Having your kidney cancer operation
This page tells you about what may happen when you go into hospital for your kidney cancer operation. You can find information about
Having your kidney cancer operation
Before your operation you will have various tests to check your general health. Your nurse will teach you breathing and leg exercises to do after the operation to prevent chest infections and blood clots. Your surgeon, anaesthetist, physiotherapist and nurse will all come to talk to you about what will happen during and after the operation. Do ask as many questions as you need to.
Immediately after your operation
When you wake up, you will have several different tubes in place. You will have a drip into your arm, and one or more drainage tubes from your wound. You will have a tube down your nose into your stomach (nasogastric tube) to drain it and stop you feeling sick. And you will have a tube into your bladder (catheter) to measure your urine output.
If you have open surgery, you will almost certainly have pain for the first week or so. There may be less pain with keyhole surgery. It is important to tell your doctor or nurse as soon as you feel any pain. They need your help to find the right type and dose of painkiller for you.
After a few days you will be able to get up and about. Usually people are eating normally 2 to 3 days after this type of operation. About a week after your operation, you should be just about ready to go home.
You can view and print the quick guides for all the pages in the Treating kidney cancer section.
Having all, or part of your kidney removed is major surgery. We have information about
When you go into hospital for your operation, your surgeon, anaesthetist, physiotherapist and nurse will all come to talk to you about what will happen. Your surgeon will explain what they will do and what to expect when you come round from the anaesthetic. Do ask as many questions as you need to. It may help to make a list of your questions before you go into hospital for your operation.
The more you know about what is going to happen, the less frightening it will seem. Don’t worry if you think of more questions later. Just speak to your nurses. They can answer your questions or contact the doctor to come and talk to you again.
If you find eating and drinking difficult, you may have a drip (intravenous infusion) put into your arm before your surgery so that you can be given fluids. This makes sure you are not dehydrated before your operation.
If you have body hair, you may need to be shaved in the area where your wound will be. This is usually the side or back, but sometimes surgeons use a cut (incision) across the chest and abdomen. Shaving can reduce the risk of an infection in your wound. You may have your shave in the operating theatre after you have had your anaesthetic, instead of on the ward.
Before your surgery, you will need
- Blood tests to check your general health and kidney function
- A chest X-ray to check your lungs are healthy
- An ECG to check your heart is healthy
You may have had some of these tests while your cancer was being diagnosed. If so, you may not have to have them repeated. You may also be asked to have
- Breathing tests (called lung function tests)
- An ECG while you are exercising
These tests are to make sure you are fit enough to make a good recovery from your surgery.
Your nurse will teach you breathing and leg exercises. You can help yourself to get better by doing these exercises after your operation. You should do them as often as you are told you need to.
Breathing exercises help to stop you getting a chest infection. And leg exercises help to stop clots forming in your legs. Both these complications of surgery can happen when you are not moving around as much as you would normally be. Your nurses will encourage you to get up and about as soon as possible after your operation. But this is major surgery, and you may have to stay in bed for the first couple of days.
Below is a short video showing breathing and circulation exercises after surgery when the wound is on your side. Click on the arrow to watch it.
View a transcript of the video showing breathing and circulation exercises after surgery (opens in new window).
You may wake up in intensive care or a high dependency recovery unit. These are places where you can have one to one nursing care. And your surgeon and anaesthetist can keep a close eye on your progress. As soon as your doctors are sure you are recovering well, you will be moved back to the ward.
When you wake up, you will have several different tubes in place. This can be a bit frightening. But it helps to know what they are all for. You will have
- Drips (intravenous infusions) to give you blood transfusions, and fluids until you are drinking again
- One or more drains coming out of your back or side, near your wound – the drains stop blood and tissue fluid collecting around the operation site
- A tube down your nose into your stomach (nasogastric tube) to drain fluid and stop you feeling sick
- A tube into your bladder (catheter) so that your urine output can be measured
If you have had part of a kidney removed, you will have another drainage tube from the wound site. This is to collect urine, and stop it leaking into the wound. Your nurse will check this bag and measure the contents frequently.
You will have a blood pressure cuff on your arm when you first wake up. And you will also have a little clip on your finger (called a pulse oximeter) to measure your pulse and the oxygen levels in your blood. You may also have an oxygen mask on for a while. Your nurse will check your blood pressure often for the first few hours after you come round from the anaesthetic. Your urine output will be monitored very closely, at least once an hour at first.
