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Nephrectomy A Nephrectomy is a surgical procedure to remove a kidney or a section of a kidney (partial nephrectomy). Nephrectomy is performed on patients with diseases such as cancer, infection, injury or congenital conditions (born with), and during kidney transplants. The nephrectomy is performed traditionally (open surgery) or using minimally invasive techniques (laparoscopic).
Open Nephrectomy
• During open surgery the surgeon makes a 6 to 10 inch incision through several layers of muscle on the side or front of the abdomen. The blood vessels connecting the kidney are cut and clamped and the tubes connecting the kidney and bladder (ureter) are also cut and clamped. The kidney is removed and the incision is closed. Some conditions require removal of the entire ureter through the same or separate incision.
• The procedure is inpatient and is performed under general anesthesia and takes at least 3 hours.
• You will be in the hospital between 3-5days.
Laparoscopic Nephrectomy
• During laparoscopic surgery the surgeon makes several small incisions and utilizes a videoscope and special surgical instruments to isolate the kidney which is removed, secured in a bag and pulled through a small incision.
• The procedure is inpatient and is performed under general anesthesia and may take several hours.
• Any risk to the patient may require the laparoscopic surgery to be converted to an open procedure.
• You will be in the hospital between 2-5 days.
Nephrectomy is generally a safe procedure.
Possible complications of these procedures include:
• Injury to neighboring abdominal organs.
• Bleeding inside the abdomen even weeks after surgery.
• Infection.
• Blood clots in the legs.
• An accidental cut or puncture into the chest cavity.
• Temporary decrease in lung function.
• Risk of pneumonia.
• Temporary reduction in kidney function.
• Injury to nerves near the incision site.
• Incisional hernia.
• If the procedure is done to remove cancer, the cancer may come back even years after wards.
• Risk of kidney failure.
Please observe the following Pre-Operative Guidelines:
• The following medications should be Avoided One Week Prior to the Date of Surgery: All aspirin (ASA) or NSAID’s (Motrin, Advil), Coumadin, Lovenox, Celebrex, Plavix (Please contact us if you are unsure about which medications to stop, Do not stop any medication without contacting your prescribing doctor).
• The day before your surgery start the pre-operative Bowel Prep (cleansing procedure): 2 bottles of Magnesium Citrate (AM, PM), 2 fleet enemas (AM, PM). Both available at the pharmacy.
• Have nothing by mouth after midnight the night prior to your procedure unless otherwise instructed by the anesthesiologist.
After the Procedure:
Nephrectomy is considered major surgery. You can expect to be hospitalized for up to one week depending on the rate of your recovery. Once discharged from the hospital please observe the following guidelines along with any post-operative instructions given to you by the hospital.
• You may continue to have some pain after surgery. You may be prescribed pain medication to aid in alleviating any discomfort.
• Gradually increase the amount of walking you do each day. Walking will help you build strength and prevent blood clots from forming in your legs.
• Avoid lifting more than 10 lbs.
• Driving should be avoided for up to 4 weeks or until you have stopped taking your prescribed pain medication.
• Do not take tub baths until your incision is healed, showering is acceptable 48 hours after surgery.
• Eat a well balanced diet to facilitate healing and prevent constipation.
• Please contact us immediately if your pain continues to increase, the incision becomes red or swollen, the skin around your incision becomes warm and irritated, there is drainage or an opening in your incision, you experience difficulty during urination or if you have a fever above 101 degrees.
• It is necessary to schedule follow-up visits with us to assess your progress between one and two weeks after surgery.
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