Day of surgery
You will first arrive at the admissions department or be directed to the ward for the admission. The nurse will speak with you, and take medical details and check things like blood pressure, heart rate, and temperature. The nurse will answer any questions you might have at this stage about the Kidney Cancer treatment. You may be asked to supply a urine sample for analysis, and you may have to have blood, a heart tracer (called an “ECG”) and/or an X-ray of your chest. Sometimes these are all completed days or weeks before the operation in the pre-operative assessment clinic.
I (or a member of the team) will go through the details of the operation one last time with you, and when all questions are answered and you are happy, then the consent form will be signed. Lastly, your skin will be marked on the side of the operation. You will be asked to get into your hospital gown to get ready for the operating theatre.
You will then be brought up to the operating theatre reception and checked in. Here the anesthetic nurse and the anesthetist will meet with you and ask you some questions about your medical history and review your medications. When all safety checks are complete, you will be brought into the operating theatre and a final check will be made. You will be connected to an oxygen mask and will have a drip inserted into your arm. At this stage, you will go asleep and your operation will be carried out. Before we start any operation, we perform a ‘Time-Out’ where everybody in the room (surgeon, anesthetist, and nurses) goes through a final safety checklist.
You will wake up in the recovery room. This is an area with lots of machines, other patients and lots of nurse and doctors going to and fro. One nurse will be dedicated to caring for you, and you will be observed closely. You will have a urinary catheter (a tube which drains your urine) and possibly a plastic tube coming out for your abdomen (called a drain). A drain is there to collect fluid in the abdomen (this can look bloody but don’t worry that is normal). After recovering from your anesthetic, you will be taken back to the ward. You will usually be allowed eat and drink on the night of your surgery, but you won’t feel like much, to be honest! A lot of patients worry about how much pain they will experience, but you shouldn’t’ be in too much pain, as it is well controlled nowadays. You will have observations such as blood pressure and the temperature is taken overnight by the nurse caring for you, and any questions will be answered. I or a member of my team will review you at the end of the day and assess you to make sure everything is well.
Today is all about getting the tubes and drips removed, and getting you up and walking!
At 6 am your drip and a urinary catheter will be removed usually, and blood is taken. You will be a little sore and achy, and this is normal. You will be asked to get up out of bed and walk around the ward 4-6 times that day. Although you may not feel like it, this is extremely important and helps you recover more quickly, allows the bowels to return to normal function and reduces your risks of getting a clot in the legs which can be very serious. If you have a drain coming out of your abdomen, it is usually removed mid-morning but sometimes can be left in for a day or two extra.
You will receive your first injection into your tummy mid-morning. This is a medicine that helps prevent clots in the legs (called a DVT). This can be serious as it can travel to your lung (called a pulmonary embolus).
Today is about assessing whether you can go home!
You will be reviewed again by the medical team, and things that are reviewed include your progress, pain score, observations, examination, and blood test results. If all are in order – and most of the time they are – you will be discharged to home. It’s normal to go home a little sore, but you do so much better in your home environment (less risk of infections and complications). You will get a prescription for painkillers on discharge. You will be encouraged to take things very easy, and allowing your body to get over the recent surgery. You are not allowed lift anything heavier than a shopping bag for a month, as you could develop a hernia. Also, you cannot drive for 3-4 weeks after this surgery.
When do I get my results?
Results generally take about 1-2 weeks to be processed. You will be asked prior to departure if you mind receiving results over the phone, and most people do not. This allows you get your results as soon as they are available. If you do not wish this, you will be seen in the clinic about 3 weeks after surgery to discuss these. At this time you will be informed whether the lesion was cancer or not, and if it was cancer what stage and grade it is, and what the follow-up plan is.
Learn more about Robotic Partial Nephrectomy.
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