Kidney removal, or nephrectomy, is a surgery to remove a diseased or damaged kidney, or a normal kidney for donation to another person.
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 kidney only
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, has no awareness of the procedure, and can feel no pain.
The traditional type of surgery is called open nephrectomy. This usually involves making a relatively large cut into the person's side and dissecting through the muscle layers to reach the kidney. Sometimes, an approach is made through the abdomen to the kidney, which lies behind the posterior abdominal wall.
The ureter, which is the tube that carries urine from the kidney to the bladder, and the large blood vessels leading to and from the kidney are tied off and cut away from the kidney. The kidney is then removed and the incision closed in layers.
A kidney can also be removed using a more modern type of surgery called laparoscopy. In a laparoscopy, the abdomen is filled with carbon dioxide gas, through a needle, to enable the surgeon to see the interior structures more easily. Then, three or more small cuts are made at key points, one on the body surface near the kidney and the others into the abdomen.
A pencil-sized tube with a light and camera attached to the end of it is then inserted through one of the abdominal cuts into the region behind the abdomen. 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 lower abdomen.
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