Nephroureterectomy

The surgery can be performed via an open approach or with the daVinci robot laparoscopically, depending on the size of the tumor.

The procedure is done under general anesthesia and requires a stay in the hospital of 1-3 days. In an open nephroureterectomy, a larger incision is made in the flank or abdomen. Fortunately in most cases we perform a robotic laparoscopic surgery, where several small incisions are used to place the instruments and cameras into the abdomen for the initial dissection. A small incision is made once the kidney has been fully dissected to remove the specimen.

Postoperative care includes monitoring for complications such as bleeding, infection, or urinary leakage. Pain management is usually effectively done with a combination of minimal narcotic use and over the counter medication such as Tylenol or ibuprofen. Patients are encouraged to resume walking and activity beginning on the day of the surgery.

Recovery time can vary, typically lasting from a couple weeks to several months, depending on the surgical method and individual health prior to surgery.

Risks and Complications

As with any major surgery, nephroureterectomy carries potential risks, including: infection, bleeding, blood clots in the veins of the lower extremity, damage to surrounding organs or nearby tissue, urine leakage from the surgery in the bladder, need for prolonged bladder catheter to encourage healing, and more severe complications such as heart attach or stroke from the anesthesia.

Long term risks of the procedure are due primarily to the loss of one kidney, with a natural reduction in the overall kidney functional reserve. For most patients this will not impact their long term health, but for patients with high blood pressure, diabetes, or other kidney concerns careful attention to kidney function after surgery is critical.