腹腔镜肾切除术

                               
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Laparoscopic Nephrectomy by Dr P P Singh

What Is Kidney Removal?

A nephrectomy is a surgery to remove all or part of kidney. The kidneys are two small, bean-shaped organs in the abdomen. They filter water and waste products from your blood. They also produce certain hormones.

A nephrectomy is done when:
Kidney is damaged
Kidney is no longer functioning properly
Kidney cancer
Donating kidney

Your doctor may remove kidney through open surgery or laparoscopically. Laparoscopic surgery involves smaller incisions and has a faster recovery time. Recovering from a nephrectomy can take several weeks. It may be painful. As with any surgery, complications such as infections are possible. However, the outlook is usually very good.

Patient may need to have part or all of kidney removed if isn’t functioning properly. Reasons for removal include damage or scarring. These may be due to disease, injury, or infection. Cancer is another reason to remove a kidney. If a kidney tumor is small and you catch it early, only part of patient's kidney may need to be removed.

Donating a Kidney
Sometimes, a person will donate their healthy kidney to someone who needs a new kidney. Kidney transplants are more successful with kidneys from living donors than deceased donors. Patient can be healthy with only one kidney.

What Are the Types of Kidney Removal Surgery?
There are several different types of nephrectomy.
A simple nephrectomy involves removing the entire kidney. Surgeon will make a cut up to 12 inches long in patient's side. The surgeon will cut away patient's kidney’s blood vessels and its connections to bladder. Surgeon will then remove the entire organ. They may need to remove a rib to access kidney.

Laparoscopic Surgery
This technique can be used for either a simple or partial nephrectomy. Instead of one long incision, surgeon will make a series of smaller incisions in your abdomen. They will insert a camera and other small instruments through the incisions. This will allow the surgeon to see inside and remove kidney. This type of surgery is usually less painful than open surgery. Recovery time is shorter as well.

What Are the Risks of Kidney Removal?
There are risks associated with any major surgery. Complications are rare, but they include:

loss of blood
allergic reaction to anesthesia or other medications
the formation of a blood clot in your legs that moves into your lungs, which is called a pulmonary embolism
breathing difficulties
infection at the surgical incision site

Other risks are specific to a nephrectomy. They include:
an injury to other organs or tissues around your kidney
a hernia in which organs might bulge out of your surgical incision

How Do I Prepare for Kidney Removal?
Be sure to tell surgeon if patient might be pregnant. Also, inform them about all medications patient taking, including those that are over the counter. Patient may need to stop taking certain medications before the surgery, especially blood thinners.

Several days before the surgery, doctor will draw blood. This will determine blood type in case patient needs a transfusion during the procedure.
Patient will also need to fast and stop drinking liquids for a period before surgery.

What Is the Long-Term Outlook?
Recovery after surgery should take between three and six weeks. Patient may need to stay in the hospital for up to seven days. Surgeon will discuss the success of the surgery and any follow-up treatments may need.

Doctor will monitor the function of remaining kidney. The outlook is typically very good in cases where one kidney remains.