A nephrectomy procedure is performed during general anesthesia. You'll receive a medication (anesthetic) before surgery so that you won't be awake or feel pain during surgery. You'll also have a urinary catheter — a small tube that drains urine from your bladder — placed before surgery.
During the procedure
The nephrectomy procedure varies, depending on how the surgery is performed and how much of the kidney is removed. Variations include:
- Open surgery. In an open nephrectomy, the surgeon makes a cut (incision) along your side or on your abdomen — usually between the lower ribs on the side of the affected kidney. The surgeon may need to remove a lower rib to gain better access to the kidney.
- Laparoscopic surgery. In this minimally invasive procedure, the surgeon makes a few small incisions in your abdomen to insert wand-like devices equipped with video cameras and small surgical tools. The surgeon makes a somewhat larger opening if your entire kidney needs to be removed.
- Robot-assisted laparoscopic surgery. In a variation of laparoscopic surgery, the surgeon may use a robotic system to perform the procedure. Robotic tools require very small incisions, provide better imaging of the procedure and enable precise removal of diseased tissue.
- Radical nephrectomy. In a radical nephrectomy, the surgeon removes the whole kidney, the fatty tissues surrounding the kidney and a portion of the tube connecting the kidney to the bladder (ureter). The surgeon may remove the adrenal gland that sits atop the kidney if a tumor is close to or involves the adrenal gland.
- Partial nephrectomy. In a partial nephrectomy — also called kidney-sparing surgery — the surgeon removes a cancerous tumor or diseased tissue and leaves in as much healthy kidney tissue as possible.
The smaller incisions in robotic and laparoscopic surgery usually mean less pain after surgery and a faster return to normal activities.
After the procedure
Recovery time after the procedure and the length of your hospital stay depend on your overall health and the type of nephrectomy performed. The urinary catheter remains in place for a short time during your recovery.
Expect to receive instructions before leaving the hospital about restrictions to your diet and activities. You may be encouraged to begin light, everyday activities as soon as you feel able, but you'll need to avoid strenuous activity or heavy lifting for several weeks.
May 16, 2015
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