Nephrectomy (Open, Laparoscopic and Robotic)

A nephrectomy is the removal of the kidney. The procedure is typically performed for kidney cancer, polycystic kidney disease, kidney trauma, non-functioning kidneys, or severe kidney infections. It is performed in the operating room under general anesthesia and typically takes 2-3 hours. A traditional open nephrectomy is performed through a flank or abdominal incision. The skin is incised and muscular layers are divided in order to gain access to the kidney. The ureter and renal blood vessels are exposed and controlled. The kidney is then freed from surrounding tissues and removed.

Depending on the size and location of the tumor, the overlying adrenal gland and surrounding lymph nodes may also be removed. You will typically be in the hospital for 3-5 days. You will have a catheter in the bladder for the first 24-48 hours. During your hospitalization, your pain will be controlled with IV and oral pain medicine as needed, your diet will be advanced as your body tolerates, and your activity level will be increased also as tolerated. For a laparoscopic nephrectomy, also called minimally invasive nephrectomy or hand-assisted laparoscopic nephrectomy, a 3-inch incision is made in the abdominal wall along with two or three ½ inch incisions. Laparoscopic instruments and a camera are placed in these incisions which are used to perform the surgery. Once the artery, vein and ureter of the kidney are controlled, the kidney is then freed from surrounding tissues. The kidney and surrounding tissue are then removed through the larger incision and the skin and incisions are closed with “skin glue”, dissolvable sutures or staples.

The procedure is performed in a similar manner to the open approach but the hospital stay is shorter and post-operative pain is significantly decreased. It is common to have redness and bruising around the incision sites. If you have skin staples they will be removed by a visiting nurse, or during a follow-up office appointment. It is typical to be sore for 2-3 weeks after a laparoscopic nephrectomy and for 4-6 weeks following an open nephrectomy.

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