Kidney

LAPAROSCOPIC KIDNEY REMOVAL

Kidney removal surgery is usually done when the kidney is not functioning or when there is a tumour. A non-functioning kidney should be removed as it will affect the functioning of the opposite good kidney. It can also produce problems like high BP, recurrent urinary tract infections etc.

Almost all kidney operations can now be performed through key holes. 3 to 5 key holes are required each about 0.5 to 1cm size. A telescope connected to a TV is first passed inside to visualise the kidney on the TV screen. Special operating instruments can then be passed through the key holes to perform operations on the kidney.
If the kidney is to be removed, this can be done by enlarging one of the instrumentation sites suitably . In cases of tumours of the kidney, this ensures that there is no spillage of cancer cells.

When compared to open surgery, there are several advantages for laparoscopic kidney surgery.Click here for video
1. At the time of surgery, the image obtained is magnified 10 to 15 times, increasing the accuracy of the surgery performed.
2. The internal wound is correspondingly small and therefore, postoperative recovery is very short.
3. As the external wounds are small , post operative pain is less.
4. The person does not have to stay away from work for more than 2 weeks as compared to 6 to 8 weeks for open surgery.
5. Open surgery scar for the kidney is very long and ugly. The 0.5 and 1cm scars after laparoscopy, are hardly noticeable.

PRE-OPERATIVE CHECK UP
1. Before the admission date, you will have a medical check up for assessment of medical fitness for anaesthesia.
DAY OF ADMISSION
1. You should come to the hospital to attend the Urology OP.
PRE OPERATIVE PREPARATION -
Laparoscopy is hindered by distended bowels. Hence suitable purgatives are given to clear the bowels. This also helps in preventing post operative discomfort.

As during laparoscopic surgery, if any difficulty is encountered, the surgery will be converted to an open procedure, skin preparation would be as for open surgery. Hair would be shaved from nipple to thigh.
DAY OF SURGERY.
1. The anaesthetist would decide from what time you should fast. Usually this is for a minimum of 6 hours.
2. After surgery, you will be in the post operative intensive care ward on the day of surgery.
3. You will have a catheter(tube) through the water passage (urethra) to your bladder and a small tube through the side of the abdomen (drain), to the operation site inside.
4. One person will be allowed to visit you in the post operative ward after surgery. To maintain the sterility of the ward, you are requested to persuade your dear ones to co-operate.
1ST POST OPERATIVE DAY
1. After the doctor examines you, you will be allowed to have a liquid diet. On some occasions the intestines will not be active for a day or two after surgery. The doctor will then advice you not to have anything by mouth .
2. You will normally be allowed to move about, and walk to the toilet.
3. The catheter in the bladder will be removed.
2ND POST OPERATIVE DAY.
1. Usually allowed to have a normal diet.
4 TH POST OPERATIVE DAY.
Usually allowed to go home. Delay in discharge is usually due to infection.
By the 4 th postoperative day, you will be able to move with very little pain. If there are any stitches to be removed, this is done as an outpatient, after about 10 days.
AT HOME
1. You should come for review after about 10 days.
2. You are allowed to take a shower - but not allowed to bend down and lift the water to pour on your head.
3. You should not strain for 10 days.
4. You will allowed to go back to work in 2 weeks from the date of surgery.