Nephrectomy refers to the surgical removal of a kidney. A doctor may suggest removing part of or the whole kidney due to kidney cancer or a serious injury to this organ.
The kidneys are a pair of bean-shaped organs that regulate blood pressure, balance electrolyte levels, and remove waste products from the body. In some cases, a person may require medical reasons to remove their kidney. These reasons can include treating kidney cancer.
There are different techniques for carrying out a nephrectomy. A doctor may suggest a partial or complete removal of one kidney. It is possible to live a long and healthy life with only one kidney.
In this article, we will discuss the purpose, types, preparation, and risks relating to nephrectomies.
A nephrectomy may be necessary to treat kidney cancer and other kidney diseases and injuries. It is one of the main treatment options available for kidney cancer and is often successful if the disease has not spread beyond the kidney. A person may also require a nephrectomy if their kidney is not functioning properly. This can occur due to:
- chronic infections resulting in kidney scarring
- kidney stones that damage kidney tissue and cause infections
- kidney trauma
- shrunken kidneys
A surgeon can also perform a nephrectomy so a person can donate their kidney for an organ transplant. If someone has two healthy kidneys, they may consider donating one. Both the donor and recipient can live a healthy life with one functioning kidney.
There are two main types of nephrectomy: partial or radical. A partial nephrectomy is when a surgeon removes only part of the kidney. Conversely, a radical nephrectomy involves removing the entire kidney. Sometimes, a surgeon may also remove other structures, such as fatty tissue, the ureter, an adrenal gland, and some lymph nodes.
Surgeons can perform a nephrectomy using different types of procedures, such as:
- Laparoscopy: This is a minimally invasive procedure to remove a kidney. During a laparoscopic nephrectomy, a doctor will perform three to five incisions on the patient’s abdomen, about 1 cm in length, to access the organ. One of the incisions will be a bit longer and is where the surgeon will extract the kidney from the body. They then introduce a thin tube with a camera and a light to see the kidney and the surrounding tissues. The operation usually takes 2–3 hours, but it can vary depending on the case.
- Robot-assisted nephrectomy: This is similar to a laparoscopic procedure but involves a robotic assistant, such as a da Vinci Surgical Robotic System. The surgeon performs the surgery remotely, and the robotic system helps control the surgical instruments with greater precision. This approach offers many advantages but requires a skilled surgeon with training to use the robotic system.
- Open nephrectomy: This requires a single wider incision in the side of a patient’s abdomen so that the doctor can access the kidney they need to remove. The duration of the surgery is usually between 1 and 2 hours, but it can vary depending on the case. Doctors usually do not perform this type of surgery if not strictly necessary, as it is more invasive and may require removing a rib.
As with any type of surgery, nephrectomy involves potential risks and complications, such as:
- puncture of the lung cavity
- post-operative pneumonia
- kidney failure
- abdominal wall hernia
- urine infection
- cardiovascular problems such as heart attack, stroke, or blood clots
- allergic reactions to anesthesia
- fatal outcomes, in rare cases
Before the surgery, a person has tests to ensure they are a suitable candidate for surgery and will likely be able to make a good recovery. These tests mayinclude:
- a chest X-ray to check that the person’s lungs are healthy
- an electrocardiogram to check someone’s heart is healthy
- blood test to check the person’s general health and kidney function
- breathing tests, which doctors also call lung function tests
- an electrocardiogram while the person is exercising
Before the operation, a person might also meet members of their treatment team, such as:
- the surgeon
- the anesthetist
- a nurse or healthcare assistant
- the specialist cancer nurse
- the dietitian
- the physiotherapist
A person might consider asking them questions about the procedures, surgery, and any other information they may want to know more about.
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Preparation for a living donor
Before a person can donate their kidney, they need to undergo tests to ensure they are healthy and do not have conditions that may lead to kidney failure. These conditions include diabetes or hypertension.
A doctor will also check the blood compatibility of a donor with the recipient. It is also necessary to confirm if there are health problems that may lead to a kidney rejection from the recipient. Usually, a donor can live a long and healthy life without complications.
A nephrectomy is the surgical name for kidney removal. A person may require this operation due to kidney damage or the presence of kidney cancer. An individual will also undergo a nephrectomy if they choose to donate one of their kidneys. There are two main types of nephrectomy — partial and radical — which involve removing either a part of or the whole kidney.
There are also different types of procedures that a surgeon can use to perform a nephrectomy. The least invasive is laparoscopy, and robotic technology can assist in performing the surgery. The procedure is typically safe but may include risks such as bleeding, infection, and kidney failure. Following surgery, it is possible to live a long and healthy life with only one kidney.