Surgery

1. Nephrectomy
Jinu Janet Varghese
Group 4
TSMU

2. Definition
 A nephrectomy is a surgical procedure for the
removal of a kidney or section of a kidney.

3. History
Laparoscopic Nephrectomy was first performed
in 1990 by Clayman, Kavoussi et al, where
they removed the Right kidney from a patient
diagnosed with Renal Oncocytoma
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.

4. Laproscopic approach to kidney
 Transperitoneal  Retroperitoneal

5. Procedure
 The surgery is
performed with the
patient under general
anesthesia. The surgeon
makes an incision in the
side of the abdomen to
reach the kidney.

6.  The ureter and blood
vessels are
disconnected, and the
kidney is then removed.
The surgery can be
done as open surgery,
with one incision, or as
a laparoscopic
procedure, with three or
four small cuts in the
abdominal and flank
area.

7.  Recently, this procedure
is performed through a
single incision in the
patient's belly-button.
This advanced
technique is called as
single port laparoscopy.

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

10. Risks
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.

11. Aftercare
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.