Infection
Bleeding
Blood clots
Damage to nearby organs
Reactions to the anesthesia
Leakage of urine from the remaining kidney tissue, if only part of the kidney is removed

Long-term complications from decreased kidney function may include:

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as:

Smoking
Drinking
Chronic diseases, such as diabetes or obesity

What to Expect TOP

Prior to Procedure

Your blood type is checked. This is done in case a blood transfusion is needed before or after surgery.

Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.

Do not eat or drink after midnight before the procedure. You may need to take medication to cleanse your bowels.

Anesthesia

General anesthesia will be used. You will be asleep during the procedure.

Description of Procedure TOP

A tube called a catheter will be inserted into your bladder. An incision will be made in the abdomen or side of the abdomen. A rib may need to be removed to access the kidney. The tube from the kidney to the bladder is known as the ureter. If the whole kidney is being removed, the ureter and blood vessels will be cut before kidney will then be removed. If only part of the kidney is removed the ureter and blood vessels will be kept. The incision will be closed.

Kidneys, Ureters, and Bladder

Laparoscopic surgery may also be used for a nephrectomy. The abdominal cavity will be inflated with gas. Several keyhole incisions are made in the area. A laparoscope, a long tool with a camera on the end, will be inserted through one of the holes. This allows the doctor to see inside you. Tools will be inserted through the other holes to perform the surgery. The same steps will be used to detach the kidney. A small incision will be made to remove the kidney.

How Long Will It Take? TOP

Between 2-4 hours

How Much Will It Hurt? TOP

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay TOP

The typical hospital stay after a nephrectomy is 2-7 days. The exact length depends on the type of surgery. Your doctor may choose to keep you longer if complications occur.

Post-procedure Care TOP

At the Hospital

IV fluids and pain medication will be given after surgery. Blood pressure, electrolytes, and fluid balance will all be carefully monitored to evaluate kidney function. A urinary catheter is often needed for a short time following surgery.

You will be encouraged to move around and be cautiously active as symptoms allow.

Preventing Infection

During your stay, the hospital staff will take steps to reduce your chance of infection, such as:

Washing their hands
Wearing gloves or masks
Keeping your incisions covered

There are also steps you can take to reduce your chance of infection, such as:

Washing your hands often and reminding your healthcare providers to do the same
Reminding your healthcare providers to wear gloves or masks
Not allowing others to touch your incision

At Home

Avoid difficult exercise or activities for about 6 weeks. Follow instructions about wound care to avoid infection. Your doctor may advise medications to manage discomfort.

If both kidneys are removed hemodialysis or kidney transplantation will be necessary.

Call Your Doctor TOP

Contact your doctor if your recovery is not progressing as expected or you develop complications, such as:

Signs of infection, including fever or chills
Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
Persistent nausea and/or vomiting
Pain that you cannot control with the medications you were given
Difficulty urinating
Sudden weakness

If you think you have an emergency, call for medical help right away.

RESOURCES:

National Cancer Institute
http://cancer.gov

National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov

CANADIAN RESOURCES:

Health Canada
http://www.hc-sc.gc.ca

The Kidney Foundation of Canada
http://www.kidney.ca

References:

Andersen MH, Mathisen L, Oyen O, et al. Postoperative pain and convalescence in living kidney donors—laparoscopic versus open donor nephrectomy: a randomized study. Am J Transplant. 2006;6(6):1438-1443.

Bartlett ST, Schweitzer EJ. Laparoscopic living donor nephrectomy for kidney transplantation. Dialysis and Transplantation.1999;28(6):318-331.

Dunn MD, Portis AJ, Shalhav AL, et al. Laparoscopic versus open radical nephrectomy: A 9-year experience. J Urol. 2000;164(4):1153-1159.

Fabrizio MD, Ratner LE, et al. Laparoscopic live donor nephrectomy. Johns Hopkins Medical Institutions website. Available at
...(Click grey area to select URL)
Accessed May 23, 2013.

Kidney cancer. Urology Care Foundation website. Available at:
...(Click grey area to select URL)
Updated March 2013. Accessed May 23, 2013.

Park YH, Byun SS, Kang SH, et al. Comparison of hand-assisted laparoscopic radical nephrectomy with open radical nephrectomy for pT1-2 clear cell renal-cell carcinoma: a multi-institutional study. J Endourol. 2009;23(9):1485-1489.

6/3/2011 DynaMed's Systematic Literature Surveillance
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Mills E, Eyawo O, Lockhart I, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.

Last reviewed March 2017 by EBSCO Medical Review Board Donald Buck, MD
Last Updated: 1/23/2014

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