Laparoscopic Cancer Surgeries

North Bay Ontario

Urology North

Call Us: +1-705-995-2490

At Urology North we strive to provide the most advanced, safe,

and technologically feasible treatments possible to our patients.

With the advances being made in minimally invasive surgery, both

Dr. Goldfarb and Dr. Pace are constantly evolving their practices to

provide the most up-to-date surgical interventions possible to the

patients of Northern Ontario.

Both Dr. Goldfarb and Dr. Pace offer laparoscopic surgical treatment

for a number of urologic oncologic cases.
The most common of these is a radical laparoscopic nephrectomy.

Sometimes, for particularly difficult cases, Dr. Goldfarb and Dr. Pace will choose to operate jointly to maximize our patient outcomes.

The Procedure

Please arrive at the surgical unit on time. You can expect that following your laparoscopic surgery that you will require a stay in hospital for a few days. This can vary greatly depending on the surgery and will be discussed with you and your family prior to the surgery date. Laparoscopic surgery (sometimes called key-hole surgery) can reduce the recovery time following the procedure due to the smaller incisions made through the abdominal wall and musculature. Rather than a large single incision, you can expect multiple smaller port site (or Key hole) incisions when you wake up after your surgery. It is also important to remember that with cancer operations it is important for prognosis to remove the entire organ "en block". For example, when removing a kidney because of a kidney mass, the entire specimen must be removed as one so the pathologist can accurately assess it. This means that often one of the port sites must be extended (leaving a slightly larger incision at one of the sites) to remove the specimen completely.

Risks

All surgical procedures have inherent risks associated with them. Despite these risks usually being low, we believe it is important that all patients who choose a surgical option are aware of the potential for unwanted outcomes.

Laparoscopic cancer operations can vary greatly in the risks associated with them. Cancer, unfortunately, can be unpredictable. As such, we strive to provide our patients with as accurate an overview of the expectations of a given surgery as we possibly can.

Generally speaking, Laparoscopic surgery for cancer does carry common risks. These include anesthetic complications such as cardiovascular issues, cardiopulmonary issues, adverse drug reactions or even death. Surgical port site infection can occur as well as port site herniations. The risk of damage to adjacent organs, the risk of bleeding, and the risk of surgical failure are all possible as is the need for conversation to an open procedure. These risks are individual to every surgery we do and we will discuss this with you at your consultation prior to proceeding to surgery.

When you arrive

Laparoscopic surgical procedures are typically done under a general anesthetic. On arrival to the hospital you will be brought to the operative suite where you will be given an anesthetic. Once this has been administered you should not feel any pain during the procedure. Please do not eat or drink anything on the day of your surgery. You can take your morning pills with a sip of water if indicated as per your pre-surgical instructions.

After Surgery

After your surgery you can expect to wake up in the recovery unit. You will be kept in this area until it is determined that it is safe to move you to a less monitored setting. Sometimes patients will require a temporary stay in the ICU (intensive care unit) following surgery to allow for ongoing monitoring. The majority of patients will then be moved to the wards for recovery over the next subsequent days. The expected care course of your specific surgery will be unique to you, and this is something that can be discussed during consultation.

When Should I Call my Doctor?

You should contact our office if significant pain persists following discharge. Any signs of infection, such as fever or chills should prompt medical evaluation.

Q&A

1. What determines if my surgery needs to be done open vs laparoscopic?

Every surgery, especially cancer surgeries, are unique. Many factors play into the decision to perform open or laparoscopic surgery. These can include: Location of the tumour, size of the tumour, blood supply to the tumour, age of the patient, health of the patient, as well as a host other considerations. These will be discussed when making a surgical plan. Sometimes other locations, such as Toronto, may be able to offer minimally invasive techniques that we simply cannot offer in Northern Ontario. In these situations we will discuss this option with you so that you can make a decision that is best for you and your family. Our goal is always to provide the best possible care for our patients. We understand that each person deserves an individualized care plan when dealing with Cancer and we strive to provide the best possible plan we can in conjunction with the patient and their family.

2. Will it hurt?

Recovery from laparoscopic surgery is often easier than with open surgery but can sometimes still be difficult. We are fortunate to have a dedicated team of nurses, physiotherapists, and home care assistants to help in the transition periods following surgery. It is common to need pain medicine following laparoscopic surgeries. Our anesthesia team is able to provide world class anesthetics, including epidurals, PCA pumps, and oral pain medications to minimize the pain associated with surgery to the best of their ability. The vast majority of patients will not need pain medication for more than 5-7 days following a laparoscopic procedure.

3. How long will it take?

The procedure length is extremely variable. Surgeries can range from less than 1 hour to greater than 8 hours. Please feel free to ask any questions during your consultation. Most patients will be able to go home from hospital within 2-3 days following a laparoscopic surgery.

4. What if I need further treatments beyond surgery?

If it is believed that further treatments could be beneficial, referrals will be made to medical and radiation oncologists associated with the North East Cancer Centre located in Sudbury, Ontario at Health Sciences North. We have an excellent working relationship with the North East Cancer Centre and will strive to work together to gain access to the best possible therapies available.