procedures for kidney cancer

---

This involves removal of the entire kidney. Dr. Ivan Aw may recommend this, when the tumour size and location factors are not suitable for a partial removal. Dr. Ivan Aw’s preferred option is to perform this with minimally invasive laparoscopic approach.  

Preparing for your surgery

If you are advised that you are undergoing a nephrectomy, please inform the clinic if you are on blood thinning medication.

Risks of surgery 

• General risks: risks with any general anesthesia, including heart and lung issues, blood clots or infection 
• Bleeding: this is a rare complication, which may necessitate transfusion. In some circumstances, a return to theatre may be required 
• Incision site issues: wound infection can occur in less than 5% of cases 
• A hernia may develop: this is rare and it is advised to avoid heavy lifting >6kg for 2 weeks to allow the sutured wound to heal 
• Conversion to open: this is uncommon however, where the dissection can be more difficult than anticipated, and an open conversion may be needed to allow safer completion of the surgery 
• Injury to surrounding organs: this is a rare complication, and may require repair during surgery 
• Cancer recurrence: the risk of recurrence increases with more advanced cancers 
• Mr Aw will put you on a surveillance program after surgery, with interval imaging with CT and ultrasounds over a period of 3-5 years 

Recovery after your surgery 

• You will have a catheter for fluid monitoring after the surgery 
• It is anticipated that you will stay in the hospital for 2-5 days 
• You will have 2-3 keyhole incisions, and an incision in the lower abdomen (this is where the kidney is extracted from your body) 
• No heavy lifting  >6kg for 3 weeks and driving until you have been seen by Mr Aw 
• We encourage you to take laxatives and not strain when going to the toilet, as well as keeping well-hydrated  

When should you be concerned?

There are some things to look out for as you recover after your surgery. These include symptoms like: 

• Unable to pass urine 
• Passing large blood clots in urine 
• Fever with temperature >38 degrees 

If any of the above symptoms occur, please contact the clinic on (08) 6317 3464 during the hours of 9am – 5pm, Monday to Friday.  For medical emergencies after hours, go to your local emergency department. 

This involves the removal of only the cancerous tissue, instead of the entire kidney. Technical feasibility is dependent on the size of the tumour, location as well as patient anatomy. Other patient factors, including kidney disease or multiple tumours are also important considerations as it is more vital in these scenarios that we preserve as much healthy kidney tissues as possible.  Removal of the renal tumour alone is a more complex and technically demanding procedure compared to the removal of the entire kidney. Mr Aw will assess your suitability and discuss this with you. 

Preparing for your surgery

If you are advised that you are undergoing a partial nephrectomy, please inform Dr. Ivan Aw’s clinic if you are on blood thinning medication.

Risks of surgery

• General risks 
• Risks with any general anesthesia, including heart and lung issues, blood clots or infection 
• Bleeding 
• This is a rare complication, which may necessitate transfusion and a further procedure. In some circumstances, a return to theatre may be required 
• Conversion to open 
• Uncommonly, the dissection can be more difficult than anticipated, and an open conversion may be needed to allow safer completion of the surgery 
• Positive margins 
• This may occur when the tumour is seen to extend to the edge of the specimen. The risk is reduced with the use of ultrasound during the procedure 
• Conversion to removal of entire kidney 
• If we find that the tumour is more advanced and invasive during surgery, a decision to remove the entire kidney may be made to ensure we achieve a clear magin 
• Urine leak 
• A small leak may be present at the site where the tumour is removed. Most times this will resolve by placing a temporary stent in the ureter. 
• Injury to surrounding organs 
• This is a rare complication, and may require repair during surgery 
• Cancer recurrence 
• The risk of recurrence increases with more advanced cancers 
• Mr Aw will put you on a surveillance program after surgery, with interval imaging with CT and ultrasounds over a period of 3-5 years 

Recovery after your surgery

• You will have a catheter for fluid monitoring after the surgery 
• It is anticipated that you will stay in the hospital for 2-5 days 
• You will have 2-3 keyhole incisions 
• No heavy lifting  >6kg for 3 weeks and driving until you have been seen by Mr Aw 
• We encourage you to take laxatives and not strain in the toilet, as well as keeping well-hydrated  

When should you be concerned?

There are some things to look out for as you recover after your surgery. These include symptoms like: 

• Unable to pass urine 
• Passing blood in the urine 
• Fever with temperature >38 degrees 

If any of the above symptoms occur, please contact the clinic (08) 6317 3464 during the hours of 9am – 5pm, Monday to Friday.  For medical emergencies after hours, go to your local emergency department.