Nephrectomy is the medical term for kidney removal, explains Coral Gables, Florida urologist Paul Perito MD. When the entire kidney is extracted, says Dr. Perito, the procedure is referred to as a radical nephrectomy; partial nephrectomy indicates the removal of dead tissue alone. According to Paul Perito MD, this procedure is used most often to treat kidney cancer or to remove a defective, diseased, or damaged kidney. A nephrectomy may also be used in the case of organ transplant, so that a healthy kidney can be harvested for implantation into a waiting recipient, adds urologist and specialist Paul Perito MD.
According to Paul Perito MD, the kidneys are bean shaped organs, just above the bladder, that perform many vital functions for the body. They help regulate blood pressure and minerals in the bloodstream, produce urine, and filter waste from the blood. As an urologist, Paul Perito MD sees mostly renal cell carcinoma, which is the most common form of kidney cancer in adults. A Wilms tumor is another type of cancer and is most often seen in children and as a result of cellular defect during the kidney’s developmental stage.
The amount of tissue removed during nephrectomy is based on several factors, says Paul Perito MD:
- Number of tumors
- The kidneys containment of the tumor
- Carcinoma in nearby tissue
- Functional capacity of the alternate kidney
- Affected area
According to Paul Perito MD, multiple imaging tests are available including ultrasound, MRI, and CT scan. A nephrectomy may also be performed due to injury or a number of other diseases that affect the kidneys.
Additionally, says Paul Perito MD, since a transplant recipient’s chance for organ survival is lower with the use of a cadaverous kidney, a nephrectomy on a live donor may save a life. The organ donors, as well as those undergoing the procedure because of cancer, are cautioned that there are potential long-term complications. Paul Perito MD reminds the patient that the body is conditioned for two kidneys and removal of one may result in issues such as hypertension and chronic kidney disease.
A general anesthesia is given before surgery, explains Paul Perito MD, and anesthesiologists will ensure that the subject remains unconscious throughout the procedure. A nephrectomy is not a one-size-fits-all procedure; there are several variations. Determining which method a physician utilizes is dependent on patient overall health, the surgeon’s skill level, and a variety of other factors to be discussed prior to the procedure, says Paul Perito MD.
Paul Perito MD also reports that open surgery is the hardest to recover from as it involves an incision of up to 20 inches along the side or the abdomen. For this procedure, a lower rib may need to be removed. Laparoscopic surgery, considered minimally invasive, involves a few small puncture wounds to the abdomen. If a radical nephrectomy is performed using a laparoscope, a larger opening will be needed to extract the entire kidney, reports Paul Perito MD. Robot assisted laparoscopic surgery employs a technologically advanced set of robotics tools which offer a level of precision unrivaled by human hands.
Paul Perito notes that questions to ask the surgeon after the procedure are:
- Was all of the cancer removed?
- Was the entire kidney removed? If not, how much is left?
- Has the cancer spread, and is further treatment necessary?
- How often is follow-up recommended?
(Dr. Perito advises patients to write these questions down in advance or bring someone along who can speak to the surgeon on their behalf, as grogginess is common after general anesthesia)
Proper care is necessary after the surgery, cautions Paul Perito MD. Once a kidney has been removed, it’s important to eat a balanced diet, limit sodium intake, and avoid foods high in protein. Regular exercise, as well is enjoying alcohol or caffeine in moderation, will make the remaining kidney’s job that much easier.
While a diagnosis of cancer is never a pleasant situation for family or individual, concludes Paul Perito MD, medical advancements of the last 20 years have made it possible to undergo even a major surgery and still enjoy life.
Paul Perito MD is a Coral Gables, Florida-based urologist whose practice, Perito Urology, specializes in men’s health issues. Most notably, Dr. Perito has developed and actualized a minimally invasive penile implant procedure that is safe, efficacious, and proven to diminish the risk of infection to the patient. He is the Chairman of the Urology Department at Coral Gables Hospital as well as an active member of the American Urological Society. Paul Perito MD has traveled abroad extensively to promote his minimally invasive penile implant technique. He is a 1988 graduate of the University Of Maryland Medical School and also holds a BA in chemistry from Emory University.
The information contained in this article is provided by Paul Perito MD for educational purposes only. It is not intended to treat or diagnose any condition.