If a kidney needs to be partially or completely removed, the procedure is referred to as a nephrectomy.
Kidney cancer is one of the most common reasons to perform this type of surgery. Disease, injury, and infection are among some of the other reasons why a kidney may need to be removed or partially removed.
Here’s a closer look at three possible ways a nephrectomy may be performed.
A radical nephrectomy is complete removal of an entire kidney that includes the removal of some additional structures. For instance, the tube that takes urine from a kidney to the bladder (ureter) may also be removed. With some versions of this procedure it might also be necessary to remove adrenal glands or lymph nodes.
A radical nephrectomy is more likely to be performed if there’s a need to remove a malignant (cancerous) tumor and additional structures that may also have cancerous cells or tissues. Because of the complex nature of a radical nephrectomy, it may be performed with more invasive techniques so that all structures that need to be removed can be safely accessed.
Also referred to as kidney-sparing surgery, a partial nephrectomy is performed in a way that only removes the diseased or damaged tissue from a kidney. The goal with this approach to kidney surgery is to leave as much of the kidney intact as possible. Since only certain tissues are being removed, it’s sometimes possible to use smaller incisions.
Laparoscopic surgery is alternative to open surgery for partial or complete kidney removal that’s performed with less invasive techniques. During surgery, small incisions are made into the abdomen for the insertion of a special lighted device with a camera attached and specially designed tools. A larger incision may be necessary if there is a need to remove the entire kidney and not just certain portions of it. A live X-ray (fluoroscopy) is often used to provide additional visual guidance during the procedure.
This type of kidney removal surgery also involves the use of minimally invasive techniques meant to reduce surgical risks and improve the accuracy of the procedure. In fact, a robot-assisted nephrectomy is a variation of the laparoscopic version of this type of surgery. During the procedure, a surgeon sits in a special console in the same room as the patient. The surgeon’s hand motions guide the robotic device as incisions are made in the abdomen to access the affected kidney.
There is usually another surgeon sitting by the patient to monitor the robotic device. A major advantage with this approach to kidney removal is the improved clarity of the images produced, which are shown in 3D on the monitor the surgeon uses. The robotic device also allows very precise and complex motions to be made as the procedure is performed in a way that’s not always possible when a surgeon has their hands directly inside of the affected area.
It’s not unusual for people to recover fairly quickly from any of the approaches to nephrectomy. The ability to return to work and resume normal activities will depend on the specific way the procedure was performed. For example, some individuals are able to get back to their job two to three weeks after laparoscopic or robotic surgery. Generally, recovery periods are shorter and less likely to include unexpected issues when less invasive techniques are used, although precautions are normally taken with any type of kidney surgery.