A nephrectomy is the complete or partial removal of a kidney.
A nephrectomy procedure is often recommended when there is a malignant (cancerous) or benign (non-cancerous) tumor within the kidney. The procedure might also be done if a kidney is seriously damaged or affected by disease. Adults are more likely to need surgery of this nature than children.
- Traditionally, the procedure is performed with a large incision in the abdomen or along the side.
- Today, there are less-invasive versions of a nephrectomy that may be performed.
Complete removal of a kidney is referred to a radical nephrectomy. If an open procedure is performed, the affected kidney is accessed through an incision from the front or side to allow the kidney to be examined and determine if adjacent tissue has also been affected by the tumor. If the reason for complete removal is cancer, nearby adrenal glands and lymph nodes are usually removed, along with the ureter that takes urine from the bladder to the kidney. In some situations, only the kidney may be removed (simple nephrectomy).
If a tumor is small and there are no signs that other tissues within a kidney are affected beyond the area where the tumor is located, a partial nephrectomy may be performed. The main benefit for patients is that partial removal, which is also referred to as nephron-sparing surgery, still allows the kidney that’s affected to carry out normal functions. This option may also be recommended for patients with issues related to kidney stones and those showing signs of kidney failure. Efforts are made to leave as much of the kidney in place as possible.
With this minimally invasive approach to a nephrectomy, a lighted tube with a lens attached called a laparoscope is inserted via smaller incisions in the abdomen. Some of the incisions are used for instrument placement. One of the incisions is used to remove the affected kidney. Because smaller incisions are made, there’s less risk of wound infection, and tissues often heal faster.
Also a minimally invasive procedure, a robot-assisted nephrectomy is performed with the assistance of a specially designed system. During the procedure, the surgeon sits in an area away from the patient. From here, the surgeon will be able to transfer hand movements to the robotic device. Highly precise visuals will be produced as 3D images as the kidney is removed so the surgeon can determine if all affected tissues have been removed. The primary advantage with this approach to kidney removal is the ability to control instruments with perfect steadiness. The robotic tools are also able to reach tissues that would otherwise be difficult to access with hand manipulations.
Kidney disease affects about 10 percent of the world’s population, and more than 60,000 people are diagnosed with kidney cancer each year in the United States. A nephrectomy procedure may also be necessary if a transplanted kidney is failing. A urologist will determine which form of the operation is most likely to benefit a patient.
While overall kidney functioning is normally affected if one kidney has to be partially or completely removed, most people are able to live healthy, productive lives following the procedure.