What is a nephrectomy?
Nephrectomy (nephro = kidney, ectomy = removal) is the surgical removal of a kidney. The procedure is done to treat kidney cancer as well as other kidney diseases and injuries. Nephrectomy is also done to remove a healthy kidney from a donor (either living or deceased) for transplantation.
There are two types of nephrectomy for a diseased kidney: partial and radical. In partial nephrectomy, only the diseased or injured portion of the kidney is removed. Radical nephrectomy involves removing the entire kidney, along with a section of the tube leading to the bladder (ureter), the gland that sits atop the kidney (adrenal gland), and the fatty tissue surrounding the kidney. When both kidneys are removed at the same time, the procedure is called bilateral nephrectomy.
The procedure used to remove a healthy kidney from a donor for the purpose of transplantation is called donor nephrectomy.
Laparoscopic Radical Nephrectomy in India
Laparoscopic radical nephrectomy uses a minimally invasive approach (laparoscopy) to perform exactly the same procedure that is done in open radical nephrectomy. In any radical nephrectomy (open or laparoscopic) the entire kidney including the kidney cancer is removed. The operation involves removal of the kidney along with the fat around the kidney. All of this tissue is contained in a leathery layer known as Gerota's fascia. If the kidney cancer is quite large and near the adrenal gland which is adjacent to the kidney, the operation can include removal of the adrenal gland as well. The operation also often includes removal of the lymph nodes which are around the kidney.
The laparoscopic approach to partial nephrectomy means that no large incisions are required to perform the procedure. Instead of a large incision, three or four 1/2 cm to 1 cm incisions (less than 1/2 inch) are made. The spaces in the body are gently filled with gas to make working space and a small camera is placed into the body through one of the incisions. The other small incisions are used to place working instruments which can be used to perform the procedure.
The entire kidney with the cancer within and with the surrounding fat and the layer known as Gerota’s fascia are removed. Once the entire specimen has been separated from the surrounding tissues, it is placed in a bag while still inside the body. The bag is then removed by making an incision.
Laparoscopic Radical Nephrectomy provides patients with a safe and effective way to remove a small renal tumor, while preserving the remainder of the kidney. This is a minimally invasive technique, which provides patients with less discomfort and equivalent results when compared to the traditional open surgery.
When compared to the conventional open surgical technique, laparoscopic radical nephrectomy has resulted in significantly less post-operative pain, a shorter hospital stay, earlier return to work and daily activities, a more favorable cosmetic result and outcomes that appear to be identical to that of open surgery. laparoscopic radical nephrectomy has become a standard procedure for select patients with renal cell carcinoma (esp. small < 4cm, peripherally located tumors).
Advantages of Laparoscopic Radical Nephrectomy
• Improved visualization of surgical field
• Less blood loss
• Less pain
• Shorter hospital stay
• Quicker recovery
• Better cosmetic result
You may want to ask some questions before your treatment begins: