A nephrectomy is a surgical procedure to remove part or all of the kidney. Depending on the reason for this surgery, the procedure may involve removing thedamaged or diseased part of one kidney, all of one kidney, or the removal of the entire kidney and the surrounding adrenal gland and lymph nodes. All nephrectomies are performed under general anesthesia.

The kidneys' function is to filter the blood. All the blood in our bodies passes through the kidneys several times a day. The kidneys remove wastes, control the body's fluid balance, and regulate the balance of electrolytes in the body. As the kidneys filter blood they create urine, which is then excreted through the urinary tract. Since there are two kidneys and since each kidney cell, or nephron, is a microscopic filter, a patient can function well after a partial or complete nephrectomy.

Reasons for Nephrectomy

Removal of a kidney is a serious procedure, never undertaken lightly since the kidneys are vital organs. The kidneys are located at the back of the abdomen, protected by the lower ribs. Reasons for a nephrectomy include:

  • Congenital defect
  • Kidney damage due to kidney stones or disease
  • Kidney cancer
  • Traumatic injury
  • Severely high blood pressure
  • Kidney donation

Types of Nephrectomy

The type of nephrectomy performed depends on the reason for the procedure. There are three types of nephrectomy:

Partial Nephrectomy

During a partial nephrectomy only the damaged or diseased part of the kidney is removed. This procedure is frequently performed to treat cancer of the kidney.

Simple Nephrectomy

A simple nephrectomy involves the removal of an entire kidney. This operation may be performed to remove a diseased or severely injured organ or to remove a kidney for donation.

Radical Nephrectomy

A radical procedure is a more complex procedure. During this surgery, the entire kidney, the surrounding lymph nodes, and the adjacent adrenal gland are all removed. This procedure may be performed when a malignancy of the kidney has spread to surrounding tissue.

Nephrectomy Procedure

A nephrectomy can be performed one of two ways, each of which offers its own benefits. The doctor will decide which technique is best based on the patient's condition and overall health. The two types of nephrectomy are:

Open nephrectomy

An open nephrectomy, the traditional type of surgery, involves a major incision in the patient's abdomen or side. This procedure offers better access to the kidneys, as well as to other organs, for more complicated cases.

Laparoscopic nephrectomy

A laparoscopic nephrectomy, which is less invasive, involves four smaller incisions and the utilization of a tiny camera and small instruments. This procedure has many advantages over traditional surgery since it involves less bleeding, scarring, pain and a shorter recovery time. It is not, however, appropriate in all cases.

Risks of Nephrectomy

There are risks involved with any surgical procedure which include the following:

  • Excessive bleeding
  • Deep vein thrombosis
  • Adverse reactions to anesthesia or medications
  • Post-surgical infection
  • Damage to adjacent organs
  • Breathing problems

Risks for nephrectomy in particular are:

  • Kidney malfunction or failure in the remaining kidney
  • Hernia of your surgical wound

Recovery from Nephrectomy

Depending on the type of nephrectomy performed, the patient willl stay in the hospital for two to seven days and will then continue the recovery process at home. Patients who undergo a laparoscopic nephrectomy will usually recover in four weeks; those having an open nephrectomy may expect to spend at least six weeks in recovery. Strenuous physical activity may be restricted for a somewhat longer period. During the hospital stay the patient should expect:

  • To be catheterized for 24 to 48 hours
  • To have a drain from the surgical wound
  • To be unable to eat for a few days and then to begin ingesting a liquid diet
  • To be encouraged to do breathing exercises
  • To wear special stockings and/or to medications to prevent blood clots.

Many healthy patients can function normally with their remaining kidney, while others with more advanced kidney disease may require a kidney transplant or long-term dialysis treatment.

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