Kidney removal
Definition
Kidney removal, also called
nephrectomy, is surgery to remove all or part of a kidney. You may
be having:
- Part of one kidney removed
(partial nephrectomy)
- All of one kidney removed
(simple nephrectomy)
- Removal of all of one kidney,
lymph nodes, and the adrenal gland (radical
nephrectomy)
Alternative Names
Nephrectomy; Simple nephrectomy;
Radical nephrectomy; Open nephrectomy; Laparoscopic nephrectomy;
Partial nephrectomy
Description
This surgery is done in the
hospital while you are asleep and pain-free (general anesthesia). The procedure can take 3
hours.
For simple nephrectomy or open
kidney removal:
- You will be lying on your side.
Your surgeon will make an incision (cut) up to 12 inches long. This
cut will be on your side, just below the ribs or right over the
last ribs.
- Muscle, fat, and tissue are cut
and moved. Your surgeron may need to remove a rib to do the
procedure.
- The tube that carries urine from
the kidney to the bladder (ureter) and blood vessels are cut away
from the kidney. The kidney is then removed.
- Sometimes, just a part of the
kidney may be removed
- The cut is then closed with
stitches or staples.
For radical nephrectomy or open
kidney removal:
- Your surgeon will make a cut
about 8 to 12 inches long. This cut will be on the front of your
belly, just below your ribs. It may also be done through your
side.
- Muscle, fat, and tissue are cut
and moved. The tube that carries urine from the kidney to the
bladder (ureter) and blood vessels are cut away from the kidney.
The kidney is then removed.
- Your surgeon will also take out
the adrenal gland and some lymph nodes.
- The cut is then closed with
stitches or staples.
For laparoscopic surgery:
- Your surgeon will make three or
four small cuts, usually no more than 1-inch each, in your belly
and side. The surgeon will use tiny probes and a camera to do the
surgery.
- Towards the end of the
procedure, your doctor will make one of the cuts larger (around 4
inches) to take out the kidney.
- The surgeon will cut the ureter,
place a bag around the kidney, and pull it through the larger
cut.
- This surgery takes longer than
an open kidney removal. Most people recover faster and feel less
pain afterwards.
Sometimes, your surgeon may make
a cut in a different place than described above.
Some hospitals and medical
centers are doing this surgery using robots. See also: Robotic surgery
Why the Procedure Is Performed
Kidney removal may be recommended
for:
- Someone donating a
kidney
- Birth defects
- Kidney cancer
- A kidney damaged by infection,
kidney stones, or other
problems
- To help control high blood pressure in someone who has
problems with the blood supply to their kidney
- Very bad injury (trauma) to the
kidney that cannot be repaired
Risks
Risks for any surgery
are:
Risks for this procedure
are:
- Injury to other organs or
structures
- Kidney failure in the remaining
kidney
- After one kidney is removed,
your other kidney may not work as well for a while
- Hernia of your surgical
wound
Before the Procedure
Always tell your doctor or
nurse:
- If you could be
pregnant
- What drugs you are taking, even
drugs or herbs you bought without a prescription
During the days before the
surgery:
- You will have blood samples
taken in case you need a blood transfusion.
- You may be asked to stop taking
aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn),
Clopidogrel (Plavix), warfarin (Coumadin), and other drugs like
these.
- Ask your doctor which drugs you
should still take on the day of the surgery.
- Always try to stop smoking. This
will help you to recover quicker. Your doctor or nurse can
help.
On the day of the
surgery:
- You will usually be asked not to
drink or eat anything after midnight the night before the
surgery.
- Take the drugs your doctor told
you to take with a small sip of water.
- Your doctor or nurse will tell
you when to arrive at the hospital.
After the Procedure
You will stay in the hospital for
2 to 7 days, depending on the type of the surgery you have. During
a hospital stay, you may:
- Be asked to sit on the side of
the bed and walk on the same day at surgery
- Have a tube, or catheter, that
comes from your bladder
- Have a drain that comes out
through your surgical cut
- Not be able to eat the first 1
to 3 days, and then you will begin with liquids
- Be encouraged to do breathing
exercises
- Wear special stockings to
prevent blood clots
- Receive shots under your skin to
prevent blood clots
- Receive pain medicine into your
veins or pills
Recovering from open surgery may
be painful because of where the surgical cut is. Recovery after a
laparoscopic procedure is usually quicker, with less
pain.
Outlook (Prognosis)
The outcome is usually good when
a single kidney is removed. If both kidneys are removed, or the
remaining kidney does not work well enough, you will need hemodialysis or a kidney transplant.
References
Novick AC. Open surgery of the
kidney. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed.
Philadelphia, Pa: Saunders Elsevier; 2007:chap 50.
Review Date: 3/4/2009
Reviewed By: Louis S. Liou, MD, PhD, Assistant Professor of
Urology, Department of Surgery, Boston University School of
Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director,
A.D.A.M., Inc.
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