Laparoscopic nephrectomy (kidney removal) is a minimally invasive technique that provides the patients with less discomfort and equivalent results when compared to the larger incision required for the conventional open surgery. Compared to the traditional open surgery, the laparoscopic nephrectomy has resulted in significantly reduced post-operative pain, a short hospital stay, early return to work and daily activities, more favourable cosmetic results and an outcome identical to the open surgery. Hence, the laparoscopic nephrectomy is a safe and effective way to remove a diseased or cancerous kidney in the patients. Get in touch with us to find answers to how much does a nephrectomy cost?
Patients may need a laparoscopic nephrectomy for the following reasons:
The infections may have damaged the kidney and so it requires to be removed.
The kidney may not be working or only partially working, if left in place it can be a source of infection or pain.
A cancer arising in the kidney may have been diagnosed and the usual treatment for this is to remove the kidney.
If cancer is diagnosed in the kidney, it is sometimes essential to remove the adrenal gland that lies on the top of the kidney at the same time. Some kidney cancers have a higher risk of cancer recurrence in the ureter (a tube carrying urine from the kidney to the bladder). If this have been found, then the ureter will also be removed, which means that a small incision lower down on the abdominal wall as well as the other small incisions will be made. Your doctor will discuss the reason for removing your kidney.
Approximately 4000 people in the United States donate one of their two kidneys each year to a loved one for transplantation.
The standard surgery to remove a kidney requires a flank or abdominal incision of about 8 to 20 inches in length. Additionally, in most instances a rib has to be removed to allow enough exposure. Most of these procedures may be performed by laparoscopy with similar success rates using the “key hole” incisions.
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There are multiple advantages of a laparoscopic nephrectomy and it includes:
Smaller skin incision-about four 1cm incisions rather than a 30cm incision.
Less pain due to smaller incisions and the muscles are parted rather than cut.
Better view because of the magnification of the system.
Shorter hospital stay-about 3 to 5 days in hospitals as compared to a week or longer for the open surgery.
The ability to return to work in 2 to 4 weeks as compared to 6 or more weeks after the traditional open surgery.
Less blood loss and reduced need for a blood transfusion.
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There are no differences in the chance of cancer cure whether the surgery is performed by conventional open or laparoscopic method.
Long-term complications from a nephrectomy relate to potential problems of living with less than two complete, fully functioning kidneys. Although overall kidney function decreases following a nephrectomy, the remaining kidney tissue usually works well enough for a healthy life.
Problems that may occur with long-term decreased kidney function include:
High blood pressure (hypertension)
Chronic kidney disease
Preparing for surgery
Before surgery, you'll talk with your surgeon about what options are available for you. Questions you might ask include:
Will I need a partial or complete nephrectomy?
Am I a candidate for a minimally invasive (laparoscopic) procedure?
What are the chances that I'll need a complete nephrectomy even if a partial nephrectomy is planned?
If the surgery is for treating cancer, what other related procedures or treatments might I need?
Planning your hospital stay
Plan to stay in the hospital from one to three days, depending on the type of procedure. Ask your surgeon and health care team about your probable recovery time.
Expect to receive instructions from staff regarding what to do the day before and the day of your surgery. Bring a list of all your questions, such as:
When do I need to begin fasting?
Can I take my prescription medications?
If so, how soon before the surgery can I take a dose?
What nonprescription drugs should I avoid?
When do I need to arrive at the hospital?
Planning for a donor nephrectomy
If you're planning to donate a kidney for a transplant, you'll have thorough exams to determine if you're a suitable candidate. Criteria for donating include:
18 years of age or older
Compatible blood type with kidney transplant recipient
Generally good health
Two well-functioning kidneys
No history of high blood pressure, kidney disease, diabetes, certain cancers or major risk factors for heart and blood vessel (cardiovascular) disease
Stable mental health
The nephrectomy procedure varies, depending on how the surgery is performed and how much of the kidney is removed. Variations include:
Open surgery. In an open nephrectomy, the surgeon makes an incision about 10 to 20 inches (25 to 50 centimeters) long in either your side or your abdomen — typically between the lower ribs on the side of the affected kidney. The surgeon may need to remove a lower rib to gain better access to the kidney.
Laparoscopic surgery. In this minimally invasive procedure, the surgeon makes a few small incisions in your abdomen to insert wand-like devices equipped with video cameras and small surgical tools. The surgeon makes a somewhat larger opening if your entire kidney needs to be removed.
Robot-assisted laparoscopic surgery. The surgeon may use a robotic system to perform a laparoscopic nephrectomy. Robotic tools require very small incisions, provide better imaging of the procedure and enable precise removal of diseased tissue. The surgeon controls the surgical instruments from a remote console a short distance from the operating table. The assisting surgical team inserts the instruments through the abdominal incisions and attaches the instruments to the system's robotic arms.
Radical nephrectomy. In a radical nephrectomy, the surgeon removes the whole kidney, the fatty tissues surrounding the kidney and a portion of the tube connecting the kidney to the bladder (ureter). The surgeon may remove the adrenal gland that sits atop the kidney if a tumor is close to or involves the adrenal gland.
Partial nephrectomy. In a partial nephrectomy — also called kidney-sparing surgery — the surgeon removes a cancerous tumor or diseased tissue and leaves in as much healthy kidney tissue as possible.
Robotic partial nephrectomy, laparoscopic partial nephrectomy and traditional open surgery yield similar long-term outcomes. However, the much smaller incisions in robotic and laparoscopic surgery usually mean you'll have less postoperative pain and blood loss and a faster return to your normal activities.
Recovery time and the length of your hospital stay depend on your overall health and the type of nephrectomy performed.
Depending in part on your ability to get out of bed and the type of procedure performed, the urinary catheter will likely be removed sometime during the first 24 to 48 hours after the surgery.
Expect to receive instructions before leaving the hospital about restrictions to your diet and activity level. In general, you'll likely be encouraged to begin light, everyday activities as soon as you are able to. You'll need to avoid strenuous activity or exercise for several weeks.