Drogosis Achillefs Urological Surgeon Athens Greece

NEPHRECTOMY

This is the surgical procedure to remove part of or all of the kidney.

Nephrectomy

I: Radical nephrectomy and II, III, IV: Partial nephrectomy steps

In the former case, the intervention is termed a radical nephrectomy, while in the latter case it is termed a partial nephrectomy.

Indications

A nephrectomy is usually performed in order to treat localized renal cancer.

Less frequently, the nephrectomy is performed in cases of inflammation, serious traumatic injury, or in the event of a non-functioning kidney due to complications caused by this.

Preparation

During admission a pre-operative assessment is carried out which includes:

  • Urine tests
  • Blood tests
  • Chest X-ray
  • Cardiac assessment

In the event that a patient is on anticoagulant (blood thinning) medication, it is necessary to stop taking this or to substitute it with an alternative, a few days prior to the surgical procedure.

How the nephrectomy is performed

The procedure takes place under general anesthesia and may be an open, laparoscopic or robotic procedure.

In open nephrectomy, access to the kidney is through an incision into the skin.

In the laparoscopic procedure, several small cuts are made into the skin of the abdomen, through which are inserted the camera and instruments used by the surgeon and his assistants.

In robot-assisted laparoscopic nephrectomy, instrument control is effected through a machine connected to a console which allows the doctor to remotely operate on the patient.

Time spent in hospital following the nephrectomy can vary, and this depends on the procedure technique (open, laparoscopic, robot-assisted) and the general state of health of the patient, with an average length of stay in hospital of one week.

After the procedure

At discharge you will receive instructions on:

  • Resuming any anticoagulant (blood-thinning) medication you may have been taking prior to the procedure
  • How long to avoid physical exercise and strenuous activities
  • Antiobiotic medication to take at home
  • Receiving histological test results
  • Re-evaluation and the surveillance plan in the event that the surgery was for malignant disease.

The majority of patients have a normal life following nephrectomy. It is however necessary to have an annual renal function assessment through blood tests.

After the nephrectomy procedure, patients should follow certain rules which ensure the long-term functioning of the remaining kidney, such as:

  • Daily exercise and maintaining body weight within a normal range
  • Maintaining normal arterial blood pressure
  • A diet rich in fruit and vegetables, and low in fats
  • Restricted consumption of animal protein and salt