What Is a Nephrectomy (Kidney Removal), Types, Reasons, Preparation for Nephrectomy, After a Nephrectomy Surgery
A nephrectomy is a surgical procedure in which one or both of the kidneys is removed. The kidneys are vital organs that play a crucial role in filtering waste products and excess fluids from the blood to form urine.
The main types of nephrectomy are:
Total Nephrectomy: In this procedure, the entire kidney is removed. It is typically performed when the kidney is non-functioning, damaged, or affected by a large tumor.
Partial Nephrectomy (Nephron-Sparing Surgery): Only the diseased or damaged part of the kidney is removed, leaving the healthy tissue intact. This is often done to preserve kidney function, especially when dealing with small tumors or localized kidney disease.
Open Radical Nephrectomy: This traditional surgical approach involves making a large incision to remove the entire kidney along with surrounding tissues, adrenal gland, and sometimes nearby lymph nodes. It is commonly used for large tumors or cases where cancer has spread to nearby structures.
Laparoscopic Radical Nephrectomy: This is a minimally invasive approach where small incisions are made, and a laparoscope (a thin, flexible tube with a camera) is used to guide the surgical instruments. Laparoscopic surgery generally results in a quicker recovery time and less postoperative pain compared to open surgery.
Robotic-Assisted Radical Nephrectomy: Similar to laparoscopic surgery, this approach involves the use of a robotic system to perform the surgery. The surgeon controls the robotic arms from a console, allowing for increased precision.
Open Donor Nephrectomy: In the context of kidney donation for transplantation, an open surgical procedure may be performed. The surgeon makes an incision, usually on the side or front of the donor, to remove one kidney.
Laparoscopic Donor Nephrectomy: This minimally invasive approach is becoming more common for kidney donation. Small incisions are made, and a laparoscope is used to guide the removal of the kidney. Laparoscopic donor nephrectomy is associated with shorter recovery times and reduced postoperative pain compared to open surgery.
Nephrectomy may be performed for various medical reasons, including:
Removal of a diseased or damaged kidney may be necessary to improve overall health and prevent further complications.
Nephrectomy is a common treatment for kidney cancer. Depending on the extent of the cancer, either a partial nephrectomy (removing only the tumor and a small portion of healthy tissue) or a radical nephrectomy (removing the entire kidney) may be performed.
In the case of kidney transplantation, a healthy individual may undergo a nephrectomy to donate one of their kidneys to someone in need. This is typically a voluntary procedure, and the remaining kidney usually compensates for the loss of the donated kidney.
There are different approaches to performing a nephrectomy, including open surgery, laparoscopic (minimally invasive) surgery, and robotic-assisted surgery. The choice of approach depends on various factors such as the reason for the nephrectomy, the patient’s overall health, and the surgeon’s expertise. Each approach has its advantages and disadvantages, and the decision is made based on the specific circumstances of the individual case.
Your healthcare will provide you with preparation instructions prior to kidney surgery. Some medications, like blood thinners, must be stopped in the days leading up to the procedure. Additionally, the night before the procedure, your surgeon would likely advise you to fast (not eat) and avoid drinking any liquids.
Blood will be drawn by your healthcare provider a few days prior to the procedure. This test establishes your blood type, basic kidney function, and blood counts in case you require a blood transfusion.
Your surgeon might do open or laparoscopic procedures. You will be given general anaesthesia, a drug that keeps you unconscious, before to either kidney removal process to make sure you don’t feel anything.
Your surgeon will do a laparoscopic nephrectomy and:
Makes a single or more tiny incisions on your side or abdomen.
Makes an incision and inserts a long wand with a camera (laparoscope).
Sees the laparoscope’s camera image on a huge screen.
Removes the damaged kidney or the entire kidney using a camera image and tiny surgical instruments.
Closes all incisions with tiny stitches that will disappear on their own.
During an open nephrectomy surgery, your surgeon will:
Makes one incision in your abdominal.
Removes your kidney, the diseased area or the entire kidney.
Uses stitches to seal the incision.
Here are some general aspects of what to expect after a nephrectomy:
Hospital Stay: The length of the hospital stay varies depending on the type of nephrectomy performed and individual factors. Patients undergoing a simple or partial nephrectomy may have a shorter hospital stay compared to those undergoing a radical nephrectomy.
Pain Management: Pain is common after surgery, and the medical team will provide pain relief medications. It’s important to communicate any pain or discomfort to the healthcare providers so that they can adjust the pain management plan accordingly.
Mobility and Activity: Initially, movement may be restricted, but patients are encouraged to gradually increase their activity level as tolerated. Walking is often encouraged to prevent complications like blood clots and promote circulation.
Dietary Changes: In the immediate postoperative period, the patient may be on a restricted diet, starting with clear liquids and progressing to solid foods as tolerated. It’s essential to follow any dietary guidelines provided by the healthcare team.
Monitoring Vital Signs: Vital signs such as blood pressure, heart rate, and respiratory rate will be monitored regularly during the recovery period.
Catheter Removal: If a urinary catheter was placed during surgery, it is usually removed once the patient is able to empty their bladder independently.
Follow-Up Appointments: Patients will have follow-up appointments with their surgeon to monitor recovery, discuss any concerns or complications, and address questions about the healing process.
Incision Care: Proper care of the surgical incision is crucial for preventing infection and promoting healing. Patients will receive instructions on how to care for the incision site and when to contact their healthcare provider if any signs of infection or other issues arise.
Resuming Normal Activities: The timeline for resuming normal activities varies from patient to patient and depends on the type of surgery performed. Generally, patients are advised to avoid heavy lifting and strenuous activities for a certain period, as recommended by their surgeon.
Emotional Support: Recovery from surgery can be both a physical and emotional process. Patients may experience a range of emotions, and having a support system in place can be beneficial. It’s essential to communicate any emotional concerns to healthcare providers.
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