What Happens During Surgery f... Health Article

If your doctor is not a surgeon, he or she will refer you to a urologic surgeon, who will determine what type of surgery you should have done. Before surgery, you’ll meet with your surgeon to talk about the procedure. At this time, you can ask questions and talk about any concerns you may have. Here are some things you may want to talk about.

• What type of surgery will be done

• What will be done during surgery

• The possible risks and side effects of the surgery

• When you can expect to return to your normal activities

• If the surgery will leave scars and what they will look like

Before surgery, the surgeon will find out if you are taking any medications and will go over your medical records. This is done to make sure you’re not taking medications that could affect the surgery. After you have discussed all the details with the surgeon, you will sign a consent form that says that the doctor can do the surgery.

A surgeon does the surgery in a hospital. Just before your surgery, you will be given anesthesia so that you fall asleep and don’t feel pain. An anesthesiologist or a nurse anesthetist will give you the anesthesia. Before surgery, you’ll meet the anesthesiologist and can ask questions about the anesthesia and how it will affect you.

Your surgeon may need to do an open surgery. That means making a large enough incision for your doctor to use his or her hands for the operation. The incision will be made in your abdomen or at the side of your abdomen. The surgeon may also need to remove one of your ribs. The surgeon will cut away the tube that carries urine from your kidney to your bladder, called the ureter. He or she will also cut out the blood vessels around the kidney.

You may be able to have surgery done laparoscopically. If so, the surgeon makes 2 or 3 small incisions in your abdomen and side. Then, the surgeon inserts a laparoscope, a tool with a camera on it that lets him or her see your kidneys. You may have less pain, less scarring, and a faster recovery with this type of surgery than with open surgery.

What happens next depends on the type of surgery you are having. Here’s an overview of the main types of surgery for kidney cancer. The type you have depends on the stage of your cancer.

Radical nephrectomy. This is the surgery most commonly used to treat kidney cancer. During this surgery, the surgeon removes:

• Your whole kidney with cancer

• Your adrenal gland

• Fatty tissue surrounding the kidney

• Lymph nodes. Examining lymph nodes help determine the stage of the cancer, which is important in deciding on other treatments.

Simple nephrectomy. During this procedure, the surgeon removes only the whole kidney with cancer.

Partial nephrectomy. During this procedure, the surgeon removes only the cancerous part of the kidney. You may have this procedure if you have cancer in both kidneys or if you have only one kidney. It is also becoming more common in people who have a small tumor (smaller than 1½ inches) in one kidney only.

Surgery to remove metastases. In these cases, surgery won’t cure the cancer, but removing these tumors from your kidney can help ease symptoms, such as pressure or pain.

Arterial embolization. This procedure blocks the artery that feeds the kidney with the tumor. The surgeon makes an incision and inserts a small tube, called a catheter, into an artery in your groin. The surgeon moves it through the artery until it reaches your kidney’s artery. Then the surgeon places material, such as small pieces of a special gelatin sponge, in the artery to block it. This is sometimes done before a simple or radical nephrectomy to reduce blood loss during the surgery.