What is a nephrectomy?
A nephrectomy is a surgery in which the kidney is removed.
What is the purpose of a nephrectomy?
The most common reason to perform a nephrectomy is for the control and treatment of cancer. Other possible indications for nephrectomy include benign diseases such as advanced kidney stones, chronic infections, and some benign tumors.
There are several different variations on how a nephrectomy is performed determined primarily by the type of disease that is being treated.
- Radical nephrectomy: This is a procedure in which the entire kidney along with the surrounding connective tissue and the ureter is removed. This is most commonly performed for cancer.
- Simple nephrectomy: In this procedure, the kidney and a portion of the ureter are removed while leaving the surrounding connective tissues. This is generally performed for non-cancerous indications.
- Partial nephrectomy: In this procedure, only the tumor or diseased portion of the kidney is removed while leaving behind otherwise normal tissue. By leaving the remaining kidney, overall kidney function is improved postoperatively. This has become a common surgery for kidney cancer, but its use is restricted to only certain types and sizes of kidney tumors.
- Laparoscopic nephrectomy: Most kidneys can be removed through either a traditional open approach or a laparoscopic approach. The open approach implies performing the nephrectomy through an incision that generally ranges between 8 to 16 inches long. The laparoscopic approach utilizes surgical scopes to remove the kidney tissue. Variations of the laparoscopic approach include hand-assisted laparoscopic surgery, as well as robot-assisted laparoscopic surgery using the da Vinci Robotic System. The choice of surgery depends largely upon the size and location of the kidney tumor, as well as some specific patient issues. KCUC surgeons offer all varieties of nephrectomy.
What are common symptoms following my nephrectomy?
By the time you are discharged from the hospital, (usually 3-7 days) you should be ambulating and with good pain control with the help of pain medication. Regardless of the type of nephrectomy that is performed, it does take the body several weeks to heal following major surgery such as a nephrectomy. It is therefore common to have discomfort in the region of your incision for several weeks. Incisions gain strength over time and are strong enough for most normal activity at six weeks following surgery. It is very common to have numbness in the skin surrounding and adjacent to any large incision, especially incisions on the flank. Occasionally, muscles within the region are weak and may show signs of relaxation, thus producing a small bulge near the incision.
Fatigue is also common after kidney removal and can range from several weeks to several months depending on the patient’s age, overall health, and endurance level.
It is common to occasionally have blood in the urine following partial nephrectomy for up to several weeks. Additionally, regardless of the type of nephrectomy performed, constipation can be a common problem especially during the use of narcotic pain medication following surgery. It will be important for you to continue to monitor this closely and use over-the-counter laxatives or stool softeners as indicated.
When should I seek advice from my physician?
You should contact your physician if your wound begins to weep or bleed, if you develop fevers that are consistently above 101 degrees Fahrenheit or if you develop pain in the incision area that is not relieved with the pain medicine sent home with you by your doctor.