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Nephrectomy is the surgical removal of a kidney

History The first successful nephrectomy was performed by the German surgeon Gustav Simon on August 2, 1869 in Heidelberg. Simon practiced the operation beforehand in animal experiments. He proved that one healthy kidney can be sufficient for urine excretion in humans. Indications There are various indications for this procedure, such as renal cell carcinoma, a nonfunctioning kidney (which may cause high blood pressure) and a congenitally small kidney (in which the kidney is swelling, causing it to press on nerves which can cause pain in unrelated areas such as the back). Nephrectomy for renal cell carcinoma is rapidly being modified to allow partial removal of the kidney. Nephrectomy is also performed for the purpose of living donor kidney transplantation.

Nephrectomy is the surgical removal of the kidney. When renal cell carcinoma has been found to be the cause of a kidney mass, kidney tumor, or kidney pain surgical removal of the kidney or part of the kidney (partial nephrectomy) is the common course of action. Another minimally invasive procedure, cryotherapy is also used do destroy the kidney cancer. Nephrectomy may be performed using several techniques which include the traditional open nephrectomy, laparoscopic nephrectomy, and robotic nephrectomy. All of the above procedures are performed under general anesthesia. open radical nephrectomy, laparoscopic nephrectomy, minimally invasive robotic nephrectomy, partial nephrectomy, or a cryoablation of the kidney (freezing), Laparoscopic nephrectomy, open nephrectomy, and robotic nephrectomy are simply three different ways to surgically remove the kidney. The open nephrectomy is the original way surgery was done, by making an incision in the skin and have the surgeons place their hands inside the body to operate and remove the kidney. The object behind removing the entire kidney is to be sure all of the cancer is out of the body so it can not spread to other parts of the body. The job of the kidneys is to filter out water and waste out of our blood. Since we have two kidneys having one removed will not be a detriment to our lifestyle. However from that point on we no longer have a back up kidney if the lone kidney has any problems such as infections, kidney stones, UPJ obstruction, kidney tumor, kidney mass, diabetes, or renal cell carcinoma. Laparoscopic nephrectomy is performed by making several small incisions to allow the laparoscopic tubes to slide in the body. On of the laparoscopic instruments is a very small camera that allows surgeons to view what they are doing up on a monitor. The other laparoscopic instruments are for cutting, cauterizing, grasping, suturing, etc. Gas is blown into the body cavity to open up the surgical area to give room for seeing the organs and room to move around to perform the surgery. Laparoscopic nephrectomy has several advantages over the open nephrectomy. Generally there is less bleeding during and after the operation. The scars are much smaller and the healing time is shorter. Shorter healing time also translates into a shorter hospital stay. Patients have less discomfort and less pain with our minimally invasive laparoscopic nephrectomy Many times patients can be back into their day to day lives faster and that includes going back to work. Since

