Nephrectomy is surgical removal of the cancerous tissue. Depending upon the condition of the affected kidney and the cancerous growth nephrectomy can be:
- Partial nephrectomy – only the affected tissue is removed
- Radical nephrectomy – All of one kidney along with the neighboring adrenal gland and neighboring lymph nodes are removed
- Bilateral nephrectomy – the damage is beyond repair that both the kidneys are to be removed
A nephrectomy is just the same as any other conventional open surgery. The medical team inserts an intravenous (IV) line into one of your veins to deliver fluids and medications The patient is given general anesthesia.
The patient is made to lie on the side with the body bent sharply at the waist. This position makes the kidney more accessible to the surgical team. An angled incision is made through the skin and muscle of your side, most probably along the lower border of your ribs. This incision extends from to the front of your abdomen around your side. Occasionally a portion of one or two ribs will have to be removed to make the kidney more exposed. The organs in the vicinity are shifted aside gently. The blood vessels of the kidney and ureter are tied off and cut. The kidney is then surgically lifted out of your body. The internal and external layers of the incision are closed with sutures. A temporary drainage tube is inserted to drain fluids from the wound. After surgery, the patient is monitored for several hours. The drainage tube is removed 48 hours after the surgery. A short hospital stay of 6-7 days is required after the surgery.
The only difference here is that the incision o is made in the front of the abdomen, and extends into the lower portion of the chest. The incision is made larger than in a simple nephrectomy as here the condition is more traumatic that the adrenal gland and the surrounding lymph nodes are also to be removed along with the kidney.
Here four incisions are made in the lower abdomen and a laparoscope and small surgical instruments are inserted through them. The tiny camera mounted on the laparoscope helps the surgeon to guide the instruments so as to detach the blood vessels and ureter from the kidney. At the end of the surgery the incision located below the navel is made large enough to extract the kidney outside. A soft sling is maneuvered underneath the kidney so as to pull it out. The incisions are then sutured
Follow up visits and regular checkups are required after return from the hospital. The full recovery takes about 6-7 weeks. Even if one kidney is removed, the remaining kidney is good enough to handle the needs of the body. In case if both the kidneys are removed, dialysis or kidney transplant has to be carried out.