Nephrectomy

Alternative names
Kidney removal

Definition
Kidney removal, also called nephrectomy, is a surgical procedure to remove a kidney.

Description

While the patient is unconscious and pain-free (under general anesthesia), an incision is made in the abdomen or in the side of the abdomen (flank). The surgeon may need to remove a rib in to perform the procedure.

The ureter (the tube that carries urine from the kidney to the bladder) and the blood vessels are cut away from the kidney and the kidney is removed. The incision is then closed.

Kidney removal may be performed as open surgery, which involves a large incision in the flank. For certain patients, the procedure may be done laparoscopically, meaning the surgeon uses an instrument called a laparoscope to visualize the kidney through a smaller incision. Laparoscopic surgery requires 3 or 4 small incisions - usually no more than an inch each - in the abdomen and flank.

Indications
Kidney removal may be recommended for:

     
  • Birth defects (congenital abnormalities)  
  • Injury (trauma)  
  • Infection  
  • Hypertension  
  • Tumor  
  • Chronic bleeding

Kidney removal is also performed on someone who donates a kidney for a kidney transplant.

RISKS
Risks for any anesthesia include the following:

     
  • Reactions to medications  
  • Problems breathing

Risks for any surgery include the following:

     
  • Bleeding  
  • Infection

Expectations after surgery
Outcome is usually good in the case of the removal of a single kidney. If both kidneys are removed or if the remaining kidney does not function well enough, hemodialysis or kidney transplantation will be necessary to maintain life.

Convalescence

Recovery time is the same as for other major abdominal surgery. You will be given intravenous fluids and pain medication. Kidney removal surgery is often very painful because of the location of the affected organ.

Your blood pressure and balance of electrolytes and fluids are carefully monitored, because these functions are controlled in part by the kidneys. You will most likely have a urinary catheter in place for a short time during your recovery.

You will probably remain in the hospital for 2 to 7 days, depending on the method of surgery used. Light activity may be resumed, and is actually encouraged as soon as you can tolerate it. Strenuous activity should be avoided for 6 weeks following the procedure.

Johns Hopkins patient information

Last revised: December 4, 2012
by Janet G. Derge, M.D.

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