Nephrectomy, including partial ureterectomy, any open approach including rib resection; complicated because of previous surgery on same kidney
CPT4 code
Name of the Procedure:
Nephrectomy, including partial ureterectomy, any open approach including rib resection; complicated because of previous surgery on same kidney.
Summary
Nephrectomy is the surgical removal of a kidney. This specific version of the procedure also involves removing part of the ureter (the tube that connects the kidney to the bladder) and may include the resection of a rib. It is considered complicated due to prior surgery on the same kidney.
Purpose
The procedure addresses conditions like severe kidney damage, cancer, or chronic infection that have not improved with other treatments. The goal is to remove the diseased kidney and affected portions of the ureter to prevent further health issues and improve the patient's quality of life.
Indications
- Kidney cancer
- Severe trauma to the kidney
- Chronic kidney infection or disease
- Non-functioning kidney due to previous surgeries or conditions
- Obstructions or abnormalities that cannot be corrected otherwise
Preparation
- Fasting for 8-12 hours before surgery
- Stopping certain medications as advised
- Undergoing blood tests, imaging studies (e.g., CT scans), and urine tests
- Pre-operative assessment by an anesthesiologist
Procedure Description
- Anesthesia: The patient is placed under general anesthesia.
- Incision: An incision is made in the flank area, sometimes extending to the ribs.
- Rib Resection: If required, a portion of a rib is removed to provide better access to the kidney.
- Kidney Removal: The kidney is carefully dissected from surrounding tissues and vessels are clamped and cut.
- Ureterectomy: A portion of the ureter is also removed if it is affected.
- Closure: The incision is closed with sutures or staples.
- Post-Op Care: Immediate postoperative monitoring in the recovery room.
Duration
The procedure typically takes 3-4 hours, but duration may vary depending on complexity.
Setting
Performed in a hospital operating room with specialized surgical support.
Personnel
- Surgeon
- Surgical assistant(s)
- Anesthesiologist
- Operating room nurses
- Scrub techs
Risks and Complications
- Infection
- Bleeding
- Injury to surrounding tissues or organs
- Blood clots
- Adverse reactions to anesthesia
- Long-term issues such as decreased kidney function
Benefits
- Removal of diseased tissue
- Potential to cure or manage kidney cancer or severe infection
- Improved overall health and quality of life
- Relief from pain or other symptoms caused by the diseased kidney
Recovery
- Hospital stay of 4-7 days post-surgery
- Pain management with prescribed medications
- Gradual return to normal activities over 4-6 weeks
- Follow-up appointments for monitoring recovery and kidney function
- Restrictions on heavy lifting and strenuous activity until fully healed
Alternatives
- Laparoscopic or robotic-assisted nephrectomy: minimally invasive options with shorter recovery times.
- Non-surgical management, such as medication or procedures to drain blockages, in cases where surgery is not viable.
- Partial nephrectomy: removing only the diseased portion of the kidney.
Patient Experience
- Expect discomfort and pain at the surgical site
- Pain management will be provided, including medications and possibly epidural analgesia
- Regular monitoring by healthcare staff during recovery
- Gradual improvement in energy levels and ability to perform daily activities