Nephrectomy: Frequently Asked Questions

Live donor nephrectomy is the removal of a kidney from someone who is alive and wishes to share one of their kidneys with a person who is in need of a kidney transplant

Every operation has some risk. A nephrectomy should be performed if the advantages outweigh the disadvantages and this most importantly relates to quality of life. Potential problems include bleeding requiring blood transfusion, infection of the wound or lungs, injury to surrounding tissues (i.e. intestines, liver, spleen, pleura), the need for further procedures, blood clots, and the risks of anaesthesia (heart attack, stroke, blood clots, and death). Kidney failure is always a possible outcome, although rare. ...

In traditional open surgery, the anaesthetist gives a general anaesthetic and the surgeon makes an incision on the side or front of the abdomen or sometimes through the ribs and chest. Muscle, fat, and tissue are mobilised or divided to expose the kidney. The blood vessels supplying the kidney are tied or clipped and then divided. Depending on the type of nephrectomy procedure being performed, the ureter, adrenal gland, and/or surrounding tissue may also be cut. ...

This can refer to how much of the kidney is removed: Partial: only a small amount of the kidney is remed Simple: the whole kidney is removed Radical: the whole kidney, surrounding fat and sometimes the adrenal gland also Nephroureterectomy: the kidney and its ureter, which is the tube that carries urine from the kidney down to the bladder Donor: a kidney with its blood vessels and ureter is removed to give to another person. ...

As the hands are not directly in the body, it is less easy to feel what is happening compared to open surgery. In some situations, the tactile feedback can be important and if that becomes true, it would be necessary to make an incision to carry on. Other disadvantages include the increased length of time necessary for the operation, the significantly increased cost of the equipment and the necessity for the surgeon to be experienced in laparoscopy before being able to perform the operation.

The advantages are multiple and include the following: smaller skin incision - four 1 cm incisions rather than a 30 cm incision better view because of the magnification of the system less pain because the incisions are smaller and the muscles are parted rather than cut 3 to 5 days in hospital compared to a week or longer by open surgery less blood loss and reduced need for a blood transfusion the ability to return to work in 2 to 4 weeks compared to 6 or more weeks after traditional open surgery There are no differences... ...

Sometimes blood clots can develop in the leg veins which can sometimes be dangerous after a nephrectomy and so it is prudent to wait at least three weeks after a nephrectomy before flying. Otherwise, the major limitations to travel involve physical discomfort.

A kidney is removed either through a large skin incision necessary for traditional open surgery or by minimally invasive surgery - laparoscopic nephrectomy . There are significant advantages for laparoscopic nephrectomy over traditional surgery. Recently, it has become possible to destroy small tumours by freezing (cryoablation) without removing them surgically.

The speed at which kidney cancer grows varies from person to person. A few weeks between a diagnosis of cancer and surgery is usually insignificant as the cancer has probably been present for some time and rarely advances significantly within a short period. Nevertheless, a nephrectomy should be performed as soon as it is safe providing it is appropriate if kidney cancer is diagnosed.

Partial nephrectomy for small tumors allows the patient to preserve part of the kidney and still get rid of the cancer or tumor. One advantage is the patient keeps most of the kidney and often maintains better overall kidney function.