Nephrectomy (Kidney Removal)
Posted July 2, 2008 1:28 AM
Posted in
(Kidney Removal)
Pronounced: Neh-FREK-toh-mee
Reasons for Procedure
Kidney removal may be done because of:
- Birth defects
- Injuries to the kidney
- Infection
- High blood pressure
- Tumor
- Chronic bleeding
- Kidney donation for a transplant
Risk Factors for Complications During the Procedure
Risk factors from anesthesia include:
- Difficulty breathing
- Reactions to the anesthesia
Risk factors from the surgery include:
- Infection
- Bleeding
What to Expect
Prior to Procedure
If a transfusion is needed either before or after surgery, it’s important that your blood samples are typed and cross-matched.
A catheter is inserted into the bladder.
Anesthesia
General anesthesia will be given. You will be asleep and will not feel pain during the procedure.
Description of the Procedure
Once the anesthesia takes effect, the surgeon makes an incision in the abdomen or side of the abdomen. A rib may need to be removed to access the kidney. The ureter (which carries urine from the kidney to the bladder) and blood vessels are cut. The kidney (or part of the kidney) is removed. The incision is then closed.
Kidneys, Ureters, and Renal Blood Vessels
© 2008 Nucleus Medical Art, Inc.
Laparoscopic surgery may also be used for nephrectomy. Generally, this approach is reserved for tumors less than 10 cm in size.The surgeon inflates the abdominal cavity with gas(CO2) and makes several key-hole size incisions. Similar to the open approach, the ureter and blood vessels are cut. The kidney (or part of the kidney) is removed. A small incision is made to retrieve the kidney.
After Procedure
You are generally encouraged to move around and be cautiously active as symptoms allow. Avoid strenuous exercise or activities for approximately six weeks.
How Long Will It Take?
The surgery will take between 3-4 hours.
Will It Hurt?
Recovery from nephrectomy is usually painful, because of the location of the incision. The laparoscopic approach is significantly less painful.
Possible Complications
Risk factors from anesthesia include:
- Difficulty breathing
- Reactions to the anesthesia
Risk factors from the surgery include:
- Infection
- Bleeding
- Damage to near-by organs
Average Hospital Stay
Typical hospital stay following nephrectomy is 2-7 days. The exact length depends on the type of surgery performed.
Postoperative Care
Intravenous fluids and pain medication are given following the surgery. Blood pressure, electrolytes, and fluid balance should all be carefully monitored. A urinary catheter is often required for a short time following surgery.
Outcome
Prognosis following nephrectomy is usually good, particularly if only one kidney or part of a kidney has been removed. If both kidneys are removed, hemodialysis or kidney transplantation is necessary.
RESOURCES:
National Cancer Institute (NCI)
http://cancernet.nci.nih.gov
National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov/
CANADIAN RESOURCES:
British Columbia Ministry of Health
http://www.bchealthguide.org
Canadian Health Network
http://www.canadian-health-network.ca
References:
Andersen MH, Mathisen L, Oyen O, Edwin B, Digernes R, Kvarstein G. Postoperative pain and convalescence in living kidney donors—laparoscopic versus open donor nephrectomy: a randomized study. Am J Transplant . 2006 Jun;6(6):1438-43.
Bartlett ST, Schweitzer EJ. Laparoscopic living donor nephrectomy for kidney transplantation. Dialysis & Transplantation .1999;28(6):318-331. Available at http://www.umm.edu/transplant/lapneph.html . Accessed February 25, 2007.
Dunn MD, Portis AJ, Shalhav AL, Elbahnasy AM, Heidorn C, McDougall EM.Laparoscopic versus open radical nephrectomy: a 9-year experience. J Urol . 2000 Oct;164(4):1153-9.
Fabrizio MD, Ratner LE, Montgomery RA, Kavoussi LR. Laparoscopic live donor nephrectomy. Johns Hopkins—Brady Urological Institute—Innovative Surgery Techniques website. Available at http://urology.jhu.edu/surgical_techniques/nephrectomy/index.html#button3 . Accessed February 25, 2007.
Wash PC, Vaughan ED, Wein AJ, Kavoussi LR, Novick A, Partin AW. Campbell’s Urology . 8th ed. Saunders; 2002.
Last reviewed March 2008 by Miguel Antelo, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.
Source: EBSCO
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