Nephrectomy

Laparoscopic Nephrectomy

The kidneys are major organs located at the back of your abdomen, responsible for filtering blood and removing waste from your body in the form of urine. Kidney diseases such as cancer can cause serious impairment to the kidney’s functions. Laparoscopic nephrectomy is a minimally invasive procedure that involves the removal of a diseased kidney. Laparoscopic nephrectomy is a safe and effective alternative to conventional open surgery.

Indications

Laparoscopic nephrectomy can be performed for various reasons:

• Kidney stones that have caused extensive damage to the kidney tissues
• Chronic infection that causes scarring and loss of kidney function
• Removal of donor kidney for transplantation
• Control bleeding in case of trauma to the kidney
• Kidney cancer
• Benign kidney diseases such as polycystic kidney disease (cluster of cysts in the kidney), symptomatic hydronephrosis (swollen kidney due to urine retention) and shrunken kidney

Surgical procedure

Laparoscopic nephrectomy is performed under general anaesthesia. Your doctor will make small incisions on your abdomen to insert a thin tube with a small video camera attached to it and other surgical tools. The ureter and blood vessels that carry blood to and from the kidney to be removed are clipped. The kidney is then released carefully from the surrounding tissues and enclosed in a bag within the body. This is removed by enlarging one of the incisions by approximately 2 inches. The incisions are sutured firmly with stitches. The complete procedure may take 2-3 hours.

Post-operative procedure

You will be encouraged to have some fluids immediately after the surgery. The intravenous fluids will be stopped on the next day after the operation and you will be advised to gradually increase your food intake. You may feel nauseous and experience mild pain in your shoulder and abdomen. You will have a urinary catheter inserted to make it easier to pass urine. The nurse may measure the amount of urine you have passed. The wound dressing may be removed after 48 hours and you will be advised to walk short distances and gradually advance to longer durations. You will be advised to avoid heavy lifting and drink plenty of water so you can pass urine regularly. You can resume your daily activities gradually after 2-3 weeks.

Risks and complications

The laparoscopic nephrectomy may involve certain risks and complications. They include:

• Wound infection
• Pulmonary embolism (blood clot in the leg or lung)
• Shoulder pain and abdominal bloating
• Urine infection
• Chest infection
• Bleeding
• Injury to neighbouring tissues

Advantages

The advantages of laparoscopic nephrectomy over the open method include:

• Less invasive, less post-operative pain and discomfort
• Reduced hospital stay
• Favourable cosmetic result