Friday, July 22, 2011

Kidney Removal

Overview & Description

Kidney removal, or nephrectomy, is a surgery to remove a diseased or damaged kidney.
Who is a candidate for the procedure?
A kidney may be removed if a person:
  • has cancer or suspected cancer of the kidney

  • has severe kidney trauma, or damage from an injury

  • has a kidney that has poor function due to infection

  • is donating his or her kidney to another person who needs a kidney transplant
    How is the procedure performed?
    There are three basic types of kidney removal, including:

  • simple nephrectomy, which involves removal of just the diseased kidney

  • radical nephrectomy, which involves removal of the kidney, the adrenal gland above the kidney, the surrounding fatty tissue, and the lymph nodes next to the kidney. Lymph nodes, sometimes called glands, are part of the immune system. This procedure is usually done when cancer of the kidney is present.

  • partial nephrectomy, which involves removing only part of one kidney. This is not usually attempted unless a person has only one kidney.
    A kidney removal is usually done using general anesthesia. This means that a person is put to sleep with medication and can feel no pain. The traditional type of surgery is called laparotomy. This involves making a fairly large cut into the front or side of the stomach. The ureter, which is the tube that carries urine from the kidney to the bladder, and blood vessels are cut away from the kidney. The kidney is then removed.
    A kidney can also be removed using a more modern type of surgery called laparoscopy. This involves making three or more small cuts at key points on the body surface around the kidney. A pencil-sized tube with a light and camera attached to the end of it is then inserted through one cut and into the stomach. Using the camera on the end of the tube, the inside of the stomach can be seen. The surgeon uses other thin tools that are inserted through the other small cuts to free the kidney. The kidney is then removed through a slightly larger cut in the stomach.


  • Preparation & Expectations

    What happens right after the procedure?
    After surgery, the person will be taken to the surgery recovery room. He or she is watched closely for a short time. The blood pressure, pulse, and breathing rate will be checked often. A urinary catheter will be in place when the person wakes up. This is a tube that drains the urine from the bladder. The urine will be pink colored after the surgery due to mild bleeding. When the person can urinate on their own, the catheter is removed. A tube may be left in the skin incision to drain any blood or fluid from the surgery.
    Pain is common after surgery, and pain medications are given as needed. The person will be taken to a hospital room to recover once the anesthesia has worn off. The person will gradually be allowed to eat, starting with a liquid diet 1 to 3 days after surgery.

    Home Care and Complications

    What happens later at home?
    A person having a kidney removal usually needs a 5 to 7 day hospital stay. The recovery time depends partly on the person's age, the type of surgery done, other health problems, and any complications. A person who has had a laparoscopy often recovers faster than someone who has had a laparotomy. Pain medications are often needed for a few days at home. The person is allowed to slowly increase his or her activity level and diet.
    What are the potential complications after the procedure?
    Surgery poses a risk of bleeding, infection, and allergic reaction to anesthesia.
    If both kidneys are removed or the remaining kidney does not function well, dialysis or a kidney transplant may be needed. Dialysis is a procedure to filter the blood. It is often needed three times a week for life or until a kidney transplant can be obtained.

    Attribution

    Author:Gail Hendrickson, RN, BS
    Date Written:
    Editor:Smith, Elizabeth, BA
    Edit Date:08/16/00
    Reviewer:Adam Brochert, MD
    Date Reviewed:07/02/01
    Sources
    Mosby's Manual of Urological Nursing, 1994
    Genitourinary Disorders, Mosby's Clinical Nursing Series, 1992
    Principles of Surgery, 1999, Schwartz et al
    Professional Guide to Diseases, Sixth Edition. Springhouse: Springhouse Corporation, 1998
    Griffith, H. Winter. Instructions for Patients. Philadelphia:W.B. Saunders company,1994

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