Which is a better or safer open or Lap ... Here IS THE UPDATE AFTERMATH!!!!!!!!!!!! HELP SOMEONE P

jason.2835 said:

Surgeon is everything

From what I've read, it all depends on the surgeon. Lap seems to be the far better choice in terms of pain and recovery time, however not all surgeons are proficient in it. Older surgeons are set in their ways. It really depends on who you see. Personally, I'd find a way to talk to a surgeon who can do laparoscopic surgery; they may be younger, but your recovery time will be so much less. My surgeon was not only proficient in lap but also the robotic version, which is even less invasive and more precise. If your only choice was an older surgeon who preferred open, it's not that it's not safe. It's just a better way has been invented. 

Whether its open or lap depends on the surgeon, the size of your tumor, its location and your medical history.

Sometimes it starts as a lap and in the middle of the inning they make a game time decision to go open. There are top notch surgeons who only do open.

Good luck either way and may it be an uneventful surgery.

Icemantoo

nsb748 said:

Per my surgeon, there are

Per my surgeon, there are unique risks to each.

For example, a lap generally goes in through the front.  This means that they are in close proximity to other organs, which can cause issues like perforations.  (but very slim chance, and as long as they know about them, not a huge deal.)

An open surgery obviously is a much bigger wound, but it is basically an express route to the kidney.  (unless they have to remove a rib like they did for me)

 

Lap is quicker healing, and supposedly less painful.  I have only had the open surgery, but my doctor said that from feedback he has received...

On a scale of 1-10, if an open surgery is a 7,  a lap surgery is like a 5. 

 

Open is easier access and more maneuverability. 

Lap is the future though.  My surgeon who did my open surgery said that if he was a little younger, he would definitely learn to use the davinci and do lap surgeries.  He also said that if he had to choose, he would have a lap surgery himself. 

There are a couple of misconceptions. One is that those who don’t do it are not skilled, and second, that your wound is significantly larger. Neither is really true. My surgeon at Sloan Kettering convinced me that the open is a better procedure because he can see and feel the kidney, as well as control any bleeding etc. should it occur. He’s a widely published and cited expert on kidney cancer and surgery and obviously has the skill to do one should he wish to do so. He chooses not to for his own professional reasons. As for incision, my partial nephrectomy was open and my incision is barely over four inches, so it’s not necessarily true that the incision will be larger. I recovered quickly and was out of the hospital in two days.

I think it's all perspective and surgeon comfort level.  My surgeon told me that technique would not matter regardless.  

nsb748 said:

My surgeon told me that

My surgeon told me that success rates are virtually identical, as are the risk of complications. 

 

His practice has guys who do both types, and I was given an option.  I chose open because I prefer my mechanic to go in through the hood rather than the dashboard. 

It really doesn't matter, I just felt better about it knowing that he was in there looking around a little bit.  

 

My incision is 6-7 inches, and because of where my kidney resides (higher than expected?) I had to get my second to last rib removed. 

"I chose open because I prefer my mechanic to go in through the hood rather than the dashboard. "

I love that! I prefer that myself

a_oaklee said:

Thoughts

Re the drainage you are experiencing:  Are any medical professionals concerned?  Is that the reason that you are still hospitalized?  When my husband had his complete nephrectomy he had a drainage tube in place.  at the end of the tubing was an egg shaped bulb that collected the fluid.  There was a valve on it to empty as it filled.  Some patients have gone home with them and have them removed later.  My husbands was removed before he went home.   It makes me think that fluid accumulation must be normal.  I am not an expert.   I do hope you get some answers and that you will be home soon.

I had a drainage tube when I left the hospital like the one you describe. 

I had to go in to my surgeon's office and get it removed in 2 or 3 days.  According to a few people including my surgeon, they like to avoid having a patient leave with a drain in place if at all possible. 

Apparently the drain is a site that can get infected easily.  On a side note...  When they take that thing out, it is a very strange feeling.  It is in there a lot further than you would think. 

Jroberts1157 said:

Hello,
I have had bilateral

Hello,

I have had bilateral kidney cancer since 2007.  I have had both lathroscopic and open partial nephrectomy.  Based on my experience and according to what I trust is the best doctor ( Cleveland clinic).  Urinary leakage is a bit normal in most cases.  I had a leak after my second surgery and had to have a port put in and I had that port to drain the urine.  I had it for  a month.  But after that I was much better!  I am 37 years old.

I came home with a drain, which I had to empty and measure every day. It was in for a week. I was meticulous about it because of risk of infection. And yes, removing it felt very weird. Is your leakage urine, blood, a mix of both? Or is it an infection draining? I'm so sorry you're going through this but it will stop and you'll be home soon. Sending you good thoughts and prayers.

acole1 said:

Thanks Everyone

I have what they call a wound bagging with a drain plug to  cover the incision  in which it is leaking urine only from. I do not have a drain tube inbedded intome. should I be asking about this?I am also stuck with a catheir.. What should I do.

Yes, I would ask about the catheter and how long it needs to remain in there. Also I'd ask about the urine leakage and how that could be corrected. Have you spoken with your surgeon? Hang in there; it WILL get better.

acole1 said:

Good Morning All,, New Updates!!!!

I spoke to my surgeon he informed me that it was a 4ccm tumor  it was (Cancer) staging was pt1 and that it was removed with 0 margin and there are no signs of it anywhere else in the body. As for as the leakage it is part of the process for some patients and that it will still in a few days of so.. that tissue has to seal it self becase of the position of the tumor.. Also the Catheter will be there until the leakage subside.. GOOD NEWS is that fact the I'm alive and have another chance at life.

This sounds very similar to my situation. I had an open partial performed almost 3 weeks ago, and the tumor was almost 5 cm.  Like yours, my surgeon removed it with clear margins and saw no evidence of it having spread.  He said it appears to be a stage 1 tumor, but pathology hasn't come back yet.  I will have the chance to review pathology with him on January 8, and at that point will learn the true stage and grade of the tumor.  Also like you I had a catheter (drain tube) in my side following surgery.  This is a normal part of the procedure, as your body will most likely produce more fluid than it can absorb after surgery.  The tube helps to rid your body of this excess drainage until it subsides...in my case, I had surgery on Monday and the tube was removed Thursday morning.  I will tell you that having the tube removed is...um....interesting.  It is the strangest feeling, or at least it was for me, and somewhat uncomfortable.  It is, however, a small price to pay for the second chance at life as you stated.  Congrats on your successful surgery, and my best to you for a speedy and complete recovery.

Andy