Kidneys are primarily known for producing urine, but they are also responsible for other important bodily functions, like waste removal. Kidneys filter impurities from the blood, and with the help of the adjacent adrenal glands, they maintain fluid and mineral balance in the body. If the tiny tubes that filter blood inside your kidney become lined with cancer cells, or if your kidney gets severely damaged, you may need kidney removal surgery, or a nephrectomy.
The size of the tumor or severity of the damage will determine the type of kidney removal surgery you need. If the tumor or damaged area is small, either partial or simple nephrectomy may be recommended. A partial nephrectomy removes only the tumor or damaged portion of the kidney, while a simple nephrectomy removes the entire kidney. If you have kidney cancer and it has spread to the adrenal gland, you may need a radical nephrectomy. This more extensive procedure completely removes the affected kidney and adrenal gland. When only one of your kidneys is damaged or has cancer, a nephrectomy may be the only treatment you need. However, if both kidneys are affected, you will need a kidney transplant after your nephrectomy.
Before the development of minimally invasive techniques, nephrectomies were always done via an open approach, which requires an incision up to 12 inches on the patient’s abdomen or side. Nowadays, kidney removal surgery is often done laparoscopically or with the help of robotics.
During a laparoscopic nephrectomy, the surgeon will make three or four incisions in the abdomen and side, each about an inch long. The incisions are used to insert probes and a camera to see inside your abdominal cavity. When the surgeon is ready to take the kidney out, she will make one of the incisions about three inches larger, cut the tube that connects the kidney to the bladder (called the ureter), put a bag around the kidney, and pull the organ out through the larger incision.
Sometimes, a robot with surgical instruments assists the surgeon in performing basically the same steps described above. However, unlike the laparoscopic approach, robotic nephrectomy allows a three-dimensional view of your abdominal cavity. In addition, the surgical instruments have a wider range of motion, enabling the surgeon to perform the complex maneuvers with more ease.
Both the laparoscopic and robotic procedures may take longer than an open nephrectomy, but the recovery time is much shorter, and patients feel significantly less pain compared to an open surgery. The average hospital stay after a nephrectomy is two days, and for about a day after the operation, you will have a urinary catheter, which is a long, flexible tube that drains urine from your bladder. All strenuous activity should be avoided for several weeks, but to prevent blood clots from forming in your legs, it is important that you start walking with the help of a family member or nurse on the day of your surgery. On average, patients return to their normal routines about three weeks after a nephrectomy.