Radical removal of the kidney

What is this?

This involves removal of the kidney, adrenal, surrounding fat and lymph nodes for suspected cancer of the kidney, using an incision either in the abdomen or in the side

What alternatives are there?

Observation alone, embolisation (cutting off the blood supply by coils inserted by the radiologists), immunotherapy, partial nephrectomy and laparoscopic (telescopic or minimally-invasive) approaches to radical or partial nephrectomy

What to expect before procedure

You will usually be admitted the day before your surgery. You will normally receive an appointment for pre-assessment, approximately 14 days before your admission, to assess your general fitness, to screen for the carriage of MRSA and to perform some baseline investigations. After admission, you will be seen by members of the medical team which may include the Consultant, Specialist Registrar, House Officer and your named nurse. You will be asked not to eat or drink for 6 hours before surgery and, immediately before the operation, you may be given a pre-medication by the anaesthetist which will make you dry-mouthed and pleasantly sleepy. You will be given an injection under the skin of a drug (Clexane), that, along with the help of elasticated stockings provided by the ward, will help prevent thrombosis (clots) in the veins.

What happens during the procedure?

Normally, a full general anaesthetic will be used and you will be asleep throughout the procedure. In some patients, the anaesthetist may also use an epidural anaesthetic which improves or minimises pain post-operatively. You will usually be given injectable antibiotics before the procedure, after checking for any allergies. The kidney is usually removed through an incision in your abdomen although, on occasions, the incision is made in the side (loin) or extended into the chest area. A bladder catheter is normally inserted post-operatively, to monitor urine output, and a drainage tube is usually placed through the skin into the bed of the kidney. Occasionally, it may be necessary to insert a stomach tube through your nose, If the operation was particularly difficult, to prevent distension of your stomach and bowel with air.

After the procedure

After the operation, you may remain in the Special Recovery area of the operating theatres before returning to the ward; visiting times in these areas are flexible and will depend on when you return from the operating theatre. You will normally have a drip in your arm and, occasionally, a further drip into a larger vein in your neck. You will be able to drink clear fluids immediately after your operation and start a light diet within 3-4 days. We will encourage you to mobilise as early as possible and to take fluids or food as soon as you are able. The average hospital stay is 7-9 days.

Potential side effects