LAPAROSCOPIC RADICAL NEPHRECTOMY

What is laparoscopic radical nephrectomy? 

Laparoscopic radical nephrectomy done by surgeon when patient have kidney cancer in this procedure surgeon remove kidney as well as adrenal galnd this procedure done under the general anesthesia.

Benefits of laparoscopic radical  nephrectomy 

Reduce blood loss and transfusion. 

Reduce pain

Shorter hospital stay

Improved cosmesis

Fast recovery as compared to open surgery 

Laparoscopic radical nephrectomy  done under the full general anesthesia with  endotracheal tube intubation.General anesthesia for pain relief during surgery and comfort to patient.patient asleep during whole surgery. 

Fentanyl citrate and muscle relaxtant given to the patient and Endotracheal intubation will given and hypnotic agent like propofol given. 

Than anesthesist continue watching monitor and watch vital signs including pulse, spo2(saturation ), E.C.G,  body temperature and blood until the  patient  will not shifted from operation theatre to general ward.

In this procedure surgeon give 3 to 4 incision the abdomen which is less than 1cm for inserting the 5mm and 10mm trocar,  surgeon insert the veris needle for inflate the abdominal cavity by carbon di oxide gas for creating  sapce inside the abdominal cavity for working because surgery perform inside the abdomen by the looking at the monitor screen. After the introducing the co2 gas surgeon insert the 10mm telescope which is standard laparoscope which attached with video camera and connect the xenon cold light source and co2 cable attached  form trocar channel, after the visualization surgeon insert another 5mm trocar for inserting 5mm laparoscopic instruments like grassper and marinland after that sugeron inspect the abdominal cavity and  surgeon remove the fat and cut the renal artery & vein, ureter and clipping by hemolock clip and titanium clip after that surge also remove the adrenal gland because of cancer and also take lymph tissue near by organ for histopathology  remove the kidney or adrenal galnd by giving 3 to 5 cm incision above the abdomen and place abdominal drain for drainage output and close the incision by suturing aur stapler  and dressed by waterproof dressings or cotton pad.

After the operations patient shifted to recovery room for close monitoring of all vital signs, heart rate, blood pressure when patient get stable  then shifted to general surgical ward.

In this cancer that starts in the kidney. The most common type of kidney cancer is called renal cell carcinoma about 90% of all kidney cancer are renal cell carcinoma. The about 10% are made up of transitional cell carcinoma, milms tumours (found in children ) & other rare tumour

There are about 1, 90, 000 new cases of kidney cancer each year around the world, which means it accounts for about one in fifty cancers. In the uk and USA, it is about the tenth most common type of cancer. Estimated new cases & deaths from kidney. (Renal cell and renal pelvis) cancer in the united states in 2012 new cases 64, 770, deaths 13, 570.reports say even in india the incidence in increasing. 

As the tumour grow kidney cancer some time spreads to the lungs and surrounding organs but best things is that most of kidney cancer are found before they spread (metastasized) to distant organs. And cancer caught early are easier to treat successfully. 

Diagnose by ultrasound sonography of kidney and health checkup, computerized tomography (CT-SCAN), 

Blood and urine test

In the intial stage symptoms and signs of the kidney cancer not be noticeable but as tumour grow it can take many year to go chronic kidney disease to kidney failure then symptoms can notice 

In early stage, kidney cancer often causes no symptoms, it is usually detect by imaging like ultrasonography & CT scan of abdomen done as health check up or for vague symptoms. As the cancer grows, symptoms may common symptoms 

Long term kidney infection also cause of kidney damage and cancer

Symptoms present in patient with kidney cancer

Patient age more than 40 

Smoking 

Obesity 

Long term pain medication 

Family history of kidney cancer 

Blood in urine and stool

Rapid weight loss

Fever with no reason 

Consumption of excessive alcohol 

Issue with sexual capacity 

Menstrual period stop

Shortness of breath

Extremely ark or light skin

Disturbed concentration 

Continous hiccups

Anemia

Swelling in the hand and feet 

Image source:google 

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DR.ASHISH CHHAJAD - MBBS, MCH (UROLOGY) DNB UROLOGIST AND ANDROLOGIST 

Specialised in Kidney stones & treatment Ureteroscopy, Pcnl, Mini Perk, Benign Prostate disease treatment, TURP Uro -Oncology Laparoscopy Female urology , surgery for stress incontinence, fistulas .Paediatric urology surgery- PUValves, VUR surgery, Hypospadias Andrology & Male Infertility Men’s sexual healthReconstructive urology surgery Urethral stricture - Endoscopic surgery & Urethroplasties, Renal Transplantation surgery, Lithotripsy.