Laparoscopic nephrectomy is an effective way to remove a diseased or cancerous kidney. Laparoscopic nephrectomy is a minimally invasive technique, so when compared to conventional open surgery, it can mean significantly less post-operative pain, a shorter hospital stay, earlier return to work.
An initial ultrasonography and CT scan of the abdomen is done to know the exact extent and location of the cancer.
The procedure is carried out under general anesthesia. The patient is made to lie in an incline position at 45 degrees angle to the couch the position is supported by saline bottles kept under the back.
4-5 small cuts of 5-10 mm in length are made in the flank region on the side of the kidney to be removed. A small tube with a camera is passed through one of the holes to visualize the inside of the abdomen. This is called as the laparoscope. A small amount carbon-di-oxide gas is released into the abdomen to inflate it for better visualization of the internal organs. It is extracted later. Once the extent of the cancer is noted, other small instruments are passed through the ports to cut the kidney from its blood vessels, and fascia. The blood vessels are closed. The surrounding fatty tissue, lymph nodes and fascia are resected and pulled out.
One of the ports is slightly enlarged to pull out the kidney. The area is thoroughly searched and cleaned for any remaining cancer tissue. The instruments are removed and the area is stitched up and catheter put in place.
The patient is kept in intensive care for a day or two till the urine production normalizes after which he is shifted to ward. Discharge from the hospital takes place after 4-5 days. Once the catheter is removed the patient can go home. The patient should progress to daily routine slowly as it is a major surgery. He can resume normal activities by 6-12 weeks. Strenuous activities like car driving can take longer and should be done only after physician’s advice. The person should start with a light diet initially till the entire bladder and bowel functions are regained.
The surgery is complex and requires an experienced team of surgeons, nurses and OT technicians.
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