Nephrectomy
Nephrectomy is surgery done to remove all or part of a kidney.
Two Types of Nephrectomy
During radical nephrectomy, the surgeon removes the entire kidney and some additional structures, such as part of the ureter, adrenal gland, and lymph nodes.
A partial nephrectomy spares the kidney. The surgeon removes diseased tissue from the kidney and leaves healthy tissue intact.
The Purpose of a Nephrectomy
The procedure is typically done to remove a tumor from the kidney. These tumors are often cancerous, but may be benign. Other kidney diseases may also be treated with a nephrectomy. The procedure may be done to remove severely damaged, scarred, or non-functioning kidney tissue caused by traumatic injury.
The decision to perform a nephrectomy is based on results of the following imaging tests:
Computerized tomography (CT), a specialized X-ray technology that produces cross-sectional views of soft tissue
Magnetic resonance imaging (MRI), a scan that uses a magnetic field and radio waves to produce cross-sectional views or 3-D images
Ultrasound, an image of soft tissue produced using sound waves
The Risks of Nephrectomy
The procedure is generally safe, but may lead to bleeding, infection, and injury to nearby organs. Over time, patients may develop high blood pressure and chronic kidney disease due to reduced kidney function.
What to Expect During Surgery
Laparoscopic surgery: During minimally invasive surgery, the surgeon makes a few small incisions in the patient’s abdomen to insert small surgical tools and wand-like devices equipped with cameras. If the patient’s entire kidney needs to be removed, the surgeon will make a slightly larger opening.
Robot-assisted laparoscopic surgery: This form of laparoscopic surgery involves the use of a robotic system to remove the kidney(s). Unlike other forms of nephrectomy, robotic nephrectomy requires very small incisions to insert the tools, provides better 3D images during the procedure, and can make very fine or complex motions with extreme precision.
Open surgery: During an open nephrectomy, the surgeon makes an incision along the patient’s side or abdomen. The open approach allows surgeons to perform certain motions that can’t be done safely using less invasive methods.
Radical nephrectomy: When performing a radical nephrectomy, the surgeon removes the entire kidney, the fatty tissues surrounding the kidney, and a portion of the ureter, which is a tube connecting the kidney to the bladder. The surgeon may also remove the adrenal gland if a tumor is close to or has moved into the adrenal gland. In some cases, the surgeon will also remove lymph nodes or other tissues.
Partial nephrectomy: A partial nephrectomy — also called kidney-sparing (nephron-sparing) surgery — is the removal of a cancerous tumor or diseased tissue. The surgeon leaves as much healthy kidney tissue as possible.
A urologist will explain the advantages and disadvantages of robotic or other types of minimally invasive surgery versus open surgery to help the patient understand which approach is best for their condition. The urologist will also discuss issues such as scarring and the recovery time for each option.
