Robotic or Laparoscopic Partial Nephrectomy: Pre- & Post-Op Instructions

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Robotic or Laparoscopic Partial Nephrectomy: Pre- & Post-Op Instructions

laparoscopy

Even though robotic or laparoscopic partial nephrectomy is keyhole surgery (which means that the recovery is quicker compared to open surgery) it is still a challenge for your body. Going through any operation is going to put stress on your body, and keeping healthy and fit will be important to your recovery.

 Pre-Op Instructions 

In the days to weeks before your operation try and keep as fit and healthy as you can. A robotic or laparoscopic partial nephrectomy (or complete nephrectomy) lasts about 2-4 hours depending on the level of complexity.  A diet that is healthy and balanced is key and will help you recover quicker by enabling your bowels which can often get constipated postoperatively. Any exercise, from brisk walking to anything more aerobic will be very helpful. Often an operation that lasts a few hours would be similar to an exercise of the same length of time, therefore, fitness helps.

The day before your operation eat a simple balanced diet, with small meal portions. You don’t want to eat any huge portions of food, or foods that are hard to digest. Drink plenty of fluids to keep yourself well hydrated and this will help your kidneys. Try to limit coffee/teas which can dehydrate, and avoid all alcohol. Do not take any anti-inflammatories (ibuprofen, difene or diclofenac sodium).

You will be instructed on when to start your fast, and this needs to be strictly adhered to.  This includes chewing gum, sips of water.

Post-op Instructions 

Post-operatively everything will be looked after by your team of doctors and nurses. Most of you care is based on proven protocols for pain relief, mobilisation which works to improve your outcomes. If you already take regular medications these will be administered by the nurse when the doctor has prescribed them – do not take any of your own medications without asking as this can have serious consequences sometimes. Most of this has already been covered in the blog “What to expect during your admission for  admission for laparoscopic or partial nephrectomy” but I will include it below:

After Surgery 

You will then awaken 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). When you have fully recovered from your anaesthetic, you will then be brought back to the ward. You will usually be allowed to 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 your 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.

Day 1 

RecoveryRoom2Today 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).

Day 2 

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 (fewer risk 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 (a hernia is a weakness in the abdominal wall and bowel can stick through this). Also, you cannot drive for 3-4 weeks after this surgery.

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