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Nephrectomy is the surgical procedure of removing a kidney or section of a kidney.


Nephrectomy, or kidney removal, is performed on patients with cancer of the kidney (renal cell carcinoma); a disease in which cysts (sac-like structures) displace healthy kidney tissue (polycystic kidney disease); and serious kidney infections. It is also used to remove a healthy kidney from a donor for the purposes of kidney transplantation.


Because the kidney is responsible for filtering wastes and fluid from the bloodstream, kidney function is critical to life. Nephrectomy candidates suffering from serious kidney disease, cancer, or infection usually have few treatment choices but to undergo the procedure. However, if kidney function is lost in the remaining kidney, the patient will require chronic dialysis treatments or transplantation of a healthy kidney to sustain life.


Nephrectomy may involve removing a small portion of the kidney or the entire organ and surrounding tissues. In partial nephrectomy, only the diseased or infected portion of the kidney is removed. Radical nephrectomy involves removing the entire kidney, a section of the tube leading to the bladder (ureter), the gland that sits atop the kidney (adrenal gland), and the fatty tissue surrounding the kidney. A simple nephrectomy performed for transplant purposes requires removal of the kidney and a section of the attached ureter. A similar procedure is used to harvest cadaver kidneys, although both kidneys are typically removed at once (bilateral nephrectomy) and blood and cell samples for tissue typing are also taken.
The nephrectomy patient is administered general anesthesia and the surgeon makes an incision on the 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.
Laparoscopic nephrectomy is a form of minimally-invasive surgery that utilizes instruments on long, narrow rods to view, cut, and remove the kidney. The surgeon views the kidney and surrounding tissue with a flexible videoscope. The videoscope and surgical instruments are maneuvered through four small incisions in the abdomen. Once the kidney is freed, it is secured in a bag and pulled through a fifth incision, approximately 3 in (7.6 cm) wide, in the front of the abdominal wall below the navel. Although this surgical technique takes slightly longer than a traditional nephrectomy, preliminary studies have shown that it promotes a faster recovery time, shorter hospital stays, and less postoperative pain for kidney donors.


Prior to surgery, blood samples will be taken from the patient to type and crossmatch in case transfusion is required during surgery. A catheter will also be inserted into the patient's bladder. The surgical procedure will be described to the patient, along with the possible risks.


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.

Key terms

Cadaver kidney — A kidney from a brain-dead organ donor used for purposes of kidney transplantation.
Polycystic kidney disease — A hereditary kidney disease that causes fluid- or blood-filled pouches of tissue called cysts to form on the tubules of the kidneys. These cysts impair normal kidney function.
Renal cell carcinoma — Cancer of the kidney.

Normal 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 nephrectomy 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 undergoing a laparoscopic radical nephrectomy may be released within 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.



National Kidney Foundation. 30 East 33rd St., New York, NY 10016. (800) 622-9010.
Gale Encyclopedia of Medicine. Copyright 2008 The Gale Group, Inc. All rights reserved.


surgical removal of a kidney, a procedure indicated when chronic disease or severe injury produces irreparable damage to the renal cells. Tumors, multiple cysts, and congenital anomalies may also necessitate removal of a kidney.
Patient Care. The surgical incision for nephrectomy can be lumbar, retroperitoneal, transabdominal, thoracic, or thoracic abdominal. Upon the patient's return from the operating room the location of the surgical wound is immediately noted, as well as whether there are any tubes or drains exiting the wound. If the thoracic cavity has been entered, the patient will have one or more chest tubes. There may also be surgical drains for removal of serosanguineous fluid from the operative site.

Dressings over the wound are checked frequently and may be reinforced to keep the patient dry, but they are not changed without a written prescription to do so. The drainage on the dressings will be blood-tinged at first but should gradually become clearer. Hemorrhage is a major complication; hence, any appearance of bright red blood or a change in the amount of drainage is reported immediately. The kidney has a very rich supply of blood directly from the vena cava and aorta, so that if a ligature should slip, there could be substantial blood loss. The vital signs are therefore monitored closely and any signs of shock reported promptly. An intravenous line should be kept open in the event a transfusion is needed.

