Laparoscopic Radical Nephrectomy
Laparoscopic techniques allow the kidney to be removed using three 1cm “keyhole” incisions in the abdomen. A laparascope (small telescope/camera) is inserted into one of the incisions and takes pictures. Surgical tools operated by the surgeon are inserted into the other incisions to perform the operation.
Laparascopic surgery may be advantageous as it can result in faster recovery time and less pain.
Most patients with renal tumours are suitable for the laparoscopic approach. There is usually no limit to the size however the larger the tumour, the higher the risk of converting to open surgery.
Patients with extensive intra-abdominal surgery or where the cancer is more extensive and involves other organs such as a major vein, abdominal wall or lymphnodes may not be suitable for laparoscopy. In all cases you should discuss your options with Prof Patel.
Advantages of Laparoscopic Radical Nephrectomy
The main advantage of laparoscopy is the reduction of pain and post-operative recovery time. Patients usually mobilise within one dayof the operation and often are ready for discharge in 3 days time. Patients receiving the open operation usually take longer to recover.
Most patients after laparoscopic nephrectomy are able to return to normal activities by the end of the second week, while patients after the open operation usually take 4 to 6 weeks.
Recent results from multi-centre trials have shown this operation to be safe in the treatment of localised renal cancer.
Open Radical Nephrectomy
Open radical nephrectomy is a surgical procedure performed to remove the kidney and surrounding fat/lymph nodes for cancer cure. The procedure is performed under general anaesthesia and takes about 2-3 hours. An incision is made just below the rib. The kidney is separated from the surrounding muscles, tissues, fat, and ureter and removed. A catheter may be inserted after the surgery to help you pass urine. Discharge from the hospital is usually about 4 to 7 days after the surgery.
Like other surgical procedures, open simple nephrectomy may be involved with complications such as injury of the surrounding organs and infection of the surgical wound.
There are alternate minimally invasive/laparoscopic nephrectomy procedures that can be availed of, but are restricted to selected cases only. Prof Patel will discuss your options with you based on your particular medical history.