Nephrectomy
| Nephrectomy | |
|---|---|
| ICD-9-CM | 55.4 |
| MeSH | D009392 |
Nephrectomy is the surgical removal of a kidney.
Indications
There are various indications for this procedure, such as renal cell carcinoma, a non-functioning kidney (which may cause high blood pressure) and a congenitally small kidney (in which the kidney is swelling, causing it to press on nerves which can cause pain in unrelated areas such as the back).
Nephrectomy for renal cell carcinoma is rapidly being modified to allow partial removal of the kidney.
When one is donating a kidney for a kidney transplant, a nephrectomy is also performed on the patient.
Procedure
The surgery is performed with the patient under general anesthesia. The surgeon makes an incision in the side of the abdomen to reach the kidney. Depending on circumstances, the incision can also be made midline. The ureter and blood vessels are disconnected, and the kidney is then removed.
The surgery can be done as open surgery, with one incision, or as a laparoscopic procedure, with three or four small cuts in the abdominal and flank area.
Recently, this procedure is performed through a single incision in the patient's belly-button. This advanced technique is called as Single Port Access Surgery.
After Care
Pain medication is often given to the patient after the surgery because of the painful location. An IV with fluids is administered.
Electrolyte balance and fluids are carefully monitored, because these are the functions of the kidneys. It is possible that the remaining kidney does not take over all functionality.
A patient has to stay in the hospital between 2 and 7 days depending on the procedure and complications.
History
The first successful nephrectomy was performed by the German surgeon Gustav Simon on August 2nd, 1869 in Heidelberg. Simon trained the operation beforehand in animal experiments. He proved that one healthy kidney can be sufficient for the urine excretion in humans.