Nephrectomy Procedure – Healthnile.com

Overview

Nephrectomy refers to a surgical procedure that takes out all or part of a kidney. Surgeons mostly use it to treat kidney diseases, such as cancer or noncancerous tumors, or to prepare a healthy kidney for donation. A urologic surgeon who specializes in kidney surgeries performs this operation.

There are two main kinds of kidney removal procedures:

Type	Description
Radical Nephrectomy	Removes the entire kidney
Partial Nephrectomy	Takes out only part of the kidney

The surgeon may reach the kidney in different ways:

Open nephrectomy uses one large cut in the stomach or side.
Laparoscopic nephrectomy uses several small cuts in the stomach area.
Sometimes, robotic systems help with laparoscopic steps for improved precision.

Surgeons often handle Gerota’s fascia, a thin layer around the kidney, during this kind of surgery. The type of nephrectomy and method depend on the patient’s condition and the reason for the surgery.

Reasons for Kidney Removal Surgery

How the Kidneys Work

The kidneys play a major role in keeping the body healthy. They filter waste and extra fluids from the blood, turning these into urine, and help keep the balance of important minerals like sodium and potassium. The kidneys also produce hormones that are needed to control blood pressure, make red blood cells, and maintain bone strength.

Main Functions of the Kidneys
Filter waste and fluids
Make urine
Regulate minerals
Support blood pressure
Help bone health
Create red blood cells

When one kidney is diseased or damaged, it may not work as it should. Sometimes, only part of the kidney is affected and a partial nephrectomy, also known as nephron-sparing surgery, can remove the unhealthy tissue while saving as much of the kidney as possible.

If the entire kidney is no longer working, a more complete procedure, like a simple nephrectomy or radical nephrectomy, may be needed. For some people, surgeons remove a healthy kidney for donation to someone with kidney failure. This type of surgery is called donor nephrectomy.

Surgical Options for Tumors and Cancer

Doctors use nephrectomy as a key treatment for people with a kidney tumor or cancer such as renal cell carcinoma. The size and spread of the tumor guide the surgical plan. If the cancer is contained in one area, surgeons may use laparoscopic partial nephrectomy or open partial nephrectomy to remove just the tumor and a small part of healthy tissue around it.

For larger or more aggressive cancers, surgeons may perform open radical nephrectomy, which can involve removing the whole kidney, and sometimes nearby tissues like the adrenal gland or lymph nodes (lymphadenectomy).

Types of Surgical Approaches

Open Surgery: Traditional method with a larger incision.
Laparoscopic Surgery: Uses smaller cuts and a camera for a less invasive approach.
Robot-Assisted Surgery: Offers even more precision during procedures.

Doctors use imaging tests such as MRI, CT scans, angiography, and ultrasound to decide whether a partial or complete kidney removal is needed. These tests show where the tumor is, if it has spread, and how well the other kidney works. The main goal is to remove the cancer while keeping as much kidney function as possible.

Other Health Reasons for Kidney Removal

Doctors may remove a kidney for reasons other than cancer or tumors. They may perform a nephrectomy for chronic kidney disease, severe injury, or badly scarred tissue. These conditions can prevent the kidney from working well or may cause ongoing pain and infections. Examples of When Nephrectomy is Needed:

Long-term kidney disease needing open or laparoscopic nephrectomy.
Damage from kidney stones or injuries.
Birth defects affecting kidney functio.
When only one part of the kidney is affected, a partial nephrectomy may help preserve healthy tissue.

In some cases, surgeons may use a transperitoneal approach, depending on the person’s needs. They choose the right technique and how much kidney to remove based on the condition being treated, overall kidney health, and the best surgical technique for the patient.

Possible Risks

Kidney removal surgery is usually safe, but certain risks can occur. Bleeding can happen during or after the surgery, and in some cases, doctors may need to give a transfusion. Infection at the site of the operation or in deeper areas can also develop, so the care team monitors closely.

Sometimes people may develop pneumonia or have breathing difficulties following surgery. Injury to nearby organs can happen, although this is not common. There is also a chance of reactions to anesthesia, which can range from mild to rare but serious events.

Long-term issues may include high blood pressure, higher levels of protein in the urine, and in rare cases, the beginning or worsening of chronic kidney disease. This may result from the body working with only one kidney, though most individuals live healthy lives with a single functioning kidney.

Complication	Possible Outcome
Bleeding	May need blood transfusion
Infection	Could require antibiotics
Pneumonia	Breathing treatments needed
Anesthesia Reaction	Mild to severe effects
Organ injury	Rare, but possible
High blood pressure	Medications may help manage
Chronic kidney issues	Might need ongoing care

The risk level depends on the type of surgery, the person’s overall health, and the surgeon’s experience. Urologists with expert training can help reduce many of these risks. Speaking with a surgeon helps patients understand the specific risks in each case.

Getting Ready for Your Operation

Planning Your Time in the Hospital

Patients who need kidney surgery should ask their urologic surgeon about how long they might need to stay in the hospital. The stay can vary—a patient may go home the next day, or may need to stay a week or more. The length of stay often depends on whether the surgery uses large or small cuts and whether it is a partial or full kidney removal.

