Our Summary

This study is about a recent development in kidney surgery. Doctors have started to use a process called intraoperatory laparoscopic ultrasound during operations to remove part of a kidney (partial nephrectomy). This is particularly useful when dealing with difficult or tricky tumors. The researchers looked at other studies that had been published on this topic and reviewed their findings.

They found that the size of the tumors that had been treated with this method ranged from 2.3 to 4 cm. The rate of complications was similar to other types of kidney surgery. However, the success rate in terms of removing all the cancer was over 90%, which is comparable to the success rate for easier tumors.

The study concludes that this type of ultrasound could make partial nephrectomies possible for more complex tumors, but more research is needed to confirm its benefits. The authors also note that surgeons need to have previous experience with this procedure due to its complexity.

FAQs

  1. What is intraoperatory laparoscopic ultrasound and how is it used in kidney surgery?
  2. According to the study, what is the success rate of removing all the cancer using this method compared to more traditional methods?
  3. What further research is needed to confirm the benefits of using intraoperatory laparoscopic ultrasound in partial nephrectomies?

Doctor’s Tip

A doctor might tell a patient undergoing laparoscopic nephrectomy to make sure to follow all pre-operative instructions, such as fasting before the surgery and avoiding certain medications. They may also advise the patient to stay active and maintain a healthy diet to promote faster recovery post-surgery. Additionally, the doctor may recommend attending all follow-up appointments to monitor healing and ensure the best possible outcome.

Suitable For

Patients who are typically recommended for laparoscopic nephrectomy are those with smaller kidney tumors (2.3 to 4 cm) that are difficult or tricky to remove. This method may be particularly beneficial for patients who need a partial nephrectomy for complex tumors. It is important for surgeons to have experience with this procedure due to its complexity.

Timeline

Before laparoscopic nephrectomy:

  1. Patient consults with a urologist and undergoes various tests and scans to determine the need for surgery.
  2. Patient is advised on the risks and benefits of laparoscopic nephrectomy compared to other treatment options.
  3. Surgery date is scheduled and patient receives instructions on pre-operative preparation such as fasting and medication guidelines.

During laparoscopic nephrectomy:

  1. Patient undergoes general anesthesia before the surgery begins.
  2. Surgeon makes small incisions in the abdomen and inserts a laparoscope to view the kidney.
  3. Instruments are used to carefully remove the kidney or part of the kidney.
  4. Intraoperatory laparoscopic ultrasound may be used to assist in removing tumors or assessing the success of the procedure.
  5. Surgery typically lasts 2-3 hours.

After laparoscopic nephrectomy:

  1. Patient is monitored in the recovery room before being transferred to a hospital room.
  2. Pain medication is provided to manage post-operative pain.
  3. Patient is encouraged to walk and resume normal activities as soon as possible to aid in recovery.
  4. Follow-up appointments are scheduled to monitor progress and address any concerns or complications.
  5. Patient may need to make dietary or lifestyle changes to support kidney function and overall health.

What to Ask Your Doctor

  1. What is laparoscopic nephrectomy and how does it differ from traditional open surgery for kidney removal?
  2. Are there any specific risks or complications associated with laparoscopic nephrectomy that I should be aware of?
  3. How experienced are you in performing laparoscopic nephrectomies, especially with the use of intraoperative laparoscopic ultrasound?
  4. What is the success rate of removing all cancer with laparoscopic nephrectomy compared to traditional methods?
  5. How long is the recovery time for laparoscopic nephrectomy compared to open surgery?
  6. Are there any specific guidelines or restrictions I should follow before and after the surgery?
  7. Will I need any additional follow-up treatments or monitoring after the surgery?
  8. How soon after the surgery will I be able to resume normal activities, such as work or exercise?

Reference

Authors: Rodríguez-Monsalve M, Del Pozo Jiménez G, Carballido J, Castillón Vela I. Journal: Arch Esp Urol. 2019 Oct;72(8):729-737. PMID: 31579030