LAPAROSCOPIC ROBOTIC RADICAL NEPHRECTOMY
Discharge Instructions Following Laparoscopic/Robotic Radical Nephrectomy
Continue walking
The walking will help you build strength. Gradually increase the amount of walking you do each day. Take planned rest periods during the day. The best gauge is your own body and how you feel. It is very important that you continue walking when you are discharged from the hospital. Not only will this build strength but will also aid in preventing blood clot formation in the legs.
Avoid bending for 3 months
If you must pick something up, bend with your knees and not your waist.
Avoid heavy (Greater than 5 pounds) lifting for 3 months
Anything you need to brace yourself to pick up is too heavy. Also avoid strenuous activity.
Stairs should not be avoided
Take them slowly at first. You may wish to group your activities, so that you do not have to make many trips up and down stairs during the first week you are home.
Driving should be avoided
Driving should be avoided for at least 4 weeks after surgery or until you are pain free without medication. Take breaks every couple of hours if you are on extended trips. Get out of your car and walk around a bit to prevent blood clotting in the legs.
Body Hygiene
Patients can scrub their bodies upon discharge from the hospital with lukewarm water and soap. Avoid getting your incisions/dressings wet. Tub baths or hot tubs in the first 2 weeks are discouraged as this will allow for prolonged soaking of your incisions and increase the risk of infection. Your wound sites can get wet, but must be patted dry immediately after showering. You can resume bathing/showering with soap and water once the wounds have healed and sutures have been removed.
Diet
You should be on salt restricted diet (i.e. do not add additional salt to food) and avoid high protein diets as both can cause potential damage to your remaining kidney.
Avoid constipation
If you become constipated please take the following measures: increase the roughage in your diet and drink 2-3 liters of water per day (to be avoided in heart patients).
Chest exercises
It is important to take care of for your lung health to avoid pneumonias.
For this please do the following:
- Incentive spirometry as taught
- Steam inhalation twice a day for 1 week
- Avoid breathing exercises that cause sudden increase in abdominal pressure like Kapalabhati.
Urine Infection
If your urine becomes offensive smelling or cloudy in color, this could mean that you may be having a urine infection. Please contact us.
- Drink plenty of water (2- 3 Liters/day, provided no heart/liver/kidney problems preclude this)
- Reduce salt intake (salt restricted diet)
- Reduce intake of foods rich in oxalate like nuts and seeds, spinach, chocolates to avoid stone formation (complete avoidance of such foods is not necessary)
- Avoid Nephrotoxic drugs (drugs that may affect kidney function)
- Do not take over the counter pain medication or any new medication without physician advise. This includes alternative medication such as ayurvedic and homeopathic medication.
Solitary Kidney Precautions
- Drink plenty of water (2- 3 Liters/day, provided no heart/liver/kidney problems preclude this)
- Reduce salt intake (salt restricted diet)
- Reduce intake of foods rich in oxalate like nuts and seeds, spinach, chocolates to avoid stone formation (complete avoidance of such foods is not necessary)
- Avoid Nephrotoxic drugs (drugs that may affect kidney function)
- Do not take over the counter pain medication or any new medication without physician advise. This includes alternative medication such as ayurvedic and homeopathic medication.
Medications:
- As per your discharge papers
- Continue medication for heart, thyroid or diabetes as before.
- Blood thinners like Aspirin/Ecosprin/Clopidogrel to be restarted only after discussion with surgical team and cardiologist.
- Regular follow up as advised
Red Alert Signs: Reasons to Call the Physician:
- Your incision becomes red or swollen
- The skin around your incision is warmer than elsewhere and is slightly red
- There is drainage(pus/fluid) from your incision
- There is an opening in your incision if visible.
- You are having difficulty passing urine or your urine output become less than it normally has been
- There are chills or fever of 101degree Fahrenheit or more
- Severe pain that is not relieved by pain medications
- Blood in urine
- Foul smelling urine