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advised."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":7,"max":14,"unit":"days","qualifier":"Early postoperative review, often with pathology results."}},{"purpose":"assessment","requirement":"routine","after":{"min":30,"max":90,"unit":"days","qualifier":"Review of recovery and renal function (creatinine/eGFR) of remaining kidney."}}],"indications":["Renal cancer unsuitable for partial nephrectomy (radical nephrectomy)","Upper tract urothelial carcinoma","Non-functioning kidney due to obstruction, chronic infection, reflux or stones","Symptomatic atrophic kidney with hypertension or recurrent infection"],"main_risks":["Bleeding, possibly requiring transfusion or conversion to open surgery","Injury to adjacent organs (bowel, spleen, liver, pancreas, vessels)","Wound infection, port-site hernia","Postoperative ileus, pneumonia, urinary tract infection","Venous thromboembolism","Reduced renal function or chronic kidney disease progression","Anesthesia-related risks and pneumoperitoneum-related effects"],"pain":"Moderate postoperative pain at port sites and shoulder-tip pain from gas, usually controlled with oral analgesia within several days; less than open surgery.","preparation":["Preoperative imaging (CT/MRI) and assessment of contralateral kidney function","Blood tests, including renal function and coagulation, and anesthesia assessment","Fasting before surgery as instructed by the anesthesia team","Review of current medications with the surgical team","Thromboprophylaxis planning and smoking cessation advice"],"recovery_timeline":[{"phase":"Hospital stay (days 0-4)","description":"Early mobilization, catheter and drain removal as applicable, diet resumption, pain control.","restrictions":["No driving","Avoid lifting"]},{"phase":"Weeks 1-2","description":"Home recovery with walking, port-site healing, gradual reduction of analgesics.","restrictions":["Avoid lifting more than about 4-5 kg","No strenuous activity"]},{"phase":"Weeks 3-6","description":"Return to desk work and light activity; fatigue gradually resolves.","restrictions":["Avoid heavy lifting and intense exercise until cleared"]},{"phase":"Weeks 6-12","description":"Return to full activity as cleared by surgeon; follow-up of renal function and pathology plan.","restrictions":[]}],"rehabilitation_days":{"min":14,"max":42,"unit":"days","qualifier":"Ordinary functional recovery to routine daily activities; formal physiotherapy not usually needed."},"result_longevity":"Kidney removal is permanent. Outcome depends on indication: for cancer, long-term control is assessed by surveillance imaging; the remaining kidney usually compensates over months.","revision_rate_pct":{"min":1,"max":4,"unit":"percent","qualifier":"Unplanned return to theatre or reoperation (bleeding, hernia, wound) within 90 days."},"scars":"Usually three to four small port-site scars (about 0.5-1.5 cm) plus one slightly longer incision (about 4-7 cm) if the kidney is extracted intact; usually fade over months.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single operation."},"stages":[{"code":"surgery","label":"Laparoscopic removal of the kidney in one operation","after":{"min":0,"max":0,"unit":"days","qualifier":"Performed on the day of surgery."}}],"qualifier":"Single-stage procedure."},"success":{"metric":"Successful completion laparoscopically without conversion to open surgery","value":97,"unit":"percent","horizon":"At surgery","population":"Adults undergoing laparoscopic nephrectomy for benign or malignant kidney disease","evidence_status":"limited"},"techniques":[{"name":"Transperitoneal laparoscopic nephrectomy","suits_whom":"Most patients, including larger tumors; offers wider working space.","recovery":"Typically 2-4 nights in hospital; return to desk work in about 2-4 weeks."},{"name":"Retroperitoneoscopic laparoscopic nephrectomy","suits_whom":"Selected patients, e.g., posterior tumors or prior abdominal surgery, with surgeon experience.","recovery":"Similar to transperitoneal approach."},{"name":"Hand-assisted laparoscopic nephrectomy","suits_whom":"Larger kidneys or bulky specimens needing hand access.","recovery":"Similar, with slightly longer hand-port incision."}],"treatment_conditions":["inpatient"],"treatment_duration_hours":{"min":2,"max":4,"unit":"hours","qualifier":"Operative time for uncomplicated adult laparoscopic nephrectomy; longer for complex cases."},"initial_assessment_documents":["Abdominal CT or MRI report with images","Recent creatinine and eGFR blood results","Biopsy report (if available)","Renal scintigraphy (DMSA) report (if available)","List of blood thinners","Previous abdominal surgery reports (if available)"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single-stage surgery; stay about 7-10 days including 2-4 hospital nights and early review. Later follow-up is done remotely or locally."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check the practitioner's experience with the surgery you plan to have, since it shows their skill with it","scope":"treatment_type","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Ask for examples of the practitioners’ experience with the surgery you are intending to have.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C2","text":"Check that the surgeon you consult is the same person who will carry out the procedure","scope":"treatment_type","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Check that the surgeon you consult with, will be the same person carrying out the procedure.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C3","text":"Check the qualifications of the medical team that will treat you","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you checked the qualifications of the medical team treating you?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C4","text":"Check that you can ask the team questions about your treatment","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you been able to ask them questions about your treatment?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C5","text":"Check that you are satisfied with the facilities and standards of the clinic or hospital","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Are you satisfied with the facilities and standards at the clinic or hospital where you'll be treated?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C6","text":"Check how your aftercare will be coordinated, since you may need care after returning","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Ensure you're clear about how your aftercare will be coordinated.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"Pressure into quick decisions or cheap, time-limited offers","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Don’t be pressured into quick decisions either through forceful persuasion or cheap, time limited offers.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F2","text":"Package deals that combine surgery with holidays","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Be wary of package deals which combine surgery with holidays – any decision to have surgery should be taken based on medical reasons only.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F3","text":"An advert or information guaranteeing complete success","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Any advert or information that guarantees complete success should raise concerns.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F4","text":"Adverts or advice that omit complications and aftercare requirements","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Make sure that any adverts or advice you receive when making your decision gives you all the necessary information, including any potential complications and aftercare requirements.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F5","text":"The clinic or surgeon cannot explain the practitioner’s experience with the planned surgery","scope":"procedure","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Ask for examples of the practitioners’ experience with the surgery you are intending to have.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Redness or swelling of the wound site","urgency":"contact_clinic","general":false,"source":{"url":"https://www.gloshospitals.nhs.uk/your-visit/patient-information-leaflets/laparoscopic-nephrectomy-and-nephroureterectomy/","host":"gloshospitals.nhs.uk","quote":"Any redness or swelling of the wound site after the operation may need further treatment.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W2","text":"Major bleeding after kidney 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sites","urgency":"contact_clinic","general":false,"source":{"url":"https://www.gloshospitals.nhs.uk/your-visit/patient-information-leaflets/laparoscopic-nephrectomy-and-nephroureterectomy/","host":"gloshospitals.nhs.uk","quote":"Infection - any cut to the skin carries a risk of infection.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"It gives home doctors important information about the admission and operation","document":"discharge summary","source":{"url":"https://www.cuh.nhs.uk/patient-information/laparoscopic-radical-removal-of-the-kidney/","host":"cuh.nhs.uk","quote":"When you leave hospital, you will be given a discharge summary of your admission.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"T2","text":"It provides results about the removed kidney and supports further treatment 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