Robotic Kidney Surgery Patient Instructions
You have chosen to undergo a state of the art robotic procedure to treat your cancer. In our experienced hands, this operation decreases recovery time, post-operative pain, and blood loss during surgery. Using small and exacting surgical instruments, our team removes cancerous tissue while precisely sparing as much of the kidney to give our patients the best possible outcome.
Even though this is a minimally invasive procedure, it is still considered major surgery and certain guidelines must be followed to avoid unnecessary complications. The following provides information for you and your loved ones to review and with which to become familiar in order to ensure a smooth and speedy recovery after your operation. Of course, if you have more specific questions, you should discuss it with your surgeon.
We thank you for choosing the Robotic Surgery Team at Mount Sinai for your care. We continually strive to improve our efforts for our patients; any feedback or comments you may have would be greatly appreciated.
Preoperative Testing & Medical Clearance
Every patient needs to get preoperative testing done either at the PMD or here at Mount Sinai within 30 days of the surgery. The testing includes blood work, urine testing, an EKG, and a chest x-ray. If you have not scheduled this appointment, please call LaToya at 212-636-4150 to make an appointment.
Every patient needs a medical clearance letter from their primary care provider. This is a letter stating that you are in good health and that you are cleared for surgery. Please call your doctor’s office to let them know that you will need this letter; you will most likely need an appointment with your primary care provider. Make this appointment for 2-3 days after your preoperative testing appointment so that we can fax the results of your tests to your provider’s office for them to review. Have your doctor fax your clearance letter to 212-636-4162. If you have a history of cardiac disease, we may also request that you receive an additional clearance letter from your cardiologist.
Preoperative Medical Instructions
It is imperative that you follow these instructions beginning 7 days prior to your surgery.
7 days prior
STOP any blood thinning medications. NSAIDs: Ibuprofen, Aleve, Advil, Motrin, Excedrin
Aspirin, Ecotrin, Coumadin or Warfarin, Plavix, Trental, Heparin, Lovenox, Pradaxa, Xarelto, Apixaban, Eliquis, Effient Herbal Supplements/Vitamins/Nutritional Supplements:Vitamin E & D, Garlic supplements, Multivitamins, St. Johns Wart, Gingko, Omega-3 and Fish Oil. It is best to stop ALL nutritional supplements
*If any of your blood thinners is prescribed by one of your healthcare providers (especially your cardiologist), please call them to let them know that you need to stop the medication for 7 days. You may need to take another medication in the interim and this is at the discretion of the prescribing provider. If you are not sure if one of your medications is blood thinning, please call the office at 212-241-3919 and ask to speak to a PA.
2 days prior
Do not drink any alcoholic beverages 48 hours before (or after) the surgery.
1 day prior
The day before surgery, please drink one bottle of Magnesium Citrate in the morning (before 11 AM). This can be purchased over the counter at any pharmacy without a prescription. Make sure you can be close to a bathroom afterwards.
Breakfast & Lunch: Light soft diet. No meat/dairy. Example: light sandwich, oatmeal, rice, mashed potatoes, scrambled eggs, bananas, peaches, pears, juices, coffee, tea, gelatins, flavored ices, popsicles, broths, chicken noodle soup, hard candy
Dinner: you may only have clear liquids (broth, water, non-pulp juices). Drink plenty of fluids throughout the day. You will receive a call from the Admitting Unit after 4 pm the day before you surgery with instructions on what time to arrive. If your surgery is on Monday, you will receive this call on the Friday before your surgery. If for some reason you do not receive this call, please call 212-636-4150.
DO NOT EAT OR DRINK ANYTHING AFTER MIDNIGHT. This includes candy, gum, water, coffee and tea.
Day of Surgery
If you normally take medications in the morning, take them with a very small sip of water the morning of the surgery. If you take insulin in the morning, take half of your normal dose. Do not take any pills for diabetes. Please bring a list of all medications that you take regularly with you to the hospital. If you wear contact lenses or glasses, you must bring a case in which to store them. Leave all jewelry and valuables at home. Bring loose fitting clothing such as sweatpants, or pants with an elastic or drawstring waist to wear home the following day.
Hospitalization
The operation lasts 2 – 4 hours and the hospitalization usually lasts 24 hours. You may wake up with an abdominal drain. You may go home with this drain and will be given separate instructions on how to care for it. You will wake up with a Foley catheter. The Foley catheter will be removed the next day.
Postoperative Instructions
General
If you feel warm, take your temperature. Call the office at 212-241-3919 if you have a fever of 101 F or higher.
Diet
Drink plenty of fluids, especially water. You may resume a regular diet. It is best to eat 5 smaller meals throughout the day because it is easier to tolerate until you feel less bloated. Bloating may continue for 2 – 3 weeks after surgery. Avoid carbonated beverages and excessive dairy products during this time. Also avoid alcohol, caffeine, citrus juice, and spicy food as these can cause or worsen heartburn symptoms.
Activity
You should walk around throughout the day. You may walk outside, up and down stairs, as well as travel to neighbors, the grocery store, etc.Do not sit in one place for longer than 45 minutes at a time. You may drive if you are NOT TAKING PRESCRIPTION PAIN MEDICATION and do NOT have a catheter in place. Wait 6 weeks before resuming weight lifting and other resistance exercises such as abdominal crunches and leg squats. DO NOT lift anything heavier than 5 pounds (a gallon of milk weighs approximately 8 pounds, for reference) for 2-4 weeks after surgery. Do not lift anything heavier than 20 pounds for 6 weeks after surgery. You may shower normally 48 hours after surgery. NO BATHS, TUB SOAKS, OR SWIMMING for 3 – 4 weeks after the surgery.
Skin & Incisional Care
You will have 5 – 6 port sites (small incisions through which the operation is performed). In most instances, most of your incisions will be sutured closed and will not require dressings. If you had a drain that was removed in the hospital, that site will have a dressing which should be removed 2 days after it was applied. After you remove the original dressing you may use either a band-aid or gauze and tape.
Drain Site
You may go home with a drainage tube that comes out of one of the port sites on your abdomen. You will get separate instructions on care for it and when it will be removed.
Medications
Resume all of your preoperative medications with the EXCEPTION of blood thinning medications listed previously. You may resume these medications and supplements 5 days after surgery unless instructed otherwise.
Constipation
You will get a prescription for a stool softener or you can take an over the counter stool softener. You may not have a bowel movement for 3-4 days, but if you have not had a bowel movement 5 days after surgery, please call the office.
Pain Management
You will be prescribed a narcotic pain medicine. You should use this ONLY when you need it. If not medically contraindicated, you may take ibuprofen (Motrin, Advil) regularly every 8 hours to reduce swelling and inflammation after the surgery. You may also take Tylenol.
Recovery Time
You may return to work 2 – 4 weeks after surgery, depending on the nature of your job. You may resume all normal activities of daily living 2 weeks after surgery EXCEPT weight lifting, abdominal crunches, leg lifts and other resistance-type exercises.