What is a nephrectomy?

A nephrectomy is a surgical procedure for removing a kidney.

What are the advantages of a nephrectomy at Cleveland Clinic?

Cleveland Clinic is the only medical center in the United States where the retroperitoneal (behind the peritoneum) approach is used consistently for laparoscopic radical nephrectomy. Technically more advanced, Clinic urologists believe this approach to nephrectomy offers significant advantages to the patient, including:

  • Avoidance of potential bowel complications
  • Reduced hospital stay (one day in younger, healthy patients) and faster healing
  • Less postoperative pain and less need for pain medication
  • Quicker return to normal activity and work
  • Smaller incisions and less scarring than a traditional nephrectomy

How long has Cleveland Clinic been performing laparoscopic radical nephrectomy procedures?

Cleveland Clinic was the first medical center in Ohio to perform laparoscopic radical nephrectomy for kidney disease, beginning in 1997. Cleveland Clinic now offers laparoscopic options for a majority of kidney diseases and has, by far, the most experience with laparoscopic surgery for kidney cancer in the United States.

Why would someone need a nephrectomy?

Laparoscopic simple nephrectomy is suitable for patients with benign conditions resulting in end-stage kidney disease (kidney failure) including infection, stones, obstruction, dysplasia and renal vascular hypertension.

Laparoscopic radical nephrectomy is an excellent minimally invasive treatment for the majority of localized renal tumors, up to 12 to 15 centimeters in size.

Cleveland Clinic offers a wide variety of renal surgical procedures including robotic partial nephrectomy and nephroureterectomy.

What happens before a nephrectomy?

If you take blood thinners such as warfarin, aspirin, or plavix, your surgeon will instruct you to stop taking those 5 to 7 days before surgery. Anti-inflammatory medications and certain vitamin supplements can cause increased bleeding so disclose all of your medications and supplements to your surgeon and anesthesiologist.

It is very important that in preparation for your surgery that you stop smoking. Tobacco hurts the body's natural ability the heal itself which is very important after laparoscopic kidney surgery.

Your surgeon will ask you to not eat or drink anything after midnight the night before your surgery. This is to prevent negative effects of the potential nausea that some patients experience due to anesthesia. Your surgeon may instruct you to take your blood pressure medicine the morning before surgery and you may do so with small sips of water.

What happens during a nephrectomy?

During nephrectomy a surgeon will carefully remove one or both faulty kidneys. Open nephrectomy is rarely used anymore and laparoscopic nephrectomy, or robotic laparoscopic nephrectomy are now preferred. This is because laparoscopic surgery requires only several small incisions. Through these incisions, a surgeon uses a powerful endoscope – a tiny camera – and specialized surgical instruments to conduct the operation and remove the kidney.

How long does laparoscopic nephrectomy surgery take?

Laparoscopic nephrectomy surgery takes approximately 2 to 2-1/2 hours, and the hospital stay is usually just overnight, even for large tumors.

What happens after a nephrectomy?

After your nephrectomy, you will be monitored closely by medical experts and treated for post-procedure pain. As stated before, laparoscopic nephrectomies are far less traumatic than open surgery. However, this does not mean it is pain-free. As you recover, you'll be treated with pain medication and management techniques that are appropriate for you.

You'll be encouraged to walk around shortly after your surgery to encourage healing, blood flow, and to restore normal functioning. Walking after surgery also helps prevent pneumonia and other complications.

Immediately after surgery, you'll be given a liquid diet. As you heal and recover from surgery, you'll be reintroduced to a solid normal diet.

Normal functioning of the body can be maintained by a single healthy kidney. However, it is possible that your doctor will recommend a healthy diet for you to eat when you return home, physical activity, and regular checkups to help preserve kidney function.

Reviewed by a Cleveland Clinic medical professional.

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