Some hospitals use painkillers given into the fluid around the spinal cord for the first day or so after surgery. This method of pain control works very well. You have a very fine tube taped to your back. The tube is connected to a pump, which gives a continuous dose of painkiller. Tell your nurse if you are in pain as they can increase the dose.
One of your drips may have painkillers in it. You may have a hand control with a button to press, to give yourself extra painkillers, as you need them. This is called PCA, or patient controlled analgesia.
If you have open surgery, you will almost certainly have pain for the first week or so. If you have keyhole surgery, you may not have pain for as long as that. There are many different painkilling drugs you can have. It is important to tell your doctor or nurse as soon as you feel any pain. They need your help to find the right type and dose of painkiller for you.
Painkillers work best when you take them regularly. With kidney surgery, you are bound to need quite a lot of painkillers for at least the first 3 days or so after your operation. If you have a button to press to give yourself extra painkillers, do use it whenever you need to. You can’t overdose because the machine is set to prevent that. Tell your nurse if you need to press the button very often. You may need a higher dose in the pump.
After surgery to any part of the abdomen, the bowel often stops working for a while. Until it starts up again, you will not be able to eat or drink. At first you will be given clear fluids. Once you are able to drink without being or feeling sick, your nurse will take your drip and nasogastric tube out. You can then try something like tea or soup.
When your doctor is able to hear the normal gurgling sounds that your bowel makes when it is working normally, you will be able to start eating solid food. Usually, people are eating normally 2 or 3 days after this type of surgery.
At first, your nurse will keep a very close eye on the amount of urine draining from your catheter. If you are producing enough urine, they will take your catheter out. You will still be asked to collect all the urine you produce while you are in hospital. This will be noted down and compared to the amount you are drinking. Then the treatment team can make sure that your kidney (or kidneys) is working well.
The wound area will depend on the size and position of the kidney tumour and on the type of surgery you have. If you have open surgery, you may have a wound on your back and side. Or the wound may be on your front, across the chest and abdomen. If you have keyhole surgery, you will have two or more small wounds.
The wounds from the operation will be covered up when you come round. They will be left covered for a couple of days. Then the dressings will be changed and the wound(s) cleaned.
The wound drains will be left in until they stop draining fluid. The bottles attached to them will be changed every day. Wound drains can usually be taken out 3 to 7 days after your operation. Your stitches or clips will be left in for at least 10 days.
The most common complications of surgery are infections and blood clots.
Infections can develop in your lungs or in your wound site. Your breathing exercises will help to stop you from developing a chest infection. Your nurse will change the dressings on your wound when necessary, to help keep it clean. If any signs of infection appear, you will have antibiotics straight away. If you think your wound may be infected, tell your doctor or nurse. The signs of a wound infection are
- Oozing from the wound
Blood clots can develop because you are not moving around as much as usual. You may be given compression stockings to wear. The compression stockings, along with your leg exercises, help to keep your blood moving. And your nurse will encourage you to get up and move around as soon as you are able to. This will help to stop clots from forming. The signs of a blood clot are
- Pain in the leg, usually the calf
- Swelling in an arm or leg
- Sudden chest pain and breathlessness
If you notice any of these signs, tell your doctor or nurse straight away. If your doctor thinks you are at risk of clots, you may be given anti clotting medicines such as heparin, tinzaparin, or dalteparin to prevent them. You have them as daily injections just under the skin.
This may seem impossible at first. Moving about helps you to get better but you will need to start very gradually. Your physiotherapist will visit you every day after your operation to help you with your breathing and leg exercises.
Your nurses will encourage you to get out of bed and sit in a chair one or two days after your surgery. They will help you with all the drips and drains. Over the next couple of days, the tubes, bottles and bags will start to be taken out. Then, it will be much easier to get around and you will really feel that you are beginning to make progress.
About a week or so after your operation, you should be just about ready to go home. If you have had keyhole surgery, you may be able to go home after a few days.
You will have an outpatient appointment made before you leave the ward. The appointment is usually 6 weeks after your operation. Tell the nurses when you first go into hospital if you live alone, or if you might have difficulty managing after your operation. They can arrange for help to be there for you when you go home.
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