Scientific Editor: Editorial Board ISUD website
It is a minimally invasive procedure to partially or fully remove the kidney. Radical Nephrectomy is when the entire kidney is removed, while Partial Nephrectomy is when only a part of the kidney is removed.
Nephrectomy is usually performed to treat renal cancer. In more rare cases, it is performed for inflammations or severe renal injuries. It is also applied when there is an inactive kidney causing infections due to stagnation of urine.
The standardized preoperative preparation is carried out in hospital, including blood tests, chest X-ray and ECG (electrocardiogram).
If you are on anticoagulants, you should inform your doctor. You will be given instructions about discontinuing them for some days before the procedure and, if necessary, replacing them with low molecular weight heparin injections.
Nephrectomy can be open surgery (with skin incision), laparoscopic or robotic, under general anaesthesia. There is usually need for placing a urocatheter. When open surgery is performed, a skin incision is made so that the surgeon can have access to the kidney. In the laparoscopic method, small skin incisions are made to allow for a small high-resolution camera to be inserted and transfer the image to the screen, as well as for multiple surgical instruments to pass through and be used by the surgeon and surgical group (usually 2 assistants). As for robotic-assisted surgery, this is based on laparoscopic surgery, with the only difference that all surgical instruments are connected to an apparatus giving the potential to the surgeon to operate while sitting in front of a screen using all instruments remote from the patient.
In Radical Nephrectomy, the surgeon removes the entire kidney along with the fat that normally surrounds it. In Partial Nephrectomy, only the afflicted part of the kidney is removed.
Hospital stay depends on the surgical method and the patient’s health condition. On average, in open procedures hospital stay is 7 days (to remove sutures) and in endoscopic procedures 3 days.
Upon discharge from hospital, you will be given specific instructions.
- If you had been taking anticoagulants before, you will be informed about when to start them again.
Also, you will be instructed:
- when to start intense physical exercise
- what kind of postoperative antibiotic treatment will be required
- whether you should be followed up by an Oncologist (in case you were operated for cancer)
Most people have a perfectly normal life after having one kidney removed. However, their renal function should be checked on an annual basis, by having a simple blood test. In addition, they should follow some instructions for preserving the normal function of the remaining kidney. The most important of these instructions have to do with:
- maintaining blood pressure at normal levels
- adopting healthy nutrition -rich in fruit, vegetables, whole grain cereals and with low fat content
- limiting salt and animal protein consumption
- exercising on a regular basis