Kidney surgery, also known as Nephrectomy, is a common surgical procedure in medical practice. It may involve removing only part of the kidney tissue, called partial nephrectomy, or removing one entire kidney, called total nephrectomy. It can also involve removing one kidney along with the adrenal gland and nearby lymph nodes, called radical nephrectomy, or removing both kidneys, called bilateral nephrectomy.
Surgical Techniques
The first method is called conventional open surgery, which refers to traditional surgery using major surgical principles.
The second method uses a camera and is called laparoscopic surgery. It is suitable for surgery on one kidney. In the first method, the surgeon makes an 8-12 inch incision on the side of the body to minimize disturbance to the internal organs in the abdominal cavity. Sometimes the incision may extend to the front or back depending on the case. For laparoscopic surgery, the surgeon makes four small incisions on the abdominal wall to insert surgical instruments, including a camera and various surgical tools. After the kidney surgery is completed, the doctor may enlarge one incision to remove the kidney from the body.
Both conventional open nephrectomy and laparoscopic nephrectomy are performed under general anesthesia. The advantage of laparoscopic surgery is that patients experience less pain after surgery, the wounds heal faster, and there is less scar tissue formation. However, the disadvantage is that the surgery takes longer and requires a highly skilled surgeon. In the near future, robotic surgery techniques for kidney surgery, known as robotic surgery, are being developed and are becoming more widely used in many countries.
Kidney Surgery in Various Cases
- In cases of cancerous tumors, most require removal of one kidney along with the adrenal gland and nearby lymph nodes.
- In cases where kidney tissue is damaged due to infection, kidney stones, cysts, or urinary tract obstruction.
- In cases where the patient develops severe hypertension due to renal artery stenosis, which causes kidney tissue damage. After kidney surgery, blood pressure control becomes easier.
- In cases of trauma, such as car accidents.
- In cases of kidney transplantation.
Preparation for Kidney Surgery
- Avoid aspirin and all blood-thinning medications for at least one week before surgery.
- Do not eat or drink after midnight before the surgery day to prevent vomiting during surgery.
- Review medication allergies, medical history, and past surgeries.
- If pregnancy is suspected, inform the doctor immediately.
Patient Follow-up Care
After the doctor permits discharge, a follow-up appointment is scheduled one week later to check the surgical wound and evaluate the initial surgical outcome. Generally, for conventional open surgery, the recovery period is about 6 weeks, while for laparoscopic nephrectomy, the recovery time is about 4 weeks.
Possible Complications
- Risk to nearby organs including intestines, liver, spleen, and pancreas.
- Bleeding in the abdominal cavity or at the surgical wound.
- Leakage into the pleural cavity during surgery causing lung collapse.
- Reduced lung and respiratory function after surgery.
- Infection of the surgical wound.
- Some reduction in kidney function shortly after surgery.
- Risk to nerves near the surgical wound.
- Hernia at the surgical wound site.
Summary of Kidney Surgery
Kidney surgery (Nephrectomy) nowadays is not as frightening as it used to be, thanks to significant advancements in medical innovation. The reasons for kidney surgery vary by case and may be due to complications or accidents. If anyone has problems, they can contact the clinic or message Line to consult with Dr. Beer.
