It's normal to feel a little scared and anxious when a doctor tells you or someone you know that you need kidney surgery. It's not surprising, especially since the kidneys are such a vital organ in our bodies. But your doctor understands your feelings. That's why they will explain the surgery, the expected results, and the recovery time to you.
Simply put, what is Heminephrectomy?
Heminephrectomy (hemi-nephrec-to-me) is a surgical procedure that removes only the dysfunctional part of your kidney. The entire kidney is not removed, just the dysfunctional part.
This surgery is usually performed on people with a condition called Duplex Kidney . Now you may be wondering what that is.
Imagine, we all have two kidneys in our bodies. Normally, there is only one ureter to carry urine from one kidney to the bladder. But some people are born with two ureters in one kidney due to a congenital condition. That is why we call it ``Duplex Kidney``.
But not everyone with a ``Duplex Kidney'' will have problems. Some people live without even knowing they have this condition. But sometimes it can cause some complications.
What problems can occur due to a Duplex Kidney?
There are three main problems that can occur due to a `Duplex Kidney`. Let's see what they are.
| Problem (Condition) | Simply put... |
|---|---|
| Vesicoureteral Reflux (VUR) | This causes urine in the bladder to flow back up into the kidneys. In the long term, this can damage the kidneys. |
| Ectopic Ureter | What happens here is that the extra urethra is not connected to the bladder, but to another nearby organ. This can also cause damage to that organ. |
| Ureterocele | The urethra, where it enters the bladder, swells like a balloon, obstructing the flow of urine. This can increase pressure inside the kidney and cause damage. |
Even with these problems, most of the time, your doctor will just monitor you. However, if you have frequent urinary tract infections , or if part of your kidney has completely lost function due to the above-mentioned reasons, your doctor may recommend a heminephrectomy.
How should you prepare before surgery?
Before the surgery, your surgeon (urologist) will explain the surgery to you thoroughly and obtain your consent. In addition, they will perform several tests to make sure you are in a healthy condition for the surgery. They will definitely ask you about the following:
- Your complete health history .
- You should tell your doctor about any medications you take. This includes prescription medications, over-the-counter medications, herbal products, and even vitamins. Some medications, such as blood thinners, can increase the risk of bleeding during surgery.
- About any allergies you may have.
A few days before the surgery, you will be advised on what medications, if any, you should take and when to stop taking them. You will also be told exactly when you should stop eating and drinking (fasting) before the surgery.
How is the surgery performed?
This surgery can be performed in three main ways: open surgery, laparoscopic surgery, and robotic surgery.
| Type of surgery | How to do it and benefits |
|---|---|
| Open Heminephrectomy | The doctor will make a 12-inch incision in your abdomen, between your ribs and your hip. This will allow the doctor to see the kidney better. The non-functioning part can be removed manually. |
| Laparoscopic Surgery | This involves making several small incisions in the abdomen instead of one large incision. A thin instrument with a camera (laparoscope) is inserted through one incision to view the kidney. Surgical instruments are inserted through other incisions to remove the dysfunctional part. The advantage of this is that the scar is smaller and the healing is faster. |
| Robotic Surgery | This is similar to laparoscopic surgery, but here the doctor controls the surgical instruments using the hands of a robotic machine. This allows for very delicate and precise surgery. |
Before the surgery begins, the anesthesiologist will give you general anesthesia (`General Anesthesia`). So you won't feel any pain, you'll be asleep. Then a Foley catheter will be inserted to empty your bladder. The surgery can usually take about two to three hours .
What happens after the surgery? And how long does it take to recover?
After surgery, you will be monitored in a recovery room until you wake up and your health is stable. You will be given medication to control your pain.
The recovery time will vary depending on the type of surgery you had.
- After laparoscopic or robotic surgery, you can usually return to normal activities within 4-6 weeks .
- It can take about 8-12 weeks to fully heal after open surgery .
Your doctor will encourage you to walk a bit during your recovery. Walking is good for your body and can help prevent things like blood clots and pneumonia. But you should avoid lifting anything heavier than 10 pounds (about the weight of a gallon of water).
Do you need to be careful about food and drink?
Yes. For the first four weeks after surgery, you will be advised to drink 6-8 glasses of water a day and eat a soft, easily digestible diet. You will also be advised to avoid certain foods until your bowel movements return to normal.
| Good things to eat | Things to avoid |
|---|---|
|
If you have these symptoms, see a doctor immediately!
If you experience any of the symptoms below after surgery, you should call your doctor immediately or go to the Emergency Department (ETU) of the nearest hospital.
- Difficulty breathing
- Excessive bleeding from the suture site
- Skin separation through stitches
- Signs of an infection: This includes redness, purple, brown, or black discoloration around the wound, fever, pus draining from the wound, or a foul odor.
- Increasing unbearable pain
- Leg pain
- Blood in the urine
It's normal to be afraid of surgery. It's natural to have questions like, "What if the surgery doesn't go well?" or "What if my symptoms get worse?" But think about the positives as well. "How much easier will this surgery make my life?" or "Will I be able to get rid of the infections I've been having?" Thinking this way can help you feel a lot better.
Take-Home Message
- Heminephrectomy is a surgery that removes only the dysfunctional part of a kidney. The entire kidney is not removed.
- This surgery is often performed for complications caused by a congenital condition called Duplex Kidney.
- The surgery can be done open, laparoscopically, or robotically. The recovery time depends on the method.
- Follow your doctor's instructions carefully after surgery, especially regarding diet and weight lifting.
- If you notice warning signs such as difficulty breathing, excessive bleeding, or signs of infection, seek medical advice immediately.
- Talk openly with your doctor about any questions or fears you have.
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