Robotic Assisted Laparoscopic Nephrectomy

A nephrectomy is the surgical removal of the whole or part of a kidney, performed for cancer or serious kidney diseases. Kidney function is critical to life, being responsible for filtering waste and fluid from the bloodstream, however, one kidney can maintain body activity.

Nephrectomy may be;
Radical – involves total removal of the kidney, adrenal gland, a section of the ureter, lymph nodes and some surrounding tissue.

Partial – removal of a portion of the kidney.

A robotic assisted laparoscopic nephrectomy is an operation that uses the latest da Vinci XI Robot to assist the surgeon with either a partial or complete surgical removal of the kidney.

A high definition 3D view results in enhanced vision for the surgeon and allows all members of the surgical team to view the procedure. The robotic system uses wristed instruments that bend and rotate far greater than the human hand, ensuring greater precision and control.

It is less invasive for the patient, and enables quicker recovery post-op and shorter hospital stays.

Websites for learning more about robotic surgery are listed below.

Intuitive Surgical:
www.intuitivesurgical.com

Da Vinci Surgery:
www.davincisurgery.com

Prior to the operation you would have discussed important aspects of the surgery. The way your surgery is approached depends upon the extent of the disease. Six small ‘band-aid’ type incisions are made across the lower abdomen.

If the kidney needs to be removed, a 5cm incision will be made in the lower left or right side of the abdomen.

We will provide you with instruction regarding all aspects of preparing for your operation;

• Pre-operative blood and urine tests
• Details of admission to hospital
• Information regarding fasting and medications

In recovery, staff will make sure you are comfortable and pain relief will be given as required. Fluid and diet is given as tolerated and early ambulation is encouraged. Deep breathing exercises may be uncomfortable but should be performed to prevent pneumonia. Compression stockings are worn for prevention of deep vein clots, as is the use of the medication Clexane, which stops unwanted blood clots from forming.

A urinary catheter may be in place but is usually removed within 48 hrs post operatively. The hospital stay depends on the type of surgery but in most cases is usually 2 nights.

The most common complications related to nephrectomy are leaking of urine, infections and bleeding. These will be discussed prior to your procedure with your Urologist.

You will be discharged home with antibiotics, analgesics and Clexane. Ensure your compression stockings are worn until the Clexane has finished. Keep the wounds clean and dry and notify your Urologist if there is redness, swelling or pain. The time taken to return to normal activities is usually around 4 weeks but avoid strenuous activity for at least 6 weeks. Avoid constipation with a high fibre diet and the use of aperients if necessary. It is important to maintain healthy functioning of the remaining kidney and this will be discussed with your Urologist.

You should not drive for at least 4 weeks after the operation (or as instructed by your Urologist).

Patients who are travelling outside the metropolitan area are required to check when they are able to travel, and will be required to stay in the metropolitan area for 24 hours (or as instructed by your Urologist).

In the event of an emergency, call our office within business hours and speak to our Practice Nurse. If out of hours, please call our office to contact our On-Call Urologist, or present to your nearest Emergency Department.

Ashford Hospital
55 Anzac Highway, Ashford SA 5035
8375 5205
Until 10:00 PM

Flinders Medical Centre (access to Flinders Private Hospital)
Flinders Drive, Bedford Park SA 5042
8204 5511
24 Hours

Calvary Adelaide Hospital
120 Angus Street, Adelaide SA 5000
8227 7027
24 Hours Royal

Royal Darwin Hospital
Rocklands Drive, Tiwi NT 0810
8922 8888
24 Hours

**For patients outside the Metropolitan area, please present to your nearest hospital emergency department.

A follow up appointment will be planned for about 6 weeks post-operatively. If you have any concerns after your procedure, then please contact us at Urological Solutions.

The content provided within this document is intended as a guide only and does not apply to all patients. Additional information, including patient specific potential risks, must be obtained during consultation with your Urologist.