Laparoscopic Cystectomy With Ileal Conduit
What you should know
Laparoscopic Cystectomy With Ileal Conduit (Precare) Care Guide
- Laparoscopic Cystectomy With Ileal Conduit Aftercare Instructions
- Laparoscopic Cystectomy With Ileal Conduit Discharge Care
- Laparoscopic Cystectomy With Ileal Conduit Inpatient Care
- Laparoscopic Cystectomy With Ileal Conduit Precare
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- A cystectomy is a surgery to remove your bladder. Your bladder is the organ that holds the urine in your body before you urinate. Normally, your urine passes from your kidneys into your bladder through tubes called ureters. Your urine then moves out of your bladder through a tube called your urethra. You may need a cystectomy if your bladder does not work. You also may need a cystectomy if your bladder or kidneys are damaged. In a laparoscopic cystectomy, small incisions (cuts) are made in your abdomen. Caregivers will put tools and a scope with a camera on it through these cuts to remove your bladder.
- After your bladder is removed, your ureters are connected to a piece of your bowel. This creates a passage called an ileal conduit. This passage drains your urine out of your body through a hole in your abdomen. This hole is called a stoma and is attached to a bag that collects your urine. With an ileal conduit, urine may leave your body even when your bladder is not working. An ileal conduit may help prevent damage to your kidneys. If you have cancer, a cystectomy may help treat it and decrease the risk of it spreading to other parts of your body.
Care AgreementYou have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.
- Your caregiver may switch to an open surgery and make a large cut on your abdomen. After surgery, your abdomen may be swollen or painful. You may feel more tired than usual, lose your appetite, and lose weight. The skin around your stoma or wound (surgery cut) may become red, infected, or pull apart. Your stoma may leak urine. You may have an organ in your abdomen push through your stoma. You may get an infection or small stones in your ureters or kidneys. Your ureters, conduit, or bowels may become blocked, which may stop you from urinating or having a BM.
- You may bleed more than expected and need a blood transfusion. Your bowel may leak inside your abdomen and cause a serious infection. Your lungs may become infected, you may have trouble breathing, and you may have a heart attack. You may die from some of these problems. You may get a blood clot in your leg. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot may break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.
- Without surgery, your bladder problems may get worse. If you have cancer, it may spread to other parts of your body. Call your caregiver if you have questions or concerns about your cystectomy, medicine, or care.
Before your surgery:
- Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
- Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
- Your caregiver will ask about your current and past health. He will ask if you have had any surgeries. Tell your caregiver if you have any bleeding problems or problems with your heart or lungs.
- If you smoke, your caregiver may ask you to stop smoking before your surgery. Smoking may slow down your healing after your cystectomy. Ask your caregiver for more information about how to stop smoking if you are having trouble quitting.
- You may meet with a caregiver to talk about taking care of your stoma after your cystectomy. Together you may decide the best place in your abdomen for your stoma. Often your stoma will be placed in the lower part of your abdomen below your belly button.
- You may need to take an antibiotic medicine before your surgery. This medicine helps kill bacteria that may cause an infection.
- Your caregiver may ask you to stop taking certain medicines before your surgery. Do not stop taking any medicines unless your caregiver tells you to stop.
- You may need a blood transfusion if you lose a large amount of blood during surgery. Some people are worried about getting AIDS, hepatitis, or the West Nile virus from a blood transfusion. The risk of this happening is very low. Blood banks test all donated blood for AIDS, hepatitis, and the West Nile virus. You may be able to donate your own blood before surgery. This is called autologous blood donation. This must be done no later than three days before surgery. You may also ask a family member or friend with the same blood type to donate blood for you. This is called directed blood donation.
- You may need to have tests done on your blood and urine. You may have imaging tests, such as an x-ray or a computed tomography (CT) scan. You also may need a heart test, such as an electrocardiogram (EKG) or echocardiogram. Your caregiver may need to look inside your bowel with a small camera. Ask your caregiver for more information about tests that you may need. Write down the date, time, and location of each test.
The night before your surgery:
- You may need to drink only liquids for a day or two before your surgery. Ask your caregiver about directions for eating and drinking before your surgery.
- You may need to empty your bowels before surgery. Your caregiver may ask you to take medicine or drink liquid that will help you have bowel movements (BM).
The day of your surgery:
- Write down the correct date, time, and location of your surgery.
- You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
- Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
- An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.
What will happen:
- You will be taken to the room where you will have surgery and moved to a table. Your skin will be cleaned and sheets will be put over you to keep your surgery area clean. Your caregiver will make small incisions (cuts) on your abdomen. Your caregiver will put tools in these incisions and remove your bladder. He also may remove lymph nodes and other organs. Your lymph nodes are lumps of tissue that help fight infection. Your caregiver may use a machine to do your surgery, which he controls from a computer.
- Your caregiver will cut off a small part of your bowel and connect your ureters to make the conduit. Your caregiver also will make an opening in your abdomen for a stoma. He will attach the conduit to the stoma and use stitches to reconnect your bowels. Your caregiver may put drains (tubes) in your abdomen to remove extra fluid from the surgery area. Your caregiver will close your cuts with stitches and staples.
After your surgery:
You will be taken to a room where you can rest until you are awake. Your caregiver will decide when it is okay for you to be taken to your hospital room. Do not try to get out of bed until your caregiver says it is okay. A caregiver may help you start walking. Caregivers will measure the urine in your bag and the fluid in your drains. Your caregivers may remove your drains and other tubes.
This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.
Contact a caregiver if
- You cannot make it to your surgery.
- You see blood in your urine.
- You have a fever (high body temperature).
- You get sick with a cold or the flu.
Seek Care Immediately if
- You are unable to urinate.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.