Sometimes the drain will have a safety pin attached to its end. The pin is kept closed at all times and is never attached to the dressings, the patient's gown, or the bedclothes. When dressings are reinforced or changed, care must be taken that drains and tubes are not dislodged or pulled from the surgical incision. All tubes and drains are checked frequently to assure that they are patent and draining freely. The exception, of course, is a chest tube attached to a closed system.

Positioning of the patient will depend on the site of the incision and the preference of the physician. Some may prefer that the patient lie only on the affected side to facilitate drainage and protect the remaining kidney. Turning, coughing, and deep breathing will produce some discomfort because of the location of the incision. However, adequate aeration of the lungs is essential. One also should watch for spontaneous pneumothorax, which can occur if the thoracic cavity has been entered accidentally during surgery.

Adequate drainage from the unaffected kidney is of extreme importance. Urinary output is monitored hourly at first and then at longer intervals to be sure there is normal renal function. Fluids may be restricted immediately after surgery and gradually increased as the remaining kidney compensates for the loss of its partner. A single kidney can carry out the work of two kidneys; thus a patient can survive a nephrectomy in good health.
radical nephrectomy removal of a kidney with its fascia, the adjacent adrenal gland, and all lymph nodes in the region; done for renal cell carcinoma.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.


Removal of a kidney.
[nephr- + G. ektomē, excision]
Farlex Partner Medical Dictionary © Farlex 2012


n. pl. nephrecto·mies
Surgical removal of a kidney.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.


The surgical removal of a kidney.
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.


Surgery Surgical removal of a kidney. See Partial nephrectomy, Radical nephrectomy, Simple nephrectomy.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.


Surgical removal of a kidney.
[nephr- + G. ektomē, excision]
Medical Dictionary for the Health Professions and Nursing © Farlex 2012


Surgical removal of a kidney. This may be necessary because of injury and severe bleeding, cancer, severe infection, malfunctioning from loss of blood supply or multiple stones. If the other kidney is healthy there is no apparent functional disadvantage from nephrectomy. One kidney provides ample kidney function to maintain health and allow full physical activity.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
References in periodicals archive ?
To date, few clinical studies have demonstrated the importance of NGAL in diagnosis of possible AKI in partial nephrectomies. However, Abbasi et al.
Pathological analyses revealed renal cell carcinoma in 72% and 89% of the radical nephrectomies in the RN and TLN groups, respectively, without surgically positive margins in all cases.
This was compared to all the other urological procedures performed during the study period, including nephrectomies for malignant diseases.
The sample size in their study was 67 laparoscopic nephrectomies and 55 open nephrectomies.
(3,4,8) Two separate studies demonstrate the presence of diagnostic pathologic findings in as much as 90% (9) and more than 60% (4) of the kidneys where the nontumor portion from tumor nephrectomies were reviewed.
Objective: To evaluate the impact of 3-month laparoscopic fellowship programme (LFP) on the laparoscopy experience mainly related to laparoscopic nephrectomies.
SAN FRANCISCO -- Laparoscopic surgery accounted for more nephrectomies and nephroureterectomies in 2002-2003 than in the prior 2 years, Dr.
For example, if a center wants to perform laparoscopic donor nephrectomies, the qualifying donor surgeon must have performed no fewer than 15 hand-assisted laparoscopic nephrectomies, or asking as primary surgeon on no fewer than 15 in the past 3 years.
In Hartford Hospital, of the 104 patients treated with handoscopy between March 1998 and August 1999, there were 52 radical nephrectomies, 15 nephroureterectomies, eight simple nephrectomies, two partial nephrectomies, and 27 donor nephrectomies.
(9) Both of our patients had prior partial nephrectomies and ablations of their remaining single kidney, and reduced nephron mass may have been a predisposing factor for this toxicity.
This can be an independent risk factor for developing chronic renal insufficiency in partial nephrectomies. (6)
Operating times are on average an hour longer than for open nephrectomies, laparoscopic equipment and disposables are expensive, and there is a steep learning curve.