Do you want to have part of your kidney removed? (Partial Nephrectomy) - Don't be afraid, let's talk about this.

Has your doctor told you that you need to have a kidney transplant due to a kidney tumor, infection, or other problem? It's normal to feel a little scared and anxious when you hear something like this. But don't worry. In this day and age of advanced medical science, such surgeries can be performed very successfully. Today, we'll talk about this so-called 'Partial Nephrectomy', or the surgery to remove part of a kidney, in a simple way that you can understand.

Simply put, what is Partial Nephrectomy?

Partial Nephrectomy is a surgical procedure in which only the diseased, damaged, or cancerous part of one of your kidneys is surgically removed, and the remaining healthy part of the kidney is restored.

Think about it, the kidneys are the main filter in our body. These two kidneys filter out waste products from the body and keep us healthy. So the main goal of this surgery is to remove only the diseased part, without removing the entire kidney, and to save as much healthy kidney tissue as possible. Because the functioning of a kidney is essential for our life, it is very important to protect its healthy parts.

Why do you need to have this kind of surgery?

Your doctor may recommend this surgery for a number of different conditions. The main reasons include:

• Kidney Cancer: This method is often used to remove small cancerous tumors, especially those that develop in the kidneys.
• Recurrent Infections: Severe infections that are limited to one part of the kidney and are not treatable with medication.
• Damage caused by kidney stones: If a part of the kidney has become dysfunctional or damaged due to kidney stones.
• Injury: If a part of the kidney is damaged due to an accident.
• Birth Defects: If there is a defect in some part of the kidney at birth.
• High blood pressure: This surgery may sometimes be necessary to control high blood pressure caused by a problem with the blood vessels that supply blood to the kidneys.

What are the main surgical methods?

There are generally two main methods for performing this surgery. Depending on your condition, your doctor will determine the method that is best for you.

What happens before the surgery?

After scheduling your surgery, you will need to meet with the doctor. There,

• Your overall health will be checked. Things like blood pressure and pulse will be measured.
• It is important to tell your doctor about all medications (prescribed and over-the-counter), vitamins, and herbal supplements you are taking. Blood thinners, such as aspirin, may need to be stopped before surgery. However, never stop taking any medication without talking to your doctor first.
• Inform about any allergies you have (medicines, skin cleansers, latex, food).
• You will be advised not to eat or drink anything after midnight the night before the surgery. If you need to take any essential medication, you may be able to take it with a sip of water. The doctor will also tell you about that.

What happens during the surgery?

This is a team effort. This team usually includes a kidney surgeon (Urologist), an anesthesiologist, and a nursing staff.

First, the anesthesiologist will put you under general anesthesia. This means you won't feel any pain during the surgery, and you'll be asleep. Then, a urinary catheter will be inserted.

Next, the surgery is performed according to the chosen method.

• In open surgery: The doctor makes a large incision and temporarily closes the blood vessels that carry blood to and from the kidney with a clip. Then, ice is placed on the kidney to reduce the temperature of the kidney. This is done to minimize damage to the kidney tissue while the blood flow is stopped. The diseased part is then removed and the kidney is repaired.
• Robotic Surgery: A camera and instruments are inserted through small incisions, and the abdominal cavity is filled with carbon dioxide gas. This creates space inside the abdomen, allowing the doctor to easily reach the kidney. Then, using robotic arms, the diseased part is removed very delicately and the kidney is repaired.

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

What happens after the surgery? And how long does it take to recover?

After the surgery, you will be taken to a recovery room. You will be conscious but a little sluggish. You will be given medication to control the pain. You may feel nauseous due to the anesthesia, and medication will be given for that as well.

• Food: You will only be given liquid food for the first day or two. Then you will gradually be introduced to regular food.
• Walking: Surprisingly, you will be encouraged to get out of bed and walk around the day after surgery. Walking can help speed up recovery, improve blood circulation, prevent blood clots, and prevent complications like pneumonia.
• Hospitalization: After robotic surgery, you will usually have to stay in the hospital for 1-2 days . After open surgery, you will have to stay for about 3-4 days .
• Recovery time: You can return to normal activities within 4-6 weeks after robotic surgery. It can take about 8-12 weeks after open surgery. If your job is physically demanding, it is wise to take a little longer to recover.

When should you call the doctor immediately?

After you go home, you will need to see your doctor on your scheduled appointments. However, if you experience any of the following symptoms, call your doctor immediately or go to the nearest hospital Emergency Department (ETU).

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