm.
- You will spend up to 3-5 nights in hospital.
- You will have a catheter for that time.
- A drain for 2-3 days.
- You will a trial without the catheter on the 3rd day.
- Renal functions will be checked daily.
- You may enter a phase of poly-uria. High production of urine as the remaining kidney adjusts to the higher work-load.
- You will be discharged as soon as your renal function has stabilised and you can function independantly.
- Allow for 6 weeks for stabilization of symptoms.
- Restrict fluid intake to less than 3 L per day.
- A ward prescription will be issued on your discharge, for your own collection at any pharmacy.
- A follow-up appointment will be scheduled for 6 weeks. Remember there is no pathology due to vaporization.
- Don’t hesitate to ask Jo if you have any queries.
- DON’T SUFFER IN SILENCE, OR YOU WILL SUFFER ALONE!
- Minimal Blood loss.
- Wound Infection.
- Post-operative hernia formations especially associated in the elderly with atrophic abdominal muscles.
- Prolonged hospital stay due to impaired renal function recovery.
- Dialysis as discussed by your Nephrologist, if pre-operatively indicated.
- NB! Each person is unique and for this reason symptoms vary!
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