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Laparoscopic Partial Nephrectomy provides patients with a safe and effective way to remove a small renal tumor, while preserving the remainder of the kidney. This is a minimally invasive technique, which provides patients with less discomfort and equivalent results when compared to the traditional open surgery.
When compared to the conventional open surgical technique, laparoscopic partial nephrectomy has resulted in significantly less post-operative pain, a shorter hospital stay, earlier return to work and daily activities, a more favorable cosmetic result and outcomes that appear to be identical to that of open surgery. Partial nephrectomy has become a standard procedure for select patients with renal cell carcinoma (esp. small < 4cm, peripherally located tumors). The results of partial nephrectomy are less satisfactory in patients with larger renal cell carcinomas, leaving radical nephrectomy (removing the entire kidney) as the standard approach.
Johns Hopkins Hospital Patients 410-955-6100
Johns Hopkins Bayview Medical Center Patients 410 550 7008.
In the event of an emergency and you need to contact someone in the evening hours or on the week end, please call the paging operator at 410-955-6070 (for Johns Hopkins Hospital Patients) or 410-550-0100 (for Johns Hopkins Bayview Medical Center Patients) and ask to speak to the urologist on call.
NOTE: Patients must remember to bring all pathology reports, PSA values, and glass pathology slides to their consultation appointment. The pathology slides will be submitted for review at Johns Hopkins.
During your initial consultation with your surgeon, he will review your medical history as well as any outside reports, records, and outside Xray films (e.g. CT scan, MRI, sonogram). A brief physical examination will also be performed at the time of your visit. If your surgeon determines that you are a candidate for surgery, you will then meet with a Patient Service Surgery Coordinator to arrange for the date of your operation.
NOTE: It is very important that you gather and bring all of your Xray films and reports to your initial consultation with your surgeon.
Since insurance companies will not permit patients to be admitted to the hospital the day before surgery to have tests completed, you must make an appointment to have pre-operative testing done at your family doctor or primary care physician's office within 1 month prior to the date of surgery.
For Johns Hopkins Hospital Patients: These results need to be faxed by your doctor's office to the Pre-operative Evaluation Center at 443-287-9358 two weeks prior to your surgery. Please call The Documentation Center at 410-955-9453 two weeks before your surgery date to confirm that this information was received.
For Johns Hopkins Bayview Medical Center Patients : These results need to be faxed by your doctor's office to the Pre-operative Evaluation Center at 410-550-1391 one week prior to your surgery. Please call The Documentation Center at 410-550-2495 before your surgery date to confirm that this information was received.
Once your surgical date is secured, you will receive a form along with a letter of explanation to take to your primary care physician or family doctor in order to have the following pre-operative testing done prior to your surgery.
Medications to Avoid Prior to Surgery
• Aspirin, Motrin, Ibuprofen, Advil, Alka Seltzer, Vitamin E, Ticlid, Coumadin, Lovenox, Celebrex, Voltaren, Vioxx, Plavix and some other arthritis medications can cause bleeding and should be avoided 1 week prior to the date of surgery (Please contact your surgeon's office if you are unsure about which medications to stop prior to surgery. Do not stop any medication without contacting the prescribing doctor to get their approval).
Bowel Preparation and Clear Liquid Diet
Do not eat or drink anything after midnight the night before the surgery and drink one bottle of Magnesium Citrate (can be purchased at your local pharmacy) the evening before your surgery.
Drink only clear fluids for a 24-hour period prior to the date of your surgery. Clear liquids are liquids that you are able to see through. Please follow the diet below.
Clear Liquid Diet
Remember not to eat or drink anything after midnight the evening before your surgery.
Clear liquids are liquids that you are able to see through. Please follow the diet below.
Laparoscopic partial nephrectomy is performed under a general anesthetic. The typical length of the operation is 3-4 hours. The surgery is performed through 4 small (1cm) incisions made in the abdomen. A telescope and small instruments are inserted into the abdomen through these keyhole incisions, which allow the surgeon to completely free and dissect the tumor without having to place his hands into the abdomen. The defect in the kidney is then sewn closed with sutures and a special sealant glue. The tumor is then placed within a plastic sack and removed intact through an extension of one of the existing incision sites.
Although this procedure has proven to be very safe, as in any surgical procedure there are risks and potential complications. The safety and complication rates are similar when compared to the open surgery. Potential risks include:
During your hospitalization
Immediately after the surgery you will be taken to the recovery room and transferred to your hospital room once you are fully awake and your vital signs are stable.