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Lap Radical Nephrectomy - What should I expect post-op?

Posts: 2
Joined: Mar 2010

I am 39 years old and I was recently diagnosed with a T1 Renal Tumor. I am scheduled for a laparoscopic radical nephrectomy the end of April. I have found multiple blogs about open nephrectomies but not many from people who have undergone a lap procedure. Can anyone give me some information about what to expect post-operative? Also, my urologist said I did not require any additional testing for mets because the rest of my abdominal CT was clean and I am not completely comfortable with that. This tumor was missed on a CT I had 2.5 years ago and I don't want them to miss anything else.

Any feedback would be greatly appreciated.

Posts: 2
Joined: Mar 2010

I'm 74 years old and I had my Radical Lap Nephrectomy on Mar 16, 2010. I've had this tumor for 5 - 6 years but it grew slowly and remained small. It actually seemed to have disappeared on an ultrasound last summer but a CT scan in Feb showed it was back at 3.4 cm which was a fairly significant increase since a previous CT scan. The tumor was not in a good location for a partial removal or for cryo surgery. Besides the kidney had quite a few stones and while not a problem recently led the surgical team to recommend the radical approach.

The surgery was started around noon and I was in my room by around 4:30. I don't remember much about the first day because I was so groggy from the anesthesia (propofol commomly called milk of amnesia but also the Michael Jackson drug) and pain medication (Hydocodone). I didn't have any nausea from the anesthesia. The surgeons made 4 small holes for their instruments and enlarged one of the small incisions to 6 - 8 inches to remove the kidney, part of the adrenal gland and other surrounding tissue. There are no external stitches. The 3 remaining keyho;es were closed with butterfly bandages and the larhe incision was closed with some kind of bonding agent (all I call think of is crazy glue).

They got me up in a chair in the evening but I couldn't stay awake. They had me up walking the next day but I used a walker because my wife was afraid I'd fall. I didn't need much pain medication - I think only twice. The worst part was the sore throat from the ventilation tube and they bloatting sensation and shoulder pain from the air they inflate your abdomen with to work their magic. It was difficult to swallow and my lips were very dry. I was on a liquid diet for the first day post op. They also removed the sleeves they put on your legs for clotting.

Second day post op they put me on a solid food diet but I didn't eat much solid food because my throat was still sore. I got up several times and walked without a walker (my wife wasn't present). I was still on oxygen the second day post-op because of low oxygen level likely from a partially collasped lung - again from the injected gas - but not much pain. The doctor sent me home in late afternoon with a slightly low oxygen level.

I took paim pills at night the first couple of nights but only Aleve during the day mostly because I felt shitty not for pain. I walked outdoors the day after I came home gradually working up to going around the block. On Mar 23 we picked our dog up from the kennel and we started doing our usually walking. 2 or 3 times a day for about a 15 - 20 minutes. We're up to 4 times a day, 1 - 2 miles each time. She's a 58 lb pitbull mix fron the shelter.

I have my post surgery visit with the surgeon on Thursday, April 1. I'll find out the complete pathology findings then abd what to expect down the road. I think the surgeon told me on the phone that the tumor was confined to the kidney.

Posts: 49
Joined: Dec 2009

You mention the cryo surgery was not a good choice for you due to the location. Just where was the growth located? The reason I ask is because I just have one kidney (lost Right in 2006 due to cancer) now have spot located in middle back of Left side. I'm scheduled for laproscopic cryoablation next week. Thanks for your help.

Posts: 2
Joined: Mar 2010

Mine was located on the inside, close to all the plunbing.

Posts: 2
Joined: Mar 2010

Mine is also in the middle part of the kidney and is moving toward the major arteries. There is about a 20% change they could do a partial nephrectomy would that would require an open incision vs a lap.

icemantoo's picture
Posts: 3336
Joined: Jan 2010

I had my left nephrectomy 7 & 1/2 years ago and I am still going strong. I will be 67 in a couple of months.It was done laproscopically. Assuming the Cancer has not spread you can expect a C_T scan annually although this year the Surgeon has ordered an ultrasound. I keep getng told that I will die of something else although statistically I have a higher chance than the general public in having kidney cancer diagnosed in the other kidney. I do not believee the Kidney Cancer in the past limits anything that i do although I do not feel as young as when I was 59. The surgery was not fun and it was a little more stressful than some of the other posts make it out to be. Get the surgery over and get on with the rest of your life with few if any limitations other than a little scaring and swelling at first.

Posts: 2
Joined: May 2010

I had laproscopic left radical nephrectomy Thursday morning June 24, 2010, I was sent home Friday afternoon, I think the insurance companies have something to do with the short hospital stay. The Dr. didn't know if my growth was cancerous or not...just said it was strange...actually two Drs. had said it was unusual, they kept an eye on it for about five years and it had remained the same size, and then all of the sudden it started to grow. They tried to remove just the part of the kidney that had the mass but it was laying on top of a major artery to the kidney, so they took it all. I go into see him on friday to get the staples out and to find out the results of the biopsy. I just wanted to let you know that I liked what you wrote about getting the surgery over with and on with your life. I found it to be incouraging. Thanks, Take care!

KCFighter's picture
Posts: 50
Joined: Jan 2006

I was 35 when I had my right kidney removed. I had the laproscopic nephrectomy and am glad I did. They told me I'd need 4 weeks off work, I could've used 6 weeks easily. I could walk but the swelling & soreness made work days very long. They had to cut along the "C-section" line on my abdomen to remove the kidney & all the poking around they must do to get the kidney out makes you extremely sore. But, the recovery is still MUCH better than open surgery from everything I've read.

Most of my distress came with a surgeon who didn't think I was a person, just lap nephrectomy #456. He did not visit me in the pre-op, nor did I see him after my surgery other than one 5 minute visit after my husband demanded he come see me 2 days after my surgery. My recommendation would be to ask a lot of questions about your care and how that will go both in pre-op (imporant that the doc sees you before he does surgery to answer any last minute questions & provide some reassurance.)

Posts: 3
Joined: Mar 2010

I had a 10.5cm cancerous left kidney removed on March 31st. Because of the size I wasn't sure if they would have to do open or not, but fortunately I was able to have it done laproscopically. The surgery took about 4.5 hours and I wasn't back in my room until late afternoon. Since I was pretty doped up I slept most of the time and didn't realize too much pain. The next day when they got me up I learned very quickly which way NOT to move because it would send a sharp burning pain thru my abdomin. I had surgery on a Wednesday and was sent home by noon on Saturday. By then I was able to control the pain with hydrocodone and in a few days after going home I was off the pain killers altogether. I'm feeling fine 3 weeks after surgery, but I still have discomfort in my lower back and abdominal area if I over do it. I get tired pretty easily, but as far as any pain, there isn't any. Having had major surgery before, this is pretty comparable to other surgeries I've had. I was able to get into my regular clothes within 2 weeks, minimal swelling.

Posts: 12
Joined: Apr 2010

Christine, I know your surgery went well. Mine was, surprisingly, a piece of cake and I hope yours was/is too. I was numb for weeks and by the time the numbness was over, whatever pain there would have been was gone. Honestly, I could've went back to work in a week, but I'm glad I had the six weeks. I was 39 (last year) when I had my left radical nephrectomy, too. The hardest part isn't the surgery, it's the mind after the surgery. Found a book that really helped me with that, if you're interested--it's called Anticancer-A New Way of Life.

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