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Nephrectomy:  aka Kidney Removal




What Is It?


A nephrectomy involves the surgical removal of the kidneys, and usually is reserved for patients that have cancer of the kidneys or patients that require kidney removal because of kidney disease resulting from other serious conditions. The kidneys are responsible for removing waste products and fluid from the bloodstream. Because of this the kidneys are vital to the body’s survival. A serious infection or cancer can be life threatening and can critically damage the kidneys.


Candidates for kidney surgery typically elect surgery only as a last resort. If the patient loses function in the remaining kidney after a nephrectomy then the patient may require a kidney transplant or may require chronic dialysis until a kidney becomes available for transplant.




The Operation


Nephrectomy ay require removal of a portion of one kidney or removal of the entire kidney and the tissues surrounding the kidney in cases of server malignant cancer. A partial nephrectomy involves removal of the infected and diseased parts of the kidney. The removal of the entire kidney including part of the bladder connected to the kidney is known as a radical nephrectomy. This procedure usually also includes removal of the adrenal gland and any fatty tissue surrounding the kidney.


There may be situations where both kidneys must be removed, a surgery known as a bilateral nephrectomy. If this surgery occurs the patient will usually require an immediate kidney transplant or chronic dialysis until one is available.


Typically a patient will receive general anesthesia prior to surgery. The surgeon will then create an incision in the abdomen and remove any muscle, fat and tissue covering the kidney. The blood vessels and other tubes connected to the kidney are then cut and clamped and the kidney or portion of the diseased kidney is removed. Any cut vessels are then sutured and the patient is sewn up (unless a new kidney is being implanted at the same time, in which case the surgeon will perform this surgery).




Alternatives to Surgery


Instead of traditional surgery some surgeons elect to perform a laparoscopic nephrectomy, which is much less invasive. This involves the placement of a long scope with a video camera attached through several small incisions in the abdomen. The laparoscope is guided into the body where it assists the surgeon in freeing the kidney, where it is placed in a bag and pulled through another incision that is approximately 3 inches wide in the front part of the abdomen. This surgical technique does take more time to perform than a traditional surgery but patients generally recover much faster and often enjoy shorter hospital stays.


A surgeon must be highly qualified in this technique prior to administering it however.




Before The Operation


To prepare for surgery your doctor will match your blood type to make sure they have blood samples available in the event you require a transfusion. The medical team will also insert a catheter prior to surgery. The staff will discuss the surgery and any risks associated with surgery. You will need to avoid food for 12 hours before surgery to avoid complications associated with general anesthesia.




After The Operation


Recovery time depends on the type of procedure performed. Recovery is often quicker for patients undergoing laparoscopic nephrectomy. For traditional surgeries and laparoscopic surgeries patients often experience discomfort. Traditional surgeries often cause more discomfort especially around the incision site. Some patients also report numbness which may result from nerve endings that were cut during surgery.


Most patients receive pain medicine following surgery in the hospital and some to take while they are recovering at home.




Possible Complications


Possible complications include infection at the incision site and kidney failure in the remaining kidney. Should this happen the patient may require chronic dialysis or may require a kidney transplant, if a donor kidney is available. This may place the patient in danger and may place the donor in danger if the donor develops kidney problems. The kidneys are vital organs to the body.


It is important the patient follow their doctor’s advice and eat well and drink plenty of clear fluids to help promote good kidney functions. Patients should avoid excessive intake of fatty foods and alcohol. Recovery time will vary from patient to patient depending on their overall health and wellness. Kidney patients should talk with other doctors about their condition so they are not prescribed medications that may be harmful to the kidneys, as many medications are processed through the kidneys instead of the liver.




General Advice


Nephrectomy is surgery to remove one or both kidneys in the event of renal cell carcinoma, infection or kidney disease. Patients undergoing kidney surgery probably have had some experience with dialysis and poor kidney function. Some patients undergoing surgery have a congenital defect that leads to kidney swelling which can cause pain and discomfort.


It is not always necessary to remove the entire kidney to help the patient recover. Some patients can heal when the surgeon removes only the diseased part of the kidney. The less invasive the surgery the more likely the patient is to recover faster and without the risk for serious complications. It is important patients take great care to eat well and minimize the ingestion of products and substances that are toxic to the kidneys following surgery.




Estimated Costs for Kidney Surgery


Nephrectomy is not an inexpensive surgery. The prices quoted below vary significantly because they include the cost of a consultation and the costs associated with a replacement or transplant in some cases if required.


Your cost may vary and may be significantly less if you only require a partial nephrectomy, so be sure to consider your case individually. The lower end of the costs typically reflects the price for patients requiring a partial nephrectomy.


Country Costs
USA $60,000-115,000
Malaysia $5,000-24,000
Singapore $6,000-26,000
India $3,000-19,800
Thailand $4,000-22,000

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