It is a good idea to make a list of questions for the care team. These may include asking about the use of general anesthesia, when to expect to start moving around after surgery, and when visitors are allowed. Patients should also ask if advanced imaging such as a CT scan or MRI is required before the procedure.

Tip: Bring comfortable clothing, as you will switch between your own clothes and a hospital gown.

Steps to Take Before Your Procedure

In the days leading up to surgery, the surgeon or nurse gives detailed instructions. Usually, patients are told when to stop eating and drinking (often midnight before surgery) to help prevent problems when given anesthesia.

Questions about continuing regular medicines are common—make sure to ask which prescription or over-the-counter drugs should be taken or stopped. Doctors may order tests like blood work or imaging before surgery. Some patients might need antibiotics or a gastric tube placed as part of their preparation, based on the type of operation. A simple checklist can help:

Task	Check When Complete
Talk with surgeon	✓
Review fasting rules	✓
List all medicines	✓
Clarify antibiotic use	✓
Know hospital arrival	✓

What You Can Expect

What Happens While You Are in Surgery

Doctors give patients medicine to help them sleep through the procedure and not feel pain. This is called general anesthesia. Before the operation begins, the medical team places a thin tube, known as a urinary catheter, to drain urine from the bladder. The type of nephrectomy may change what takes place during the operation:

Total Kidney Removal: The surgeon removes all of one kidney. Sometimes, the surgeon also takes out part of the ureter and the adrenal gland, along with a few nearby lymph nodes.
Partial Removal: The surgeon removes only the part of the kidney that is sick or damaged. The healthy part is left inside the body.

Surgical Methods

Surgical Approach	Number of Incisions	Description	Common Benefits
Open Surgery	Usually 1 large	The surgeon makes one larger cut in the abdomen or side.	Allows certain complex procedures.
Laparoscopic Surgery	Several small	The surgeon makes a few small cuts and uses a special camera called a laparoscope.	Smaller incisions, less pain, faster healing, shorter hospital stay.
Robot-Assisted Laparoscopy	Several small	A robotic system helps the surgeon perform the procedure.	Precise movements, often less blood loss and quicker recovery.

With laparoscopic or robotic methods, patients often recover faster compared to open surgery. The small incisions used with the laparoscope help reduce pain and limit scarring.

Throughout the operation, doctors work to keep pain low and help prevent any problems. The surgeon and anesthesia team pay close attention to the patient’s comfort and stability during each step.

What to Expect When Surgery Is Complete

After the operation, staff move people to a recovery area. The urinary catheter, inserted earlier, may remain for a short while to help drain urine while initial healing occurs. Recovery time depends on which type of surgery was done and the person’s overall health.

Most people stay in the hospital for several days, especially after open surgery. Those who have laparoscopic or robot-assisted operations often can go home sooner. Recovery experience may include:

Pain Control: The care team provides medications to help manage soreness around the incision sites.
Activity Recommendations: Patients can usually start light activities soon after surgery. Strenuous actions or heavy lifting should be avoided for about six weeks, or as the care team advises.
Diet and Habits: There may be short-term changes to eating or drinking, and it is important to follow instructions from medical professionals.

Patients should discuss any questions about recovery or possible side effects with the surgical team. Here’s a quick summary of key points after surgery:

The catheter is temporarily inserted.
Listen closely to recommendations on movement, food, and drink.
Watch for any signs of complications and report problems.
Full recovery often takes several weeks.

Outcomes After Kidney Removal

Checking How Well the Remaining Kidney Works

After nephrectomy, healthcare teams monitor how the remaining kidney is functioning. Common checks include:

Test Name	Purpose
Blood Pressure	High blood pressure is often linked to poor kidney health.
Protein in Urine	High levels can mean the kidney is under strain.
Glomerular Filtration Rate (GFR)	Measures how well the kidney removes waste from the blood.

Blood pressure and urine tests are important because one healthy kidney can often keep the body in balance, but problems may still develop over time. If kidney function drops, the person may need extra care or, in rare cases, dialysis. People who donated a kidney should also have lifelong follow-up exams to catch any changes early.

This also applies to patients who had kidney removal due to cancer, injury, or other diseases. Health professionals might look at other organs, like the adrenal gland, if part of it was removed or could be affected. Postoperative care may include regular clinic visits, lab work, and sometimes checking for changes in nearby lymph nodes, especially where cancer was involved.

Ways to Protect Your Remaining Kidney

Living with one kidney means some lifestyle changes can help prolong its health:

Avoid Sports That Can Cause Injury: Contact sports like football and martial arts carry some risks. If you participate, use extra padding and safety gear to lower the chance of hurting the kidney.
Keep a Healthy Diet: Eat meals with less sodium and salt to lower stress on the kidney. Stay hydrated by drinking water. A doctor or dietitian can help you create a meal plan.
Watch Your Weight: Maintain a normal body weight through exercise and balanced eating to help the kidney work its best.

Some patients need to adjust medicines after surgery since some types can strain the kidney. People who receive a kidney transplant especially need to be careful. Talk to a healthcare provider to find out which medicines and foods are safest.