When your doctor tells you that you need to have one of your kidneys completely removed, you may feel a great deal of fear and shock. "What will happen to me if I have two kidneys and one is removed?" "Is this a major operation?" You may have many questions in your mind. That's very normal. So today, let's talk about this surgery called Radical Nephrectomy, and find answers to all the questions you have in mind.
What is Radical Nephrectomy?
Simply put, this is a surgery to completely remove one of your kidneys. In medical terms, "nephro" means "kidney." "ectomy" means "removal." So, a nephrectomy is the removal of a kidney.
In this operation, the surgeon removes your entire kidney, along with the fatty tissue surrounding it. Sometimes, the adrenal gland above the kidney and the lymph nodes around the kidney may also need to be removed.
But remember this: Although we all have two kidneys, we can live a normal life without any problems with one healthy kidney. The other kidney takes over the work of the removed kidney and becomes slightly larger and works more powerfully.
Why do you need to have this kind of surgery?
The main reason for this surgery is often to remove a cancerous kidney tumor. However, your doctor may recommend this surgery for several other reasons.
- Having kidney cancer: Especially if the cancer is quite large or there is a risk of spreading outside the kidney.
- Frequent kidney infections: If the kidneys are damaged due to persistent infections that cannot be controlled with treatment.
- Kidney failure: If one kidney is completely dysfunctional due to an accident, disease, or other cause.
- Kidney Donation: If you are donating a kidney to a loved one.
This is a common and commonly performed surgery, so don't be unnecessarily afraid of it.
How to prepare for surgery?
Since this is a major surgery, you will be carefully prepared beforehand.
1. Medical tests: Your doctor will first do some blood tests. These will determine your baseline kidney function and your blood type. This will help you get an idea of how well your remaining kidney will function after surgery. It is also important to know your blood type in case you need to donate blood, even if it is an emergency. In addition, your general health, fever, pulse rate, and blood pressure will be checked.
2. Informing the doctor about the medications you are taking: It is essential to inform the doctor about all the medications you are taking, whether they are prescribed by a doctor , over-the-counter pain relievers (such as NSAIDs), blood thinners (such as anticoagulants), vitamins, Ayurvedic or herbal remedies. Some medications can increase the risk of bleeding during surgery.
3. Tell us about your allergies: If you have any allergies to certain medications, latex, or iodine used to clean your skin, you should definitely tell us about them.
4. Food and Drink: You will be given clear instructions on how many hours you should fast before surgery and when you should stop drinking water. If you have food in your stomach while you are under anesthesia, you may vomit and the food may enter your lungs. This is dangerous. So follow the instructions exactly.
What are the methods of performing this surgery?
There are three main methods for performing a radical nephrectomy. Your surgeon will decide which method is best for you based on your condition.
| Surgical method | Description |
|---|---|
| Open Radical Nephrectomy | In this procedure, the doctor makes one large incision about 12 inches long and performs the surgery. This method is used if the kidney cancer is very large or if a large number of surrounding lymph nodes need to be removed. |
| Laparoscopic Radical Nephrectomy | In this, instead of one large incision, several small incisions are made, about 1 centimeter in size. A thin instrument with a camera (laparoscope) is inserted through one incision, viewed on a monitor, and fine instruments are inserted through other incisions to remove the kidney. This is the most commonly used method now. |
| Robotic Radical Nephrectomy | This is similar to laparoscopic surgery, but here the surgical instruments are manipulated by robotic arms controlled by the doctor. This allows the surgery to be performed more delicately and accurately. |
What happens during the surgery?
After you are taken to the operating room, the anesthesiologist will give you general anesthesia. This means you will not feel any pain and will be sound asleep until the surgery is over.
After that,
- You will be given a urinary catheter to empty your bladder.
- In the case of laparoscopic or robotic surgery, a few small incisions are made and the abdomen is filled with a small amount of carbon dioxide gas to create space between the organs.
- The doctor carefully clips the blood vessels connected to the kidney and removes the kidney, the tissue around it, and other parts if necessary.
- After surgery, a small tube (surgical drain) may be placed to remove excess fluid and blood that accumulates inside.
- Finally, the incisions are closed with stitches or staples.
This entire process can take 3 hours or more.
What happens after the surgery?
Once the surgery is complete, you will be transferred to a recovery room. The medical team will take good care of you until you regain consciousness and your condition stabilizes.
- Pain control: When you feel pain, you are given the necessary medication.
- Food: Only liquid food is given for the first day or two. Then gradually introduce regular food.
- Walking: You will be encouraged to walk a little from the day after surgery. Walking improves blood circulation and helps wounds heal faster. It is also very important to prevent complications such as blood clots in the legs and pneumonia.
- Going home: Once the medical team decides that you are well, you will be allowed to go home. Since you will not be able to drive, ask a family member or friend to come with you. It is important to have someone to take care of you for the first few days after you go home.
How long will it take to recover? And is it possible to relapse?
The time it takes for you to fully recover depends on the type of surgery you had. While open surgery takes about 8-12 weeks, recovery after laparoscopic surgery is much faster. You may need to avoid heavy lifting and strenuous activities for a while.
You can usually return to work in about 4 weeks. However, if you have a physically demanding job, you may need to rest longer. Talk to your doctor about this and get advice.
If you have surgery for kidney cancer, it is very rare for the cancer to come back in another part of the body or near the surgery site. This is why it is very important to have regular follow-up visits after surgery.
When to see a doctor
After surgery, you will be scheduled to have your wounds checked and stitches removed. If you had surgery for cancer, you will need to have tests like CT scans , blood and urine tests at regular intervals to check for recurrence.
Also, if you experience any of the following symptoms, call your doctor immediately or go to the nearest hospital Emergency Department (ETU) .
| Warning signs to look out for | |
|---|---|
| Excessive bleeding from the wound | If there is continuous bleeding from cuts. |
| Signs of infection | The wound is swollen, red, oozing a foul-smelling pus-like fluid, or has a fever of more than 37.8 Celsius (100 Fahrenheit). |
| Blood in the urine (Hematuria) | If you have blood in your urine. |
| Severe pain | Severe pain around the wound or in the stomach that cannot be controlled even with medication. |
Take-Home Message
- Radical nephrectomy is a major surgery that completely removes one kidney. It is most often done for kidney cancer.
- If you have one healthy kidney left, you can live a normal, full life with it. The remaining kidney will get stronger over time.
- Before surgery, it is very important to tell your doctor about all the medications you are taking and any allergies you have.
- Recovery after laparoscopic and robotic surgeries is faster.
- If you experience any warning signs after surgery, such as fever, excessive bleeding, or pus from the wound, seek medical advice immediately.
- Following a healthy lifestyle and attending scheduled medical checkups after surgery are essential for your long-term well-being.
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