Nephrectomy is the surgical procedure of removing of an entire a kidney or a section of it.
Nephrectomy is process that involves removal of a small portion of the kidney or the entire organ including the surrounding tissues. When a partial nephrectomy is done, only the diseased or infected portion of the kidney is removed. In a Radical nephrectomy the surgeon removes the entire organ (kidney) including the adrenal gland, ureter and the fatty tissue that surrounds the kidney.
The nephrectomy patient is administered general anesthesia and the surgeon makes an incision on theRADICAL OR PARTIAL NEPHRECTOMY side or front of the abdomen. Muscle, fat, and tissue are cut away to reveal the kidney. The blood vessels connecting the kidney to the circulation are cut and clamped. Depending on the type of nephrectomy procedure being performed, the ureter, adrenal gland, and/or surrounding tissue may also be cut. The vessels and the ureter in the patient are then tied off and the incision is sewn up (sutured). The surgical procedure can take up to three hours, depending on the type of nephrectomy being performed.
Open Nephrectomy
In a traditional, open nephrectomy, the kidney donor is administered general anesthesia and a 6–10 in incision through several layers of muscle is made on the side or front of the abdomen. The blood vessels connecting the kidney to the donor are cut and clamped, and the ureter is also cut between the bladder and kidney and clamped. Depending on the type of nephrectomy procedure being performed, the ureter, adrenal gland, and/or surrounding tissue may also be cut. The kidney is removed and the vessels and ureter are then tied off and the incision is sutured (sewn up). The surgical procedure can take up to three hours, depending on the type of nephrectomy being performed.
Laparoscopic Nephrectomy
This is a minimaly-invasive surgery where the surgeon uses instruments on long narrow rods to view, cut and remove the organ. A flexible videoscope allows the surgeon to view the kidney. There are 5 small incisions done in the abdomen. Four of these incisions are used by the surgeon to maneuver the surgical instruments. The freed kidney is now pulled through the fifth incision and is secured in a bag in the front of the abdominal wall below the navel. This surgical technique does takes a little longer than a traditional nephrectomy, but studies show that it promotes a faster recovery time, shorter hospital stays and less post-operative pain for kidney donors.
Nephrectomy patients may experience considerable discomfort in the area of the incision. Patients may also experience numbness, caused by severed nerves, near or on the incision. Pain relievers are administered following the surgical procedure and during the recovery period on an as-needed basis. Although deep breathing and coughing may be painful due to the proximity of the incision to the diaphragm, breathing exercises are encouraged to prevent pneumonia. Patients should not drive an automobile for a minimum of two weeks.
Possible complications of a nephrectomy procedure include infection, bleeding (hemorrhage), and post-operative pneumonia. There is also the risk of kidney failure in a patient with impaired function or disease in the remaining kidney.
Results
Normal results of a nephrectomy are dependent on the purpose of the procedure and the type of nephrectomy performed. Immediately following the procedure, it is normal for patients to experience pain near the incision site, particularly when coughing or breathing deeply. Renal function of the patient is monitored carefully after surgery. If the remaining kidney is healthy, it will increase its functioning over time to compensate for the loss of the removed kidney.
Length of hospitalization depends on the type of nephrectomy procedure. Patients who have undergone a laparoscopic radical nephrectomy may be discharged two to four days after surgery. Traditional open nephrectomy patients are typically hospitalized for about a week. Recovery time will also vary, on average from three to six weeks.
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Few Major Hospitals for Radical or Partial Nephrectomy are:
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