Nephrectomy (Kidney-Removal)

A nephrectomy is the surgical removal of one or both kidneys. The kidneys filter waste products and toxins from our blood and produce urine. We all normally have two kidneys, one on the right and one on the left. Each one is around 10 cm long. They are at the back of the upper part of our abdomen. During this procedure, either the whole kidney or just a part of it is removed:

Partial nephrectomy: Only a part of the kidney is removed.

Simple nephrectomy: The complete removal of a kidney.

Radical nephrectomy: The complete removal of a kidney along with its neighboring adrenal gland and lymph nodes.

Nephrectomy treatment duration

A laparoscopic nephrectomy takes around 2-3 hours. The duration of an open nephrectomy is shorter.

Paraclinical testing

Before the surgery, your doctor may order some blood tests, urine tests, and some images such as an ultrasound and a CT scan.

Preoperative care, the procedure, and postoperative care

Before the procedure

Consult your physician about taking blood thinners such as aspirin, warfarin, and plavix, you may have to stop taking them around 5-7 days before the surgery as they might cause a lot of blood loss during the surgery. Provide a list of all the medication, supplements, and herbal medicines that you are using. Avoid smoking as much as possible. Start fasting the midnight before the procedure. Inform your doctor if there’s a chance you might be pregnant.

The nephrectomy procedure

The procedure is done under general anesthesia. It can be done either as an open surgery or a laparoscopy.

During a laparoscopy, 3 small incisions are made on the abdomen through which the surgical tools and probe are inserted. Then, the surgeon separates and removes the kidney. If the kidney is supposed to be donated, a larger incision is made near the navel or lower abdomen to ease the extraction of the kidney.

Laparoscopic nephrectomy is more commonly used than open surgery. Depending on your condition, the doctor may decide that an open surgery is better. Laparoscopy cannot be used for a radical nephrectomy.

During an open nephrectomy, a 20-30 cm long incision is made in your abdomen. This incision may either be in the front or side of your abdomen. The surgeon may remove the last few ribs temporarily to have better access to your kidney. The kidney will be removed after cutting its connection with the bladder and closing the blood vessels.

After the procedure

Your doctor will prescribe painkillers to alleviate your pain. The medical staff will encourage you to begin doing some light activity and movements once your start feeling better. You must only consume liquids for a while after the procedure. You can start to eat solid foods once you’ve regained your appetite and passed the recovery period.

If you only had one kidney removed, the other will be able to take over its duties. Make sure to tell any doctors you visit that you’ve had a nephrectomy. You can return to your normal life 4 weeks after a laparoscopic nephrectomy and 6 weeks after an open nephrectomy. Your kidney’s function will be regularly assessed through various tests after the procedure.

When is a nephrectomy necessary?

Simple nephrectomy:

• Irreversible kidney damage due to chronic infection, urinary tract obstruction, kidney stones, or trauma
• High blood pressure due to problems in the blood vessels of the kidney or urinary reflux
• Kidney donation for a transplant

Radical nephrectomy:

Radical nephrectomy is used for patients suffering from a renal cell carcinoma (RCC) that hasn’t spread outside the kidney and its surrounding tissue.

Partial nephrectomy:

This method is used for patients suffering from kidney cancer that: has affected both of their kidneys, or has affected one kidney but it remained functional. It can also be used for patients who suffer from kidney failure in both of their kidneys. The goal of this procedure is to preserve as much functional tissue as possible.

Duration of hospitalization

You may be hospitalized for 4-6 days after the surgery.