Nephrectomy surgery removes part or all of a kidney. Doctors usually recommend this operation only when a serious condition damages the kidney or threatens the patient’s health.
Depending on the condition, the surgeon may remove only the affected section. In other cases, the surgeon may need to remove the entire kidney.
Why Is Nephrectomy Surgery Needed?
A doctor may recommend nephrectomy surgery for several reasons. The final decision depends on kidney function, test results and the patient’s general health.
1. Kidney Cancer
Kidney cancer is a common reason for nephrectomy surgery. The surgeon may remove the tumour and a small amount of nearby healthy tissue.
However, larger or more complex tumours may require removal of the entire kidney. The doctor selects the procedure after reviewing scans and other test results.
2. Severely Damaged Kidney
A kidney may lose most or all of its function because of stones, blockage, injury or another disease. If the damaged kidney causes ongoing problems, the doctor may recommend removal.
3. Repeated Kidney Infections
A poorly functioning kidney may cause repeated or serious infections. In selected cases, removing that kidney can help control the problem.
4. Difficult-to-Control High Blood Pressure
Rarely, a severely damaged kidney may contribute to high blood pressure. The doctor may consider nephrectomy when other treatments do not control the condition.
5. Kidney Abnormalities Present from Birth
Some people are born with an abnormal kidney. Surgery may become necessary if the kidney causes pain, infection, blockage or other health problems.
6. Living Kidney Donation
A healthy person may choose to donate one kidney to someone who needs a transplant. Doctors perform detailed tests before approving a living kidney donor.
7. Severe Kidney Injury
A serious accident or injury can badly damage a kidney. Doctors try to preserve the kidney when possible. However, severe bleeding or damage may require removal.
Types of Nephrectomy Surgery
There are two main types of nephrectomy. The surgeon chooses the most suitable type according to the patient’s condition.
Partial Nephrectomy
During a partial nephrectomy, the surgeon removes the tumour or damaged area. The surgeon preserves the healthy part of the kidney whenever possible.
This method can help maintain kidney function. Therefore, doctors may prefer it for suitable small kidney tumours.
Radical Nephrectomy
During a radical nephrectomy, the surgeon removes the entire kidney. The surgeon may also remove nearby fatty tissue or other structures when medically necessary.
However, the surgeon does not remove the adrenal gland in every case. The treatment plan depends on the disease and its location.
Approaches to Nephrectomy Surgery
Surgeons can perform nephrectomy through open, laparoscopic or robot-assisted surgery. Each approach has different advantages and limitations.
Laparoscopic Nephrectomy
The surgeon makes several small cuts in the abdomen or side. The surgeon then inserts a camera and special instruments through these openings.
Carbon dioxide gas gently creates working space inside the abdomen. As a result, the surgeon can see and reach the kidney more clearly.
Robot-Assisted Nephrectomy
Robot-assisted surgery also uses small cuts. However, the surgeon controls robotic instruments from a nearby console.
This system can support careful movement during complex surgery. Nevertheless, the surgeon remains in full control throughout the operation.
Open Nephrectomy
During open surgery, the surgeon makes one larger incision. This approach may help with large tumours, severe injuries or complex conditions.
Open nephrectomy usually requires a longer recovery. Even so, it may provide the safest option for certain patients.
Nephrectomy Surgery: Step-by-Step Procedure
1. Preoperative Preparation
First, the medical team reviews the patient’s health and treatment plan. The doctor may request blood tests, urine tests and imaging scans.
A CT scan or MRI can show the kidney and nearby organs. These images help the surgeon plan the operation.
Patients should tell the doctor about all medicines and supplements they take. In particular, they should mention blood-thinning medicines.
The hospital also provides fasting instructions. Patients must follow these directions carefully before surgery.
2. General Anaesthesia
The anaesthesia team gives general anaesthesia before the operation. This medicine keeps the patient asleep during surgery.
The team also supports breathing and checks the patient’s vital signs. These include heart rate, oxygen level and blood pressure.
3. Patient Positioning
The surgical team places the patient in a suitable position. Often, the patient lies on one side to provide access to the kidney.
However, the exact position may vary. The team then cleans and prepares the surgical area.
4. Surgical Access
For laparoscopic or robot-assisted surgery, the surgeon makes several small cuts. The surgeon passes a camera and instruments through these openings.
For open surgery, the surgeon makes a larger cut in the abdomen or side. The surgeon chooses the location according to the planned operation.
5. Separating the Kidney
Next, the surgeon carefully separates the kidney from nearby tissue. The surgeon also identifies the kidney’s main blood vessels and the ureter.
The renal artery carries blood to the kidney. Meanwhile, the renal vein carries blood away from it.
The surgeon safely controls and divides these blood vessels. The surgeon also divides the ureter when removing the entire kidney.
6. Removing the Kidney or Tumour
During partial nephrectomy, the surgeon removes only the tumour or damaged section. Afterwards, the surgeon repairs the remaining kidney.
During radical nephrectomy, the surgeon removes the whole kidney. The surgeon may remove additional nearby tissue if the condition requires it.
In minimally invasive surgery, the surgeon places the specimen in a protective bag. The surgeon then removes it through one of the incisions.
7. Closing the Incisions
The surgeon checks the area for bleeding before completing the operation. If necessary, the surgeon places a temporary drain.
Finally, the surgeon closes the incisions with stitches, staples or surgical glue. The team then covers the area with a sterile dressing.
Recovery After Nephrectomy Surgery
After surgery, the medical team moves the patient to a recovery area. Staff check breathing, blood pressure, pain and urine output.
The patient may receive fluids and pain medicine. A urinary catheter may also remain in place for a short time.
At first, the patient may receive liquids. Afterwards, the medical team gradually adds normal food.
Early movement can help reduce certain recovery risks. Therefore, staff usually encourage gentle walking when it becomes safe.
Hospital Stay
The length of the hospital stay varies. Patients who undergo minimally invasive surgery may leave sooner than patients who undergo open surgery.
However, the patient’s health and recovery progress determine the discharge date. The surgeon will decide when the patient can safely return home.
Recovery at Home
Patients should keep the wound clean and follow all medicine instructions. They should also avoid heavy lifting until the surgeon gives permission.
Recovery may take several weeks. However, each person heals at a different rate.
Living With One Kidney
Many people can live an active life with one healthy kidney. The remaining kidney often performs the work needed by the body.
However, regular health checks remain important. The doctor may monitor kidney function, urine protein and blood pressure.
Patients should also follow medical advice about food, fluids, exercise and medicines. These steps can help protect the remaining kidney.
Possible Risks
Like every major operation, nephrectomy surgery has possible risks. These may include:
- Bleeding
- Infection
- Blood clots
- Reaction to anaesthesia
- Injury to a nearby organ
- Temporary or long-term kidney function problems
- Pain or wound complications
The surgeon should explain the personal benefits and risks before the operation.
Conclusion
Nephrectomy surgery removes part or all of a kidney. Doctors may recommend it for cancer, severe kidney damage, repeated infection or living kidney donation.
The surgeon may use open, laparoscopic or robot-assisted surgery. The choice depends on the condition and the patient’s health.
Patients should discuss the procedure and recovery plan with a qualified urologist. The doctor can provide guidance based on the individual diagnosis.
This article provides general educational information. It does not replace professional medical advice, diagnosis or treatment.
