OVERVIEW

A nephrectomy is the surgery to remove the kidney and can be performed openly or laparoscopically. Simple nephrectomy is the last treatment option for benign renal diseases (not cancer).

The reasons to remove a kidney can be the following:

  • Tuberculosis infection in a kidney without function
  • Chronic pyelonephritis due to reflux
  • Xanthogranulomatous pyelonephritis
  • Emphysematous pyelonephritis
  • Kidney abscess
  • Trauma: kidney injury that compromises life in an unstable patient
  • Trauma: kidney injury without possibility of reconstruction
  • Kidney lithiasis: large volume stones in a kidney without function
  • Kidney donation for transplant
  • Polycystic kidney disease before a transplant
  • Simple cysts in a kidney without function that produce pain
  • Renovascular hypertension in a kidney without function
  • Hydronephrosis in a kidney without function
  • Severe hematuria in a kidney without function
  • Severe proteinuria in a kidney without function

Benefits of laparoscopic simple nephrectomy

When performed by laparoscopy, nephrectomy is a surgery that offers rapid recovery and little postoperative pain.

In case of infection in a kidney without function, the nephrectomy offers a very effective control of the infection, as well as controlling the symptoms in the case of pain due to cysts or stones.

Risks and complications

The possible complications that may occur when carrying out a simple nephrectomy are the same that can occur in general with any surgical procedure and these are: hemorrhage, damage to nearby organs, reactions to anesthesia, etc. However, these complications occur infrequently and can be resolved mostly during the same surgery.

The risk of conversion to open surgery is low, (<5%), this may be due to difficulty in the dissection or removal of the kidney and is done to maintain patient safety.

Most people can live with only one kidney, however, sometimes the patient may require replacement therapy of renal function (peritoneal dialysis, hemodialysis, kidney transplant) temporarily or permanently, joint management with a nephrologist for this purpose is suggested.

Alternatives to simple nephrectomy

Depending on the indication for a simple nephrectomy, there are other treatment alternatives, such as the administration of medications to control pain or infection; However, when there is no response to medical treatment and the function of the kidney has been lost, it is advisable to remove it.

What to expect from a simple laparoscopic nephrectomy?

Day of surgery:

The day of the operation will arrive in the morning to the hospital in fasting

The surgery lasts approximately 2 – 3 hours, however, this time is variable.

Anesthesia for this procedure is general, so you will be unconscious during surgery.

Pain after laparoscopic nephrectomy is minimal and can be effectively controlled with intravenous analgesics.

Food: on the day of surgery you can eat in the afternoon, there are no food restrictions, however, a balanced diet is recommended.

Physical activity: the same day of surgery you can walk in the afternoon. It is expected to feel a bit fatigued after any surgery, this problem resolves spontaneously within a few weeks after laparoscopic nephrectomy.

Hospital stay: most patients undergoing laparoscopic nephrectomy remain hospitalized for 2 to 3 days.

Wounds: Laparoscopic nephrectomy requires 3 small incisions in the abdomen (each 1 cm or less), once they heal completely, these scars can rarely be seen. The kidney can be extracted by one of these small wounds, for which it must be fragmented. In some cases, the kidney can be removed through a 10 cm incision in the inguinal region or in the bikini line.

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