Renal Masses Kidney Cancer & Kidney Surgery
Every year, 28,000 Americans learn they have kidney cancer. A mass on the kidney may be detected with an ultrasound or CT scan. Additional testing, including Magnetic Resonance Imaging, can help determine if the mass is cancerous. Even with proper imaging, approximately 20% of solid renal masses will ultimately prove to be benign. Some people with kidney cancer may notice the presence of blood in their urine, back pain or an abdominal mass or hard lump or there may be no outward symptoms at all.
Kidney cancer is most common in men over age 40. Unfortunately, the disease often goes undiagnosed until it has spread. Surgical removal of the entire kidney may be required. Now there is a technique for removing the diseased kidney that is less invasive than traditional surgery.
The procedure is called a laparoscopic nephrectomy.
What is a laparoscopic nephrectomy?A laparoscopic nephrectomy is a procedure for removing diseased kidneys in place of conventional surgery. It is a very delicate and precision-oriented procedure, which should be performed only by highly experienced surgeons. Laparoscopic surgery is sometimes called “keyhole” surgery because it involves relatively small incisions. The surgeon uses an endoscope and small “ports” through which miniature instruments are passed. The scope enables the surgeon to watch what he or she is doing on video monitors.
Postoperative Information
Problems You Should Report To Us:
To Deal With Inoperable Tumors
Most of the times, 12 months or higher indwelling times indicate keeping of the ureters in open condition, which further gets compressed due to tumor present in the nearby region of the ureter or because of the ureteral tumor itself. In most of the cases, these are of inoperable tumors and hence, to come up with an appropriate solution, doctors place stents to make sure easy drainage of the urine from the ureter. Reason for this is very simple, if patients and doctors compromise the drainage for a long time, it may cause damage to the kidney.
Removing Part Of A Kidney
This operation is used for small kidney cancers that have not spread. Wherever possible, its used to treat stage 1 kidney cancer .
The surgeon removes the part of the kidney containing the cancer. Some of the kidney is left behind.
Doctors call this nephron sparing surgery. The nephron is the filtering unit of the kidney so you have some working kidney left after the operation.
Some people may not be able to have this surgery because of the cancers position in the kidney. If you’re worried about this, talk it through with your surgeon.
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Cerebral Stents Are Placed To Treat Aneurysms In Your Brain
How long to leave kidney stent in. An infection can lead to a longer recovery time, as the length of the healing process can be much longer. The amount of stent encrustation is directly related to how long a ureteral stent has remained in place. How is the stent removed?
Reason behind is that if urologists left it for a long time, it may result in the formation of stones directly on it and removal of such stones becomes further difficult. How long should a stent be left in after kidney stone removal? If you see blood in your urine, drink more water than usual until the blood goes away.
Based on the severity of the obstruction these stents are either placed for a few days or weeks or may be required for a longer time period extending to several months. Commonly, a stent is inserted when it appears possible that a patient will pass a kidney stone, with a little help. Until the obstruction is relieved.
Mine has been left in over a month and i continue to bleed. This will depend on the treatment planned by you and your physician and can vary. Might mention this all took place back in feburary.
Most patients stay awake when a stent is removed, but you may have a numbing gel applied to your urethra before the procedure. How long can a stent stay in? Most of the times, stents only remain for a period of 3 months.
A stent is a supportive device inserted into the body. How long will the stent stay in the body? In the majority of patients, the stents are required
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How Long Will I Have A Ureteral Stent
Most ureteral stents are temporary. Your healthcare provider will perform another procedure to remove the stent after the kidney stone passes, infection clears up or other problems resolve. Youll probably have the stent for a few days or weeks.
Some people need stents for months or years. People who have tumors that press on the ureters or narrowed ureters may need ureteral stents for an extended time. Your provider will replace the stent with a new one every three to six months. Replacing the stent reduces the likelihood of complications.
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Removing A Whole Kidney
The surgeon removes the whole kidney and some of the tissues around it. They also remove some lymph nodes in this area.
Above each kidney is an adrenal gland. You might also have an adrenal gland removed if your surgeon thinks it may contain cancer cells. It is quite unusual for cancer to spread to one of the adrenal glands.
If you have an adrenal gland removed you will be perfectly well with only one. The remaining adrenal gland will make all the hormones you need. It’s unusual to have both adrenal glands removed. You would need to take hormone tablets every day if this happens.
A radical nephrectomy is major surgery. But if your cancer hasn’t spread, it’s all the treatment you will need.
What Is The Recovery Time After A Nephrectomy
After you return home, you may be able to return to light activity within a week or two. You will need to avoid heavy lifting or strenuous activity for at least six weeks.
After six weeks, you will need blood tests to monitor the function of your remaining kidney. Your healthcare provider will give you instructions on how often you need these tests.
