Let's learn about Partial Nephrectomy in simple terms!

Has your doctor told you that you need to have surgery to remove part of your kidney? It's normal to feel a little scared and nervous when you hear something like that. "What will happen to my kidney? Will I be able to live like before?" Many questions probably come to mind. But when you know exactly what this is, why it is being done, and how it is being done, that fear in your mind will largely disappear. So today, let's talk about this surgery called 'Partial Nephrectomy', very simply, in a way that you can understand.

Simply put, what is Partial Nephrectomy?

Partial Nephrectomy is a surgical procedure that removes only the part of your kidney that is diseased, damaged, or cancerous, while preserving the remaining healthy part. This does not remove the entire kidney. It is like cutting out only the bad part of a rotten fruit and leaving the good part.

The main goal of our surgeons is to leave as much of your healthy kidney tissue as possible in the body. Because, as you know, the kidneys are the two main filters in our body. The kidneys filter and separate the waste products in the body and excrete them as urine. So the kidneys are essential for life. If we can keep both kidneys functioning well, it is very important for our overall health.

What are the main methods of performing this surgery?

There are three main methods for performing this surgery. Your doctor will decide which method is best for you based on your condition, the size of the damaged part of your kidney, and its location.

Is this a serious surgery? Who would want to do this?

Yes, Partial Nephrectomy is a major surgery . Because it involves treating and restoring the kidney, an internal organ of the body. But thanks to techniques like robotics, which we discussed earlier, this surgery is now much safer than before, and the recovery time is shorter. Your surgeon will explain to you in detail which method is best for you and why.

There are several cases in which this surgery is usually recommended:

• Kidney cancer: This surgery is most commonly performed to remove cancerous tumors in the kidneys.
• Infection: When part of the kidney is damaged due to some severe infections, that part may need to be removed.
• Damage from kidney stones: If the kidney is damaged by large kidney stones.
• Injury: When the kidney is injured due to an accident.
• Birth defects: If there was a kidney defect at birth.
• High blood pressure: This surgery is sometimes performed to control high blood pressure caused by a problem with the blood vessels that supply blood to the kidneys.

What happens before the surgery?

After scheduling your surgery, you will need to see a doctor. Your general health will be checked. Things like blood pressure, pulse, and temperature will be measured.

And you have a very important responsibility .

• Tell your doctor about all the medications you are taking . This includes not only prescription medications, but also over-the-counter medications (OTC), vitamins, traditional medicines, and even Ayurvedic medicines. This is especially important if you are taking aspirin or blood thinners, as these medications can increase the risk of bleeding during surgery.
• Tell us about any allergies you have. This includes allergies to certain medications, skin cleansers like iodine, latex, or foods.
• Your doctor will give you some special instructions about what to eat and drink the day before your surgery. Generally, it is best not to eat or drink anything after midnight the night before your surgery . If you need to take any essential medication, ask your doctor if you can take it with just a sip of water.

What happens during the surgery?

This surgery is performed by a team of specialist doctors and nurses. Typically, this team includes a urologist, an anesthesiologist, and nurses.

First, the anesthesiologist will put you under general anesthesia . This means you will be completely asleep. You will not feel any pain and will not be conscious during the surgery. After you are unconscious, a small tube (urinary catheter) will be inserted to drain your urine.

What happens after that will vary depending on the surgical procedure you choose.

In open surgery (Open partial nephrectomy)

The doctor will make a large incision on your side, between your ribs and your hip, to expose your kidney. Then, the blood vessels that bring blood to and from the kidney are temporarily blocked with a clamp. The kidney is then covered with ice. This is done to reduce the temperature of the kidney and minimize tissue damage when the blood flow is stopped. The diseased part is then removed and the kidney is repaired.

During robotic surgery (Robotic partial nephrectomy)

Here, the doctor makes a few very small incisions in your abdomen. Then, a camera and robotic instruments are inserted through those holes. Then, your abdominal cavity is filled with a little carbon dioxide gas. This creates space inside the abdomen, making it easier for the doctor to see the kidney better and perform the surgery. Then, using robotic arms, the bleeding is stopped, the diseased part is removed, and the kidney is repaired.

At the end of the surgery, the incisions are closed with stitches or staples. Sometimes, small silicone drainage tubes may be placed to drain any blood or fluid that collects inside the wound. These are removed after a few days. The entire surgery usually takes about 3-4 hours .

What happens after the surgery?

After the surgery, you will be taken to a recovery room. As the effects of the anesthesia wear off, you will gradually regain consciousness. However, it is normal to feel a little lightheaded and drowsy at first.

After you wake up, the nurses will give you pain medication. Robotic surgery is less painful than open surgery, but you will still need medication to control the pain. The anesthesia can cause nausea. If this happens, you will be given medication for that as well.

• Diet: You will be given only a liquid diet for a day or two after surgery. This will give your body time to recover. After that, you can gradually eat normal foods.
• Walking: From the day after surgery, you will be encouraged by the nurses to get out of bed and walk around a bit . This is very important. Walking improves blood circulation, helps wounds heal faster, and prevents complications such as blood clots in the legs and pneumonia.
• Hospital stay: If you have robotic surgery, you will usually stay in the hospital for 1-2 days . If you have open surgery, you will stay for about 3-4 days .

Once the doctors decide that you are well, you can go home. But you cannot drive a car alone. You will need to have a family member or friend come and pick you up. It is also a good idea to have someone to take care of you for a few days after you go home.

How long will it take to recover? When can I go back to work?

Your recovery time will vary depending on the type of surgery you had and your general health.

• It takes about 8-12 weeks to resume normal activities after open surgery .
• Recovery after robotic surgery is rapid, with patients returning to normal within 4-6 weeks .

If your job is office-based and not very physically demanding, you may be able to return to work within 4 weeks. However, if your job is physically demanding and involves lifting heavy objects, it is best to stay home and rest for a while longer. Talk to your doctor about this and decide for sure.

What symptoms should you watch out for after surgery?

After you go home, you must go to the clinic on the days the doctor tells you. They will check your wounds and stitches. If you have non-dissolving stitches, they will be cut and removed in about a week or two.

Also, if you experience any of the following symptoms, you should call your doctor immediately.