What is a Nephrectomy?

A nephrectomy is a surgical removal of a kidney or a portion of the kidney. The kidneys are located just at the back of the abdomen and protected by the lower ribs. Their function is to filter blood, which passes through them several times a day. The kidneys filter waste, regulate fluid balance, and maintain electrolyte balance. The kidneys produce urine as they filter blood, which is then excreted through the urinary tract. Because there are two kidneys, and each kidney cell (nephron) is a microscopic filter, a patient can function well after a partial or complete nephrectomy.


Indications

Patients with severe kidney damage due to disease, injury, or congenital conditions undergo nephrectomy or kidney removal. It is also indicated in

There are two types of nephrectomy procedures:

  • Partial nephrectomy is also called kidney-sparing surgery. A partial nephrectomy is a procedure in which only the diseased or infected portion of the kidney is removed. It can be done by open, laparoscopic or robotic surgery.
  • A radical nephrectomy is a surgical procedure in which the entire kidney is removed. Surgeons may also remove a section of the ureter (the tube that connects the blad They may also remove the adrenal glands located above the kidneys der to the kidneys) in a procedure known as nephroureterectomy.as well as the fatty tissue that surrounds the kidney. This procedure can also be done open, laparoscopically, or robotically.
  • A simple nephrectomy for living donor transplantation necessitates the removal of the kidney as well as a section of the attached ureter.

Procedure

Before the procedure

  • Your doctor might ask to stop taking certain medications such as blood thinners. 
  • If you don't smoke, you'll recover faster and have fewer complications after surgery. 
  • It is recommended that you should fast from midnight, the night before the surgery.
  • Your doctor will instruct you on the medications you should take on the day of the surgery.

Nephrectomy

You will have a Nephrectomy done at a hospital or outpatient center. An IV will be placed before the procedure begins. Sedatives can be given intravenously.

During the Procedure

  • In the arm or hand, an intravenous (IV) line may be started.
  • An antiseptic solution will be used to clean the skin around the biopsy site.
  • When the local anaesthetic is injected, you will feel a needle stick. There may be a temporary stinging sensation as a result of this.
  • The needle may be guided into the kidney using ultrasound or X-ray.
  • While the healthcare provider puts the biopsy needle into the kidney, you will be urged to breathe in and hold your breath. This stops the diaphragm from moving about and interfering with the biopsy needle's positioning.
  • After the needle is removed strong pressure will be applied to the biopsy site to stop bleeding.
  • A sterile dressing or bandage will be applied.
  • The kidney tissue sample will be sent to the lab for testing.

During the procedure

Your surgeon may perform laparoscopic or open surgery. You will be given general anesthesia (medication to help you stay asleep) prior to either kidney removal procedure to ensure you do not feel anything.

During an open nephrectomy,

  • Your surgeon will make one incision in the abdomen.
  • The diseased part of your kidney or your entire kidney is removed and the incision is closed with stitches.

During a laparoscopic nephrectomy,

  • Your surgeon will make one or more small incisions in your abdomen or side. 
  • Inserts a camera (laparoscope) through the incision.
  • The camera image and small surgical tools are used to remove the diseased portion of the kidney or entire kidney. 
  • All incisions are closed with small stitches that dissolve on their own.

After the procedure

  • You may be required to stay in the hospital for one to five days following surgery. The length of your hospital stay is determined by the type of nephrectomy you had.
  • Your blood pressure, electrolytes, and fluid levels will be monitored by your healthcare team. For the first few days after surgery, you will most likely need to use a urinary catheter (a hollow tube used to drain urine).
  • At first, the incision will be sore, and you may notice some numbness, too. Your healthcare team can help you with pain management, as needed.
  • Because your incision will be near your diaphragm (muscle under your lungs), it may be uncomfortable to breathe deeply. However, performing diaphragmatic breathing exercises is important for preventing pneumonia (lung infection).

Benefits

A nephrectomy can be a life-saving procedure in cases of kidney cancer. If you undergo a nephrectomy to remove a kidney for donation, your donor kidney may save the life of another person. Most people can manage with only one kidney.


Risks

All surgery has certain risks and complications. Possible complications of nephrectomy surgery include:

  • Infection
  • Bleeding (hemorrhage) requiring blood transfusion
  • Postoperative pneumonia
  • Rare allergic reactions to anesthesia
  • In addition, there is a slight risk of kidney failure in a patient with impaired kidney function or disease in the remaining kidney.

Care at Medicover

At Medicover Hospitals, we have the most experienced team of urologic surgeons providing exceptional surgical procedures such as nephrectomy to our patients. Our urologic surgeons at Medicover use a multidisciplinary approach to diagnose and treat renal conditions with utmost precision. We provide a wide variety of diagnostic and treatment procedures using the most advanced technologies and world-class equipment, bringing out the best possible outcomes.


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Frequently Asked Questions

1. What is a nephrectomy?

A nephrectomy is a surgical procedure that involves removing a kidney, either partially or completely.

2. Can a person live with one kidney after a nephrectomy?

Yes, most people can live a healthy life with just one kidney after a nephrectomy. However, they may need to make some lifestyle changes and have regular check-ups with their doctor to monitor their kidney function.

3. Why might someone need a nephrectomy?

One might need a nephrectomy to treat kidney cancer, a non-cancerous tumor, kidney disease, or severe trauma or injury to the kidney.

4. How is a nephrectomy performed?

Nephrectomy can be performed through traditional open surgery or minimally invasive laparoscopic or robotic-assisted surgery. The surgeon will determine which method is best for the individual based on their specific situation.

5. What are the risks and complications associated with a nephrectomy?

Nephrectomy carries some risks, including bleeding, infection, blood clots, damage to surrounding organs or tissues, and reaction to anesthesia. Additionally, people who undergo a nephrectomy may experience a decrease in kidney function or require dialysis in the future.

6. Who performs nephrectomy?

Urologic surgeon performs nephrectomy.

7. Is nephrectomy a high risk surgery?

Nephrectomy is a relatively safe procedure. However, as with any surgery, there are risks of complications such as infection and bleeding.

8. Which surgery is best for kidney removal?

A nephrectomy is best for the surgical removal of a kidney. A partial nephrectomy may be performed by your surgeon to remove only a portion of your kidney.
Alternatively, you could have a radical nephrectomy, in which your surgeon removes your entire kidney. A nephrectomy can save your life if you have kidney disease or cancer.

Citations

https://www.kidney.org/atoz/content/nephrectomy#
https://urology.ufl.edu/patient-care/robotic-laparoscopic-urologic-surgery/procedures/laparoscopic-radial-nephrectomy/
https://www.rwjbh.org/monmouth-medical-center/treatment-care/surgery/surgical-services/minimally-invasive-surgery/minimally-invasive-surgical-procedures/nephrectomy-removal-of-the-kidney-/
https://urology.ufl.edu/patient-care/robotic-laparoscopic-urologic-surgery/procedures/laparoscopic-radial-nephrectomy/