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Planning For A Donor Nephrectomy
If you’re planning to donate a kidney for a transplant, you’ll have thorough exams to determine if you’re a suitable candidate. Criteria for donating include:
- 18 years of age or older
- Compatible blood type with kidney transplant recipient
- Generally good health
- Two well-functioning kidneys
- No history of high blood pressure, kidney disease, diabetes, certain cancers or major risk factors for heart and blood vessel disease
- Stable mental health
You’ll receive general anesthesia before surgery and be unconscious during the entire procedure. You’ll likely have a urinary catheter, a tube used to drain urine from your bladder.
When To Call Your Healthcare Provider
- Your calves or thighs are swollen or tender.
- One of your legs is more swollen than the other.
- You feel short of breath.
- You cough up blood.
- You have a fever of 101 °F or higher.
- You have blood in your urine.
- You have questions or concerns.
Contact information
Monday through Friday from 9:00 am to 5:00 pm, call your healthcare providers office.
After 5:00 pm, during the weekend, and on holidays, call . Ask to speak to the person on call for your healthcare provider.
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What Is Recovery From Kidney Cancer Surgery Like
If you are getting ready for kidney cancer surgery, you probably have a lot of questions, including what you might feel like afterward. Your recovery will be influenced a number of factors, including the type of surgery you have and the techniques utilized by your surgeon. For information that is specific to your unique situation, you should talk directly with your surgeon.
In general, kidney cancer surgery involves removal of the affected kidney or a partial nephrectomy to remove the tumor only. A partial nephrectomy can be performed using a traditional, open approach or a minimally invasive approach with use of a robotic platform. There are several factors that determine which type of surgery maybe the best option for a patient including the size and location of the tumor along with prior surgical treatments.
Preparing For The Surgery
Expect to receive instructions from staff regarding what to do the day before and the day of your surgery. Bring a list of all your questions, such as:
- When do I need to begin fasting?
- Can I take my prescription medications?
- If so, how soon before the surgery can I take a dose?
- What nonprescription drugs should I avoid?
- When do I need to arrive at the hospital?
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Surgery For Recurrent Renal Cancer
Some patients may have kidney cancer return after an initial surgery. Experts at Johns Hopkins specialize in surgery for recurrent renal cancer, and help patients decide if surgery is the next best approach for the treatment of their cancer. Recurrent renal cancer often involves structures adjacent to the kidney, and often requires a multidisciplinary surgical team including vascular, hepatobiliary , colorectal, and thoracic surgeons to clear a patient of disease.
Surgery For Kidney Cancer
Surgery is the main treatment for most kidney cancers and many times it can cure the cancer by itself.
Depending on the stage and location of the cancer and other factors, surgery might be done to remove the entire kidney including the tumor or the cancer alone along with some of the surrounding kidney tissue . Sometimes, the adrenal gland and fatty tissue around the kidney is removed as well. In certain cases, the nearby lymph nodes might also be removed.
Some people whose cancer has spread to other organs may benefit from surgery that takes out the kidney tumor. Removing the kidney might also lessen symptoms such as pain and bleeding.
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Care Of The Remaining Kidney
Tests will be done on a regular basis to check how well the remaining kidney is working. A urinalysis and blood pressure check should be done every year, and kidney function tests should be checked every few years . Regular urine tests for protein should be performed as well. The presence of protein in the urine may mean that the kidney has some damage.
People with one kidney should avoid sports that involve higher risks of heavy contact or collision. This includes, but is not limited to, boxing, field hockey, football, ice hockey, lacrosse, martial arts, rodeo, soccer and wrestling. This may also include extreme activities such as skydiving. Anyone with a single kidney who decides to participate in these sports should be extra careful and wear protective padding. He or she should understand that losing the remaining kidney is a very serious situation.
The Dexterity Of Robots
Surgical robots are helpful because they offer more dexterity than traditional laparoscopic instrumentation and use a three-dimensional, high-resolution camera to visualize and magnify the operating field. Some procedures, such as the removal of the prostate or the removal of just a portion of the kidney, require a high degree of delicate maneuvering and extensive internal suturing that render the robots assistance invaluable. But Chung and his colleagues wondered whether less technically challenging surgeries, such as the removal of a whole kidney, may not benefit as significantly from a robots help.
Benjamin Chung
The researchers analyzed data from 416 hospitals across the country from 2003 to 2015. They found that in 2003 about 65 percent of patients with kidney tumors that necessitated the removal of the entire organ underwent an open surgical procedure. About 34 percent had their kidney removed using a laparoscopic procedure, and only the remaining 1.5 percent of cases were conducted with robot-assisted surgery. By 2015, the proportion of patients who underwent the open procedure had decreased to about 50 percent, but the use of robot-assisted laparoscopic surgery for the remaining cases had surpassed that of traditional laparoscopic surgery, 27 percent to 23 percent.
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How Is A Nephrectomy Performed
A partial or radical nephrectomy is performed in the hospital and may require at least one or two overnight stays. It is performed under general anesthesia, meaning that you will not be awake during the operation. Once you are asleep, your surgeon will make a small incision in your abdomen.
