50220 Nephrectomy, including partial ureterectomy, any open approach including rib resection

Name of the Procedure:

Nephrectomy, including partial ureterectomy, any open approach including rib resection

• Common Name: Kidney Removal Surgery

Summary

A nephrectomy is a surgical procedure to remove all or part of a kidney. This procedure may include the removal of a portion of the ureter (partial ureterectomy) and may involve resecting a rib for better access. It is typically performed through an open surgical approach.

Purpose

The procedure addresses conditions such as kidney cancer, severe kidney damage, or other kidney-related issues causing significant health problems.

• Goals: To remove diseased kidney tissue, relieve symptoms, prevent further health complications, and improve the patient's quality of life.

Indications

• Kidney tumors or cancer
• Severe kidney infections causing irreversible damage
• Polycystic kidney disease with complications
• Traumatic kidney injury
• Obstructions in the urinary tract not manageable by other treatments
• Chronic kidney disease necessitating organ removal

Preparation

• Fasting: Patients need to fast for 8 hours before surgery.
• Medication: Adjustments or temporary discontinuation of certain medications as advised by the doctor.
• Diagnostic Tests: Blood tests, imaging studies (like CT or MRI scans), and urine tests to assess kidney function and overall health.

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is asleep and pain-free.
2. Incision: A surgical incision is made in the side or abdomen, which may involve removing a rib for better access.
3. Kidney and Ureter Handling: The surgeon carefully removes the diseased kidney and possibly a part of the ureter.
4. Bleeding Control: Blood vessels are sealed or clamped to prevent bleeding.
5. Closure: The incision is closed with sutures or staples.

• Tools Used: Surgical knives, clamps, sutures, and sometimes rib spreaders for rib resection.
• Technology Used: Imaging guidance may be utilized.

Duration

Typically, the procedure lasts between 3 to 4 hours, but it can vary based on complexity.

Setting

Performed in a hospital operating room.

Personnel

• Surgeon specialized in urological or general surgery
• Surgical nurses
• Anesthesiologist

Risks and Complications

• Common: Infection, bleeding, pain at the incision site
• Rare: Injury to surrounding organs, deep vein thrombosis, complications from anesthesia
• Possible Complications Management: Antibiotics for infections, blood transfusions for severe bleeding, pain management strategies

Benefits

• Relief from symptoms related to kidney disease
• Prevention of further health deterioration
• Potential for improved quality of life
• Benefits like symptom relief may be realized immediately post-recovery

Recovery

• Hospital Stay: Usually, patients stay in the hospital for 3 to 7 days post-surgery.
• Post-Procedure Care: Pain management, wound care, and gradual increase in physical activity
• Recovery Time: Full recovery may take 6 to 8 weeks.
• Restrictions: Avoid heavy lifting and strenuous activities; follow dietary and activity recommendations.
• Follow-Up: Regular follow-up appointments to monitor recovery and kidney function

Alternatives

• Other Treatments: Non-surgical treatments (medication, nephrostomy), laparoscopic nephrectomy, or partial nephrectomy
• Pros and Cons: Less invasive options may have shorter recovery times but may not be suitable for all conditions requiring nephrectomy.

Patient Experience

• During: The patient will be under general anesthesia and will not experience pain during the procedure.
• After: Postoperative pain managed with medications, possible discomfort at the incision site, and gradual return to normal activities.
• Pain Management: Medications, physical therapy, and other comfort measures will be provided.