Radical nephrectomy is a surgical procedure to completely remove the kidneys and the surrounding fat tissue in case of various diseases/conditions such as renal carcinoma, kidney damage, and kidney transplant. In a few cases, lymph nodes and adrenal glands close to the kidney can also be removed. It is an invasive procedure and requires inpatient hospitalization. It is a treatment of choice for renal cell carcinoma.
Alternate Name for Radical Nephrectomy
Complete kidney removal
Kidneys and adrenal glands
How is radical nephrectomy Surgery performed?
Radical nephrectomy is performed under sedatives and anaesthesia to block the pain and sensation. Surgery could be either laparoscopic or open.
- Open surgery: In this surgery, a large cut is made in the abdominal wall to access the kidneys. The kidneys and fat tissues are removed and the incision is closed with stitches. Open surgery is preferred in complex cases or large tumors and also when lymph nodes or adrenal glands are to be removed.
- Laparoscopic surgery: This is minimally invasive because many small incisions are made in the abdominal wall. The laparoscope (instrument with a small camera) is inserted through the incision to create images for guiding the surgeon to access the target area. Once the surgeon is ready, one of the incisions is cut bigger to take out the kidneys. Advanced robotic surgery is available where robots assist in removing the kidneys.
Preparation for Radical Nephrectomy
- Before undergoing radical nephrectomy, it is crucial to understand if you will undergo open or laparoscopic surgery. Your surgeon will recommend you to undergo certain blood tests and a pre-anaesthesia check-up (PAC) that would include a chest X-ray and electrocardiogram (ECG) along with a physical examination to assess your suitability for the surgery.
- You should eat light food the day before surgery and fast for at least 6-8 hours before the surgery, to avoid complications during the surgery.
- Inform your doctor about all your medications and you could be asked to discontinue blood-thinning medications. Also, you could be prescribed certain medications to calm your nerves.
- You should reach the hospital 2-4 hours before the surgery as you will be kept under observation for some time.
Radical Nephrectomy Procedure Type
You should complete your follow-ups as per the schedule to ensure a complication-free recovery. Usually, your surgeon will give a follow-up chart to follow until your incision and wounds have healed. In addition, you should take proper rest as recommended by your doctor and do not overexert yourself. Avoid bending and seek help from your family members or friends. You can start returning to your routine activities in a few weeks. However, avoid strenuous exercises such as running and weight lifting, for an additional few weeks. Make sure to adhere to the follow-up plan with your surgeon to assess the recovery and the need for any additional interventions.
Risks For Radical Nephrectomy Surgery
Laparoscopic surgery is safer than open surgery but is not preferred in certain cases such as complex cancers. The following risks could be associated with both open and laparoscopic surgery:
- Bleeding from the incision site or surrounding tissues/organs.
- Incision site infections could occur and you might need antibiotic treatment following the surgery.
In addition, surgery could be associated with the following side effects:
- Damage to adjoining organs such as the uterus and bladder.
- Post-operative wounds
Recovery From Radical Nephrectomy Surgery
Depending on the type of surgical procedure used, you will be transferred to the recovery room after a few hours to a couple of days. Once your vital signs have stabilized, you will be shifted to the hospital room/ward and within a few days, you will be discharged from the hospital.
The recovery will take a few weeks and you can start returning to your normal activities. While you are in recovery mode, avoid heavy-duty work for a few weeks that could stress your body. Getting regular follow-ups per the schedule is also crucial to achieving a complication-free recovery.
Take good care of the incision wounds and keep them clean. Take your medications including painkillers and antibiotics as prescribed. If you experience any unexplained pain, excessive vomiting, or any other side effects, then seek medical attention.
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