January 7, 2000
81-year-old recovers from kidney surgery quickly, thanks to new technique
Frank Keyser, 81, really ought to be bedridden right now. But thanks to a new surgical technique, he’s able to visit his beloved spaniel Mugsy’s kennel in his Bremerton yard.
“I’m doing fine,” Keyser says. He’s climbed the stairs of their home, reports his wife, Linda, and has shown a good appetite for their daily breakfast of grapefruit, a bagel, banana and a slice of cheese.
Keyser recently had a cancerous kidney removed by Dr. James Porter at the University of Washington Medical Center. Porter is an assistant professor of urology in the UW School of Medicine.
“The use of laparoscopic surgery can dramatically reduce the recovery time for our patients,” Porter says.
It normally takes several weeks to recover from a kidney operation. But laparoscopic nephrectomy relies on small fiber-optic tubes that enter the body through half-inch incisions and can maneuver to reach the kidney. Carbon dioxide is pumped into the body to give the surgeon room to work. The surgeon can then remove the kidney in a couple of different ways. If the kidney needs to come out whole for testing, the surgeon can pull it through an incision of 3 to 4 inches, or less. If the kidney does not need to come out whole, the surgeon can slice the 2-pound organ into pieces and remove it through the original half-inch incision.
In a conventional nephrectomy, the surgeon must make a 12- to 18-inch cut nearly from the belly button to the spine, slicing through three muscle groups to get to the kidney. That’s because the doctor must be able to get both hands into the patient. Sometimes, the surgeon must remove a rib to get enough space.
The laparoscopic technique involves half, or less, of the blood loss of a conventional surgery. It also means a hospital stay of 2 1/2 days instead of six. And the patient can often return to work in three weeks instead of seven. UW Medical Center has also used laparoscopic surgery to help supply organs to people who are on long waiting lists for donations. The technique makes it much easier for a healthy person to donate their kidney to someone who needs a transplant. Patients report much less post-operative pain, Porter says, and the incision is less conspicuous.
Jodie Beebe had a relative who was a kidney transplant recipient, so she knew that kidney surgery could mean many weeks of recovery. When Beebe’s own kidney had to be removed recently because of chronic infections, Porter did it with the laparoscopic technology. She can get out of bed easily and can walk a mile in her Des Moines neighborhood. She is already planning to return to her job in a Lake Forest Park bookstore.
“I’m very fortunate to have needed the surgery at this particular time, when this technology was available,” Beebe says. “I’m up and around, and recovering well.”
Laparoscopic surgery has been around for several years. It has only been in the last few years that doctors in some parts of the country have used it to remove kidneys. Laparoscopic surgery is not appropriate in all cases, Porter says. But when it can be used, patients report they’re pleased with how quickly they are up and about.
Keyser says his incisions are healing fine. He felt good enough to sweep outside after a storm, under his wife’s watchful eye, and to wipe clean Mugsy’s eyes after the elderly pooch’s lids became encrusted.
“I’m walking around and doing everything I want to do,” Keyser says.
