What is laparoscopic nephrectomy?

A nephrectomy is surgery to take out part or all of the kidney. One or both kidneys may be taken out. Sometimes other tissue near the kidney is taken out at the same time.

The doctor will put special tools and a thin, lighted tube called a laparoscope through several small cuts in your belly. These cuts are called incisions. Then the doctor will remove your kidney through one of the incisions. The incisions will leave scars that will fade with time.

Your body can work fine with one healthy kidney. But if both kidneys are removed, or if the kidney you have left is not healthy, you will need other treatment after surgery. Your doctor will talk to you about this.

You will probably spend 3 or 4 days in the hospital. You will need to take it easy for 4 to 6 weeks at home.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• Avoid exercises that use your belly muscles and strenuous activities such as bicycle riding, jogging, weight lifting, or aerobic exercise until your doctor says it is okay.
• For at least 4 weeks, avoid lifting anything that would make you strain. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.
• Hold a pillow over the cuts the doctor made (incisions) when you cough or take deep breaths. This will support your belly and decrease your pain.
• Do breathing exercises at home as instructed by your doctor. This will help prevent pneumonia.
• Ask your doctor when you can drive again.
• You will probably need to take 4 to 6 weeks off from work. It depends on the type of work you do and how you feel.
• You may be able to take showers (unless you have a drainage tube near your incisions). If you have a drainage tube, follow your doctor's instructions to empty and care for it. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.
• Ask your doctor when it is okay for you to have sex.

Diet

• You can eat your normal diet. If you were on a special diet for your kidneys before surgery, follow that diet until your doctor tells you to stop.
• If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Drink plenty of fluids (unless your doctor tells you not to).
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, take an over-the-counter medicine that your doctor recommends. Read and follow all instructions on the label.
  • Do not take aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve), or other nonsteroidal anti-inflammatory drugs (NSAIDs) unless your doctor says it is okay.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

• If you have strips of tape on the incisions, leave the tape on for a week or until it falls off.
• Wash the area around the incisions daily with warm, soapy water and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the incisions with gauze bandages if they weep or rub against clothing. Change the bandages every day.
• Keep the area around the incisions clean and dry.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• You may need to empty your bowels with a laxative or an enema. Your doctor will tell you if you need to do this.
• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

A nephrectomy is surgery to take out part or all of the kidney. One or both kidneys may be taken out. Sometimes other tissue near the kidney is taken out at the same time.

Your belly will feel sore after the surgery. This usually lasts about 1 to 2 weeks. Your doctor will give you pain medicine for this. You may also have other symptoms such as nausea, diarrhea, constipation, gas, or a headache.

At first, you may have low energy and get tired quickly. It may take 3 to 6 months for your energy to fully return.

Your body can work fine with one healthy kidney. If both kidneys are removed or your remaining kidney is not healthy, your doctor will talk to you about the kind of treatment you will need after surgery.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors.
• You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
• You may get an epidural catheter. This is a small tube that puts pain medicine into the area in your back around your spinal cord. It helps prevent pain after surgery.
• The surgery will take about 2 to 4 hours.
• You will have a tube that drains urine from your bladder. This is called a urinary catheter.
• You may have a small tube coming out of your belly. This tube will drain fluids.
• You may have a thin plastic tube in your nose that goes down the back of your throat into your stomach. It will drain stomach juices. It is usually removed in the days after surgery.