Have you or someone you know been told by a doctor that a kidney needs to be completely removed? It's normal to feel a little scared and nervous when you hear those words. Questions like "How will I live without a kidney?" probably come to mind. But don't worry. Let's talk about this surgery, called 'Radical Nephrectomy', in simple terms and find answers to all the questions you have in mind.
What is Radical Nephrectomy?
Simply put, this is a surgery. In this, your entire kidney is removed. In medical terms, "nephro" means "kidney" and "ectomy" means "to remove." So the name suggests it, right?
This surgery removes not only the kidney but also the fatty tissue surrounding it. Sometimes, the adrenal gland and surrounding lymph nodes may also need to be removed.
Although many people have two kidneys, they can live well with just one healthy kidney without any problems. Over time, the remaining kidney will grow slightly larger and stronger, and begin to do the work of two kidneys.
Why do you need this surgery?
Most often, the main reason for this surgery is to remove a cancerous tumor in the kidney . However, your doctor may recommend this surgery for other reasons as well.
- Frequent kidney infections: Some people have recurring kidney infections.
- Kidney failure: When a kidney stops working completely due to a disease or accident.
- Other kidney diseases or damage: Due to other medical conditions that cannot be controlled.
- Kidney donation: This surgery is also performed when a person donates their healthy kidney to another person.
How do you prepare before surgery?
Since this is a major surgery, you will be carefully prepared beforehand.
- Medical tests: Blood and urine tests will be done to check your current kidney function. Your blood type will also be checked in case you need to donate blood during surgery. Your general health, such as fever, pulse, and blood pressure, will also be checked.
- Medication Information: It is important to tell your doctor about all the medications you are taking (prescribed and over-the-counter), including vitamins and herbal supplements . Some pain relievers (NSAIDs) and blood thinners (anticoagulants) can increase the risk of bleeding during surgery.
- Allergies: Tell us about any allergies you have. For example, allergies to certain medications, latex, or iodine used to clean the skin.
- Avoid eating or drinking: You will not be allowed to eat or drink anything for a few hours before the surgery. This is because if you have food in your stomach while you are under anesthesia, there is a risk that you will vomit it up and it will enter your lungs. This can be dangerous.
What are the surgical methods?
Radical Nephrectomy surgery is performed in three main ways. Your doctor will determine the method that best suits your situation.
| Surgical method | Description |
|---|---|
| Open Radical Nephrectomy | In this procedure, the surgeon makes one large incision, about 12 inches long. This method is used if the tumor in the kidney is very large or if a large number of surrounding lymph nodes need to be removed. |
| Laparoscopic Radical Nephrectomy | This is the most commonly used method now. Instead of one large incision, several small incisions (about 1 centimeter) are made in the abdomen or groin. Through these incisions, a thin instrument with a camera (laparoscope) and other surgical instruments are inserted and the surgery is performed. |
| Robotic Radical Nephrectomy | This is similar to the laparoscopic method, but here the surgical instruments are manipulated by a robotic arm controlled by the doctor. This allows for very delicate and precise surgery. |
What happens after the surgery?
The surgery usually takes three hours or more. When the surgery is over, the anesthesiologist will wake you up. But you will feel sleepy for a while.
You will be taken to a recovery room, where your health will be monitored and you will be given medication to control the pain.
- Food: Only liquid food is given on the first day. Later, you can gradually eat regular food.
- Walking: You are encouraged to walk a little from the day after surgery. Walking improves blood circulation, helps you heal faster, and can also help prevent complications like blood clots in your legs.
- Urinary catheter: The urinary catheter placed during surgery is usually removed the next morning.
- Discharge from the hospital: You will be allowed to go home once your condition improves. If you had open surgery, you will need to stay in the hospital for a few days. After laparoscopic surgery, you can go home soon. It is essential that someone accompany you home.
How long does it take to heal?
Recovery time depends on the type of surgery you had. Open surgery takes longer to heal. Typically, it can take between 8 and 12 weeks to fully recover and resume activities such as weightlifting.
You can return to light work, such as in the office , in about 4 weeks . However, if you have a physically demanding job, it may take longer. Talk to your doctor about this and get proper advice.
Situations when you need to see a doctor immediately
It is very important to monitor your condition after you go home. If you have any of the following symptoms, call your doctor immediately or go to the hospital's Emergency Department (ETU).
- Excessive bleeding from the surgical wound.
- Swelling, redness, foul-smelling pus-like fluid around the wound, or a fever over 37.8 Celsius (100 Fahrenheit) could be signs of infection.
- Blood in the urine (hematuria).
If you have had surgery for cancer, your doctor will order tests like a CT scan and blood and urine tests at regular intervals to check for recurrence. It is very important to get these tests done regularly and without skipping them.
Take-Home Message
- Radical nephrectomy is a major surgery that completely removes a kidney.
- This is mainly done to treat serious conditions such as kidney cancer.
- Laparoscopic surgery (surgery performed through small incisions) is now widely used and allows for a faster recovery.
- It is entirely possible to live a normal, healthy life with one healthy kidney.
- Talk openly with your doctor about any fears, doubts, or questions you may have about the surgery. This will give you a lot of peace of mind.
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