1. What is it? Any common name for this procedure?
A Nephrectomy is the surgical removal of all or part of a kidney. The kidneys are bean-shaped organs responsible for filtering waste from the blood and producing urine. Depending on the reason for surgery, a surgeon may remove just the diseased portion or the entire organ, including the surrounding fat and sometimes the adrenal gland.
Common Names:
- Kidney Removal Surgery
- Partial Nephrectomy (Kidney-sparing surgery)
- Radical Nephrectomy (Complete removal)
2. Common Indications: When is it Recommended?
Nephrectomy is the primary treatment for several kidney-related conditions:
- Kidney Cancer (Renal Cell Carcinoma): To remove a tumor.
- Benign Tumors: Large non-cancerous growths that cause pain or bleeding.
- Severely Damaged Kidney: Due to chronic infection, scarring, or heavy stone disease that has caused the kidney to stop functioning.
- Congenital Abnormalities: Birth defects that lead to chronic health issues.
- Living Donation: Removing a healthy kidney from a donor to be transplanted into a recipient.
3. List of Associated Risks and Conditions
- Reduced Kidney Function: If the remaining kidney is not perfectly healthy, there is a risk of developing chronic kidney disease (CKD).
- Post-operative Hernia: Weakness at the incision site, particularly in open surgeries.
- Pneumothorax: A rare risk of a collapsed lung due to the kidney’s proximity to the diaphragm.
- High Blood Pressure: The kidneys play a major role in regulating blood pressure; removing one can sometimes cause fluctuations.
4. List of Screening Tests and Assessment Tools
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Tool
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Purpose
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CT Urogram / MRI
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To map the tumor's size, its blood supply, and its proximity to the ureter.
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Renal Function Test (eGFR)
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To check how well both kidneys are currently filtering blood.
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Renal Scintigraphy (DMSA/DTPA)
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A nuclear scan to determine exactly what percentage of work each kidney is doing.
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Biopsy:
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Occasionally done to see if a mass is cancerous, though many surgeons prefer to go straight to surgery if imaging is clear.
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5. Am I Eligible for This Evaluation?
- Localized Mass: You have a tumor that is confined to the kidney and has not spread to distant organs.
- Non-Functional Kidney: Your renal scan shows one kidney is doing less than 10–15% of the total work and is causing pain or infections.
- Contralateral Kidney Health: Your "other" kidney must be strong enough to handle the workload of two kidneys.
- Surgical Fitness: Your heart and lungs must be cleared to handle anesthesia.
6. Types of Nephrectomy Procedures
- Simple Nephrectomy: Removal of the entire kidney (used for non-cancerous conditions).
- Radical Nephrectomy: Removal of the kidney, the surrounding fat (Gerota's fascia), and often the nearby lymph nodes.
- Partial Nephrectomy: The surgeon removes only the tumor and a small margin of healthy tissue, saving as much kidney function as possible.
- Laparoscopic/Robotic: Performed through 3–4 tiny "keyhole" incisions using a camera and robotic arms (e.g., Da Vinci).
7. Days Required for Hospitalization
- Surgical Time: 2 to 4 hours.
- In-Hospital Stay: 1 to 3 Days for laparoscopic/robotic; 4 to 7 Days for traditional open surgery.
- Recovery: Most patients return to light activity in 2 weeks, but full healing of the internal muscles takes 6 to 8 weeks.
- Hospitalization: 1–3 Days.
8. Benefits of Nephrectomy
- Cancer Cure: For early-stage kidney cancer, a nephrectomy can be completely curative without the need for chemotherapy.
- Pain Relief: Eliminates the "flank pain" associated with large stones or infected, non-functional kidneys.
- Blood Pressure Control: Removing a diseased kidney that is producing too much renin can help stabilize high blood pressure.
- Life-Saving Donation: In the case of living donors, it provides a second chance at life for a person with end-stage renal failure.
