Radical and Partial Nephrectomy
What is a Nephrectomy?
A nephrectomy is the surgical removal of the kidney. Partial nephrectomy is when only a portion of the kidney needs to be removed. Whereas, radical nephrectomy is the removal of the entire kidney. Along with the kidney, the fatty tissue that surrounds it, the connecting ureter for the kidney, and the adrenal gland connected to the said kidney. This type of procedure is usually required in cases where tumors are present. Your doctor will perform a laparoscopic or open nephrectomy to remove the disease area and or the remainder of the kidney.
Laparoscopic Vs. Open Nephrectomy
There are two main types of surgery to remove the kidney. An open nephrectomy entails incisions in the abdomen which will later be stitched up. Once the patient has their abdomen open, the surgeon will remove the ureter, kidney, and adrenal gland. On the other hand, laparoscopic nephrectomy is going to be the standard option. In this case, a laparoscope is used to get a visual presentation of the body. Your surgeon will make small incisions in the abdomen to fit the laparoscope into the body. Using the tiny camera on the scope, the doctor will perform the surgery within the body and use the tools to remove the portion of the kidney that is diseased.
da Vinci System
Robotic-assisted kidney surgery can be performed using da Vinci technology. The da Vinci system is a tool used for minimally invasive surgery, but it does not treat cancer.The da Vinci system makes it possible to perform surgery through a few small incisions about the size of your fingertip. With the da Vinci system, your surgeon sits at a console near you in the operating room. The console enables your surgeon to control a camera and the tiny instruments used to perform your surgery.
The system delivers 3D high-definition views, giving your surgeon a crystal-clear view of the surgical area magnified 10 times what the human eye sees. It translates every movement your surgeon makes in real time, bending and rotating instruments that move like a human hand, but with a greater range of motion. Built-in tremor filtration technology helps your surgeon move each instrument with smooth precision.
After the surgery is concluded, you will be placed on a monitor for multiple hours to ensure that the blood levels are stable. Also, your waste filtration systems and urine protein levels will be measured for healthy kidney function. Hospital stays will most likely last 1 – 7 days. Afterward, you will be sent home with post-operative instructions from your healthcare provider. Strenuous activities of any kind should be avoided at all costs. If you have any questions or concerns about pain or your recovery, contact your healthcare provider as soon as possible.
Risks and Complications of Nephrectomy Surgery
All surgery has certain risks and complications. Possible complications of nephrectomy surgery include:
- Bleeding (hemorrhage) requiring blood transfusion
- Post-operative pneumonia
- Rare allergic reactions to anesthesia
There is also a small risk of kidney failure in a patient with lowered function or disease in the remaining kidney.
Quick Fact: You are born with two kidneys, but you really only need one. A single healthy kidney can work as well as two kidneys, but if both kidneys are removed, dialysis or a transplant is necessary to maintain life.
The risks of donor nephrectomy for kidney transplantation are very small. This is likely because almost all living donors undergo careful pre-op testing and evaluation to make sure they are healthy enough for surgery. Most studies report death rates for donor nephrectomy in the range of 1 or 2 per 10,000 donor surgeries. About 1 or 2 per 100 patients may experience a post-operative wound infection or complication and about half of these patients may require re-operation for a complication.
The vast majority of kidney donors live long and healthy lives with one kidney.