Laparoscopic Nephrectomy – Discharge Advice

  • Reference Number: HEY-653/2018
  • Departments: Urology

Introduction

Please read the information leaflet.  Share the information it contains with your partner and family (if you wish) so that they can be of help and support.  There may be information they need to know, especially if they are taking care of you following this examination. This leaflet has been produced to give you general information about your procedure and recovery at home.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion.   If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team who has been caring for you.

What is a laparoscopic nephrectomy?

A laparoscopic nephrectomy is the technical term used for someone who has had their kidney removed by keyhole surgery.

What to expect after the operation

Scar

You can expect between 3 and 5 small scars at different points on your abdomen. One of these will be longer than the others as it is through this wound that the kidney is removed. Most stitches will not require any removal as they will slowly dissolve over time. However if you do have stitches that need to be removed your doctor or nurse will advise you when they should be removed.

Dressings

You do not need to keep the scars covered though some people find it more comfortable to do so. You do not need to worry about getting your scars wet and may bathe or shower as usual.

Discomfort

You will experience some pain and discomfort around the scars, especially in the first week after surgery. You may also experience some pain in your shoulders for a few days after the operation. This is temporary shoulder pain due to leakage of carbon dioxide (a clear gas) which is used during surgery to help the surgeon see the organs within your abdomen. This can cause pain in one or both shoulders but disappears as the gas is reabsorbed by the body.  Simple pain relief such as paracetamol should be able to relieve this effectively for you.

Tiredness and feeling emotional

Your body is using a lot of energy to heal itself, so you will feel more tired than normal. If you feel upset or emotional in the days and weeks after your operation, don’t worry- this is a perfectly normal reaction which many people experience.

Can there be any complications or risks?

Most procedures have possible side-effects. But, although the complications listed below are well-recognised, most patients do not suffer any problems.

Common (greater than 1 in 10)

  • Temporary pain in the tip of your shoulder.
  • Temporary bloating of your tummy.

Occasional (between 1 in 10 and 1 in 50)

  • Bleeding, infection, pain or hernia of the incision needing further treatment.

Rare (less than 1 in 50)

  • The pathology may turn out not to be cancer.
  • Recognised (or unrecognised) injury to organs/blood vessels needing conversion to open surgery (or deferred open surgery).
  • Involvement or injury to nearby local structures (blood vessels, spleen, liver, kidney, lung, pancreas, bowel) needing more extensive surgery.
  • Anaesthetic or cardiovascular problems possibly requiring intensive care admission

Advice that will help you recover more quickly

Eat healthily

Eating a healthy balanced diet will help to ensure that your body has all of the nutrients it needs to heal.

Build up gradually

You will probably still be in hospital for up to 3 days after your operation. When you get home you should gradually build up your activities. A short walk in the morning (no longer than 10 minutes) and again perhaps, in the afternoon is recommended for the first week. Make sure you rest at regular intervals.

It is important to keep active after your operation as this helps to prevent any complications afterwards such as chest infection or blood clots. Activity will also help keep your joints and muscles supple.

After the first week you are encouraged to gradually build up you activities. By 6 weeks after your surgery you should be back to your full range of activities although you may still feel tired and need to rest more than usual.

You are at increased risk of developing blood clots (venous thromboembolism) in the weeks following your hospital admission and will have been given support stockings to wear for six weeks. It will help reduce the risk if you keep active. If your calf becomes swollen, red and painful, or if you should experience chest pains or difficulty in breathing you must seek immediate medical advice either by telephoning the ward on which you were a patient, call the NHS 111 service, or contact your GP. Alternatively you can attend the hospital Emergency Department.
Please make sure that you read the leaflet given to you ‘Venous Thromboembolism (VTE) – Reducing the risk’ carefully in the patient information pack at the side of your hospital bed.

Stop smoking

By not smoking- even if it is just for the time you are recovering, you immediately start to improve your circulation and you breathing. If you would like help stopping smoking please see-

  • Your GP
  • Hull and East Riding Stop Smoking service. Free phone 0800 915 5959
  • North East Lincolnshire and North Lincolnshire NHS Stop smoking services. 0845 6032166 (local rate)
  • Smokefree. 0800 022 4 332, http://smokefree.nhs.uk/

Family and friends

Family and friends can give you practical help with the tasks that you might be temporarily unable to do while you recover such as driving, the weekly shop, or lifting heavier items. They can also keep you company and help keep your spirits up until you feel better.

Having sex

For many people, being able to have sex again is an important milestone in their recovery. There are no set rules about when you can do so – just treat it like any other physical activity and build up gradually.

Any other important points?

Contact your doctor if:

  • You experience flu like symptoms a few days after discharge home
  • Your wound does not appear to be healing, or is painful, leaking or becoming red and swollen.

Driving after surgery

It is your responsibility to ensure that you are fit to drive following your surgery.
However you should refrain from driving for at least six weeks following this surgery. Your doctor will be happy to provide you with advice on request. If you are unsure, please contact the DVLA.

You may wish to ask advice about when it will be safe for you to return to work.

The nurse discharging you from hospital will check that you understand the advice given to you in this leaflet. You will also be given an Immediate Discharge Letter which is a summary of your hospital visit. This will include details about further appointments that have been made following your surgery which will usually be 6 weeks after your operation.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact Ward 15, Department of Urology on telephone number (01482) 623015.