The “cryo” or freezing is performed by placing a needle(s) under ultrasound guidance into the kidney tumor. When a kidney tumor or kidney mass is found to be cancerous such as renal cell carcinoma and the size of the cancer covers an area of 1. Partial nephrectomy is the removal of a cancerous kidney mass that is most often 1. or Coumadin they need to be discontinued as your surgeon prescribes. . A bowel prep the night before surgery and not drinking or eating anything after 12 o’clock before your surgery. Twenty four hours prior to surgery you should go on a clear diet which includes: water. overall health is good. and why’s that will help you make clear your understanding of your specific circumstance. where. and jello without fruit. tea. the kidneys are in good working order. or sac-like structures. Laparoscopic nephrectomy procedure preparations are similar to most surgeries. To make sure the cancer cells die the tumor is frozen again and again thawed. At the Miami urology center your preferences and concerns will be addressed by our urologists and our medical staff to help you fill in the who. or kidney removal.every patient has their own set of circumstances. your options and what you can expect in the near and far future. killing the renal cell carcinoma.6 inches or less. To qualify for a laparoscopic partial nephrectomy the kidney mass needs to be 1. what. Partial nephrectomy may also be performed with laparoscopic instruments the advantages are: less post procedure pain.6 inches or less our experienced team of Ivy League urologists have the skills and experience to perform all three kidney surgery techniques of partial nephrectomy or a cryoablation of the kidney mass. Kidney cryotherapy is another procedure that is offered at the Miami urology center in the Mount Sinai Medical Center. It is also used to remove a healthy kidney from a donor for the purposes of kidney transplantation . injury. The urologist watches the ice ball form in the kidney with ultrasound. or congenital conditions. is performed on patients with severe kidney damage from disease. When the tumor is thawed out the freezing gas is once again pumped in to freeze the kidney tumor a second time and then thawed again to make sure the all the cancer cells are destroyed. Kidney cryotherapy or cryoablation of the kidney is a procedure that freezes the tumor in the kidney. The needles have passages in them that allow gas to flow in them to freeze the metal needle(s) which turns the tumor into an ice ball. Once the tumor is frozen it is then thawed. It is during thawing that the cancer cells die. These include cancer of the kidney (renal cell carcinoma).6 inches (4 centimeters) or less. Purpose Nephrectomy. and serious kidney infections. and the kidney tumor is not in the middle of the kidney. If you are taking blood thinners such as aspirin. these positive trends that are seen are not guarantees of outcomes. less blood loss. Plavix. polycystic kidney disease (a disease in which cysts. quicker recovery and shorter hospital time. displace healthy kidney tissue). juices (no tomato or orange juice). Cryoablation of the kidney freezes the kidney tumor to -100 degrees Celsius or 100 degrees Celsius below zero. Once the ice ball encompasses the whole kidney tumor the freezing gas is sent out of the needles and another gas is sent into the needle(s) causing the needle(s) to heat up and thaw the ice ball tumor.

. near or on the incision. Risks Possible complications of a nephrectomy procedure include infection. Although deep breathing and coughing may be painful due to the proximity of the incision to the diaphragm. and post-operative pneumonia. Pain relievers are administered following the surgical procedure and during the recovery period on an as-needed basis. bleeding (hemorrhage). Patients may also experience numbness. There is also the risk of kidney failure in a patient with impaired function or disease in the remaining kidney.Aftercare Nephrectomy patients may experience considerable discomfort in the area of the incision. Patients should not drive an automobile for a minimum of two weeks. breathing exercises are encouraged to prevent pneumonia. caused by severed nerves.

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. and the ureter is also cut between the bladder and kidney and clamped.2–25. and/or surrounding tissue may also be cut. . the kidney donor is administered general anesthesia and a 6–10 in (15. open nephrectomy. The blood vessels connecting the kidney to the donor are cut and clamped.4 cm) incision through several layers of muscle is made on the side or front of the abdomen. Depending on the type of nephrectomy procedure being performed.Open nephrectomy In a traditional. the ureter. depending on the type of nephrectomy being performed. adrenal gland.

7 cm) is made in the patient's abdomen. shorter hospital stays. In the hand-assisted surgery. Although this surgical technique takes slightly longer than a traditional nephrectomy. The videoscope and surgical instruments are maneuvered through four small incisions in the abdomen. Once the kidney is isolated. . The surgeon views the kidney and surrounding tissue with a flexible videoscope. and remove the kidney.Laparoscopic nephrectomy Laparoscopic nephrectomy is a form of minimally invasive surgery that utilizes instruments on long. cut. This technique gives the surgeon the benefit of using his hands to feel the kidney and related structures. A modified laparoscopic technique called hand-assisted laparoscopic nephrectomy may also be used to remove the kidney. and carbon dioxide is pumped into the abdominal cavity to inflate it and improve visualization of the kidney. narrow rods to view. approximately 3 in (7.6 cm) wide. and less post-operative pain. a small incision of 3–5 in (7. it is secured in a bag and pulled through a fifth incision. The kidney is then removed by hand through the incision instead of with a bag. in the front of the abdominal wall below the navel.6–12. preliminary studies have shown that it promotes a faster recovery time. The incision allows the surgeon to place his hand in the abdominal cavity using a special surgical glove that also maintains a seal for the inflation of the abdominal cavity with carbon dioxide.