Nephrectomy

A nephrectomy is a surgical procedure to remove a kidney that is diseased or not functioning properly. This might seem like a drastic measure, but most people have a second, normally functioning kidney that can adequately meet the body's needs.

Sometimes, just a partial nephrectomy is performed, to remove a portion of a kidney.

Kidneys can be damaged for various reasons:

• blockage of the urinary tract from congenital causes or kidney stones
• kidney diseases such as hypertension, diabetes, or cancer
• severe trauma

How is kidney disease diagnosed?

In children, kidney disease is usually diagnosed by a blood test or x-ray, ultrasound, or CT scan. The tests are often performed following a urinary tract infection.

How will my child's nephrectomy be performed?

There are three methods of performing the surgery, all requiring general anesthesia:

• Traditional open surgery requires a large incision (8 to 12 inches long) to expose the kidney and requires a lengthy recovery (about six weeks).
• Laparoscopic surgery uses three or four small incisions and minimally invasive operating techniques to remove the kidney. Guided by a tiny camera on the end of a laparoscope, the surgeon inserts surgical instruments through the incisions and detaches the kidney from its connecting blood vessels and ureter. The kidney is maneuvered into a bag, and one of the small incisions is enlarged to allow the surgeon to lift the kidney out. This method reduces recovery time, but control and accuracy limit its use to simpler cases.
• Boston Children's Hospital is one of the few hospitals in the world to perform robot-assisted laparoscopic nephrectomy procedures. The enhanced visualization and control of a robotic system potentially offer improved efficiency and safety over standard laparoscopy, and make it suitable even for complex cases.

What happens after my child's nephrectomy?

Your child will likely need pain medications since the sites of incision will be sore. He will receive IV fluids, and his blood chemistry will be carefully monitored to make sure the remaining kidney is doing its job.

State-of-the-art treatment

Boston Children's Hospital is one of the few hospitals in the world to use robotic surgery technology to perform nephrectomy procedures. Minimally invasive robotic surgery reduces pain, results in smaller scars, and gets your child home faster.