Through the incision, the surgeon will insert the laparoscopic surgical device that allows him or her to see inside of the body. The lighted scope guides the surgeon as he or she guides the robotic-assisted device to the kidneys to remove part or all of the organ. Once the kidney is removed, the surgical devices are removed and the incisions are closed with surgical glue or sutures. You will be taken to a recovery unit to wake up from sedation.
The benefits of laparoscopic robotic-assisted nephrectomy include having a smaller incision, less pain, and a faster recovery period. You will be able to turn home quicker than you would with an invasive surgery.
How Long Can You Live With 1 Kidney
This usually takes 25 years or more to happen. There may also be a chance of having high blood pressure later in life. However, the loss in kidney function is usually very mild, and life span is normal. Most people with one kidney live healthy, normal lives with few problems.
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How Do I Prepare For Swollen Kidney Transplant
You’ll receive instructions at the kidney specialist hospital about what to do the day before and the day of your surgery. Make a note of any questions you might have:
- When do I need to begin fasting?
- Can I take my prescription medications?
- If the answer to the above is yes, how soon before the surgery can I take a dose?
- What non-prescription medications should I avoid?
- When do I need to arrive at the hospital?
Simple Nephrectomy Or Open Kidney Removal:
It requires you to be lying on your side. The surgeon will make an incision or cut up to 12 inches long. This will involve making an incision cut will be on your side, just below the ribs or right over your lowest ribs. Then the tube that takes urine from your kidneys to the bladder or ureter, and blood vessels, are surgically separated from the kidney. The kidney is then removed.
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What Is The Difference Between A Laparoscopic And Open Surgery
Surgeons use two different techniques for nephrectomies. A laparoscopic nephrectomy uses a small tool with a camera and a few tiny incisions. In a robotic-assisted laparoscopic case, a surgical robot is controlled by the surgeon to manipulate these small tools. An open nephrectomy uses one large incision. Surgeons view directly inside the body and do not use a camera.
Laparoscopic nephrectomy may lead to shorter hospital stays and quicker recovery times. However, surgeons may use open surgery if laparoscopic surgery is not an option. For example, laparoscopic surgery often requires longer periods under anesthesia. Some people may not respond well to being under anesthesia for long periods. Also, others may have a large kidney tumor for which these minimally-invasive techniques may not be the best choice. In these cases, an open approach could be safer.
What Happens After A Nephrectomy
You will need to stay in the hospital for one to five days after surgery. How long you stay in the hospital depends on what type of nephrectomy you had.
Your healthcare team will monitor your blood pressure, electrolytes and fluid levels. Typically, you will have to use a urinary catheter for the first few days after surgery.
At first, the incision will be sore, and you may notice some numbness, too. Your healthcare team can help you with pain control, as needed.
Because your incision will be near your diaphragm , it may be uncomfortable to breathe deeply. However, performing diaphragmatic breathing exercises is important for preventing pneumonia .
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Are You The Right Candidate For Kidney Surgery
Many people are of the opinion that a successful kidney transplant is the gateway to a better quality of life than dialysis. To be considered for one, you must be evaluated at a transplant centre or kidney specialist hospital. This is carried out to ensure that a kidney transplant is truly the very best choice for you. The evaluation will be very thorough, and may take several months to complete. You will meet with members of the transplant team, which may include a transplant surgeon, nephrologist, nurse coordinator and dietitian. Your transplant team will need to know a lot about you to help themand youdecide if a transplant is right for you.
What Happens Before A Nephrectomy
Before kidney surgery, your healthcare provider will give you instructions about how to prepare. You’ll need to stop taking certain medications, such as blood thinners, in the days before the operation. Your surgeon will also likely instruct you to fast and stop drinking liquids the night before the procedure.
A few days before surgery, your healthcare provider will draw blood. This test determines your blood type in case you need a blood transfusion, and will also determine baseline kidney function and blood counts
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Frequently Asked Questions About Shockwave Lithotripsy
- Where are your SWL services available?
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We offer SWL services at our Barnes-Jewish Hospital and Barnes-Jewish West County Hospital locations
- Why should I choose SWL?
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SWL is an outpatient procedure, and one of the preferred treatments for small- to medium-sized stones. It is considered a safe and effective procedure with an excellent track record. As it is an outpatient procedure, you will be home just a few hours after the procedure. Recovery is generally very rapid.
- Does SWL have any limitations?
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As with any technology, there are limitations. Certain types of stones are very hard and resistant to breakage with shockwaves. Other, less common stones are invisible on X-ray, which means that they cannot be targeted for treatment. Therefore, if you have a history of cystine, monohydrate or uric acid stones, SWL may not be the best treatment for you.
Also, very large stones or stones that have traveled into the lower part of the urinary tract may be better treated by other methods. There are also some patient factors, including other medical conditions, which may affect your suitability for SWL. For instance, patients who are on blood-thinning medications or who may be pregnant should not undergo SWL procedures.
- Is SWL associated with any side effects?
- How can I make an appointment to discuss SWL with a Washington University urologist?
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Please call 362-8200 to schedule an appointment at any of our clinic locations.