Nephro-ureterectomy

To remove the kidney laparoscopically , we make very small incisions in the abdomen. Theses incisions vary between 5 mm up to 12 mm. We go through these incisions with long instruments and we start our surgery.
The surgery has several steps:

1- We start by dissecting the ureter from the bladder wall via trans urethral approach. 

2- We start by moving the colon that is usually sitting on top of the kidney.  We then dissect the kidney and the ureter. 

3- We identify the blood vessels to the kidney (usually one artery and one vein). There are variations in 40% of the patients.

4- We clamp the artery and the vein and we then cut them

5- We then dissect the adrenal gland off the kidney ( unless we have to take it out as well)6- We put the kidney in a bag and we then extend one of the incisions to remove the bag.

What are the possible complications:

1- Infection

2- Bleeding

3- Bowel injury

4- Vessel injury

5- Conversion to open

6- Anesthesia risks

7- Ileus (lazy bowels)

8- Diaphragmatic injury

9- Urine leak

What to expect in the hospital on day of surgery:

1- You will meet the nursing, anesthesia, and surgical team

2- The different teams will go through the process with you multiple times

3- You will be taken to the operating room and you will hear the teams confirming the surgery and the side multiple times

4- The anesthesiologist will put you sleep

5- You will wake up from anesthesia feeling drowsy and sometimes with a sore throat

6- You might have some pain from the small incisions which we can control with pain medications

7- You will be drinking and eating from the first night

8- You will have a foley catheter in your bladder.

9- You will be expected to sit on the edge of the bed the first night in your room

What to expect on the day after surgery:

1- You will be eating full diet.

2- You will start walking as much as you can. 

3- You  lay in bed only to sleep, otherwise, you should sit on the bed or in your chair and keep moving

4- Blood samples will be taken from you in the morning

5- Dr. Shahrour would see you in the afternoon

6- You will be discharged home in the evening with the Foley catheter

7- If you are from out of town, you should stay in a hotel till next day. 

8- You will have follow up with Dr. Shahrour in 4 weeks

9- You will have blood work to be done 2 weeks after surgery and the catheter will be removed in two weeks.

10- Nurses will help you at home with dressing changes and staple removal ( at 2 weeks mark)