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Surgery date and question for those who have had open nephrectomy

BellaBinksMom's picture
Posts: 78
Joined: Sep 2014

I will be having my laporoscopic full nephrectomy on Monday, December 8th.  Due to previous abdominal surgeries, they have prepared me for the possibility that if the internal adhesions are too severe, they may have to switch to an open.

For anyone who has had an open, did they have to break your rib?  While my surgeon said this is not always necessary, it does happen.  He said they will cut it rather than break it, however, I didn't understand if they remove it entirely?  And is the incision a V shaped flap or a straight line from abdomen to back?

Thank you for your answers. 

Phredswife's picture
Posts: 162
Joined: Apr 2014

Hi BellaBinksMom. My husband had an open full nephrectomy and adrenalectomy in late February 2014. He never had to have a rib broken. His scar looks more like an L. He had a 13cm tumour removed. Hopefully they won't need to break your rib  either.

Thinking of you, Melissa

foxhd's picture
Posts: 3183
Joined: Oct 2011

I don't recall anyone in the last 3 years having a rib broken to get to the kidney. I would look for a doctor with sharper tools.

BellaBinksMom's picture
Posts: 78
Joined: Sep 2014

You made me laugh, thank you.  I have read where sometimes the bottom rib will crack, however, I was surprised when he said they sometimes cut through it since breaking it is more painful for the patient.  Perhaps this happens on people with much smaller frames/anatomies.  I doubt that is going to be an issue for me.

BellaBinksMom's picture
Posts: 78
Joined: Sep 2014

Thank you for your reply, Melissa.  I think the surgeon was just presenting me with all the worst case scenarios so I don't come out of anesthesia with any unexpected surprises.  How is your husband doing now?  


Posts: 16
Joined: Jul 2013

Hi Debbie. I had an open full 2 years ago. My bottom rib was removed....the surgeon said that he used an instrument similar to a small hedge clipper. It mentioned the removed rib in the pathology report as "left 12th rib. Tan, brown, soft." It measured 4.1 x 1.4 x .3 cm.   The specimen was biopsied along with the masses in the kidney and the perirenal fat.  The surgeon said it was necessary to have better access to the kidney itself.    Best wishes for a full recovery!   L~

Positive_Mental_Attitude's picture
Posts: 454
Joined: Jul 2014

I had what my doctors called "a hostile abdomen".  Two major surgeries as an infant ruled out the possibility of a laparoscopic surgery. I opted for open from the beginning.  Last time I checked, all of my ribs were in tact, and I did not hav a cast on my ribs after my surgery in July, so I don't think the doc broke any. Wink

Phredswife's picture
Posts: 162
Joined: Apr 2014

Hi Debbie. I think the docs like to give you a worst case scenario. Originally we were told Phred might need a v shaped scar and his ribs might need to be cut. I think that was only if they had to remove his spleen and pancreas too which is what they originally thought. He has taken quite a while to recover. He is back at fulltime work now and we have been told he is NED. We are very good at worrying  sadly as he doesn't feel that well. He is having a cardiac review with a whole heap of weird liver blood tests I have never seen on it before. Hopefully they are still trying to figure out why he feels unwell. He has gained quite a bit of weight back since the operation so maybe that may be making him feel sick. Take care Melissa

thaxter's picture
Posts: 124
Joined: Jan 2014

I think my urologist only told me about removing my smallest rib after the open radical nephrectomy.  I really can't tell it's gone.  Right side doesn't feel any different than the left side.  My incision is straight and about 9 inches long.

APny's picture
Posts: 1972
Joined: Mar 2014

Maybe it's different with a full nephrectomy. My open partial one did not involve any of my ribs and my scar is a straight across one, about 4 - 5 inches.

Posts: 50
Joined: Sep 2014

I had an open nephrectomy on my left side in August.  They did not have to break or remove my rib.  My incision is about 13 inches long and I had 27 staples.  They removed my left kidney along with an 11 cm mass.   I specifically asked my Dr. if they were going to have to remove my rib and he said no.  He said that generally rib removal is if they go in more towards the back while he goes in through the front.  My incision was from just to the right of my sterum and slanted down towards the bottom of the left side of my rib cage.  

Everything seems to have heald up great although I will say that my sterum was sore for a very long time.

rainsandpours's picture
Posts: 136
Joined: Apr 2013

I had an open partial last Oct.  In the surgical report, it stated they went in between the 11th and 12th ribs, but nothing was broken or sawed off. :p

I have a 10 inch scar starting just to the rear of my side, extending down across my abdomen.  It's long and ugly, but it's fading and I forget about it most of the time.  I like to shock my new doctors by showing it to them.  Most modern docs have never seen one.  They do Lap surgeries a lot more.  Unfortunately, I was not a candidate for it due to tumor location and having freak renal arteries.



nsb748's picture
Posts: 90
Joined: Feb 2014

my scar is only about 7 inches, but they took my 11th rib.  I was actually given the option of a laproscopic, but I chose the open since the doctor who does the open surgeries was more experienced.

I know that success rates are the same, but I felt better about my mechanic popping the hood and taking a look around rather than trying to go in the through the dashboard. 

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