Hand-Assisted Laparoscopic Total Nephrectomy

Overview

At Baxter Health, we use a minimally invasive technique to remove only the diseased or infected portion of the kidney. When a solid tumor is found using imaging, surgical excision is the standard treatment for removal. Smaller tumors can usually be treated, without removal of the entire kidney, by excising only the tumor and a small portion of the kidney. Many studies have proven that this technique has success rates similar to removal of the whole kidney, while retaining a majority of renal function. Use of the da Vinci robot has drastically reduced bleeding, while speeding up recovery time and maximizing renal function post surgery.

The procedure

Post anesthesia, the surgeon may place a ureteral stent into the kidney prior to removal of the tumor. Stent placement takes approximately 20 minutes. Flushing the stent will allow the surgeon to make sure there is no leakage after removal of the tumor. The procedure is performed with the patient on his/her side and 4-5 small incisions are made. Instruments are then inserted into the incisions where the kidney and tumor are exposed and the artery and vein that provide blood to the kidney are clamped to prevent bleeding. The tumor is then excised from the kidney with a small portion of normal tissue removed to ensure the entire tumor is removed. Blue dye is then flushed through the stent so that the surgeon can locate and repair possible leakage. The excised area is then sutured and the artery clamp is released. Once all bleeding is controlled the surgeon will discard the tumor and leave a renal drain for 24-48 hours.

After the procedure

Limited pain is expected but will be minimal due to the smaller incisions used with this procedure. The patients are given a regular diet and are walking around by the first day after surgery. Your hospital stay will last 2 days following surgery, and the patients may return to normal activities by 4 weeks after surgery.