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Oganes E. Dilanyan
Urologist, MD, PhD
+7(499)344-03-03

Kidney removal

In this article

Kidney removal also known as nephrectomy is a desperate measure and is the only radical method of treatment for kidney tumours over 5-6 cm in size. 
How is kidney removal surgery carried out? What surgery option to choose? What is the prognosis? I try to answer these questions first in order to help the patients to choose the right treatment option.  

Kidney removal surgery

I have been treating kidneys tumours surgically for over 12 years. And every time when a patient comes to me with kidney cancer in the 2nd, 3rd or 4th stage I have to make the decision to surgically remove the kidney affected by the tumour. Unfortunately, only the 1st stage can be treated by removing only the tumour and saving the kidney. In all other cases one has to discuss with the patient the methods of removing the kidney in order to save their life.

On its own cancer diagnosis is an ordeal for anyone especially if it results in a loss of an organ. But when choosing between one’s life and one’s body organ it is essential to choose life. Modern technological advances make it possible to surgically remove the kidney causing minimal trauma and ensuring quick recovery.

Kidney removal surgery is indicated in all cancers advanced beyond the first stage.

Now we ask if anyone can remove a kidney laparoscopically. Very soon we will be asking if anyone can do it via open surgery?

Kidney removal methods

Open nephrectomy

This is a standard method of kidney removal which is offered pretty much by any hospital. It has the following disadvantages:

  • 20 cm incision.
  • Cutting through the skin and 3 layers of muscle.
  • High risk of bleeding.
  • Post-operative peritoneal adhesions.
  • Scarring of incision site and risk of hernia.
  • Recovery can take up to six months

Laparoscopic nephrectomy

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This is a modern surgical procedure to remove the kidney affected by cancer and it is performed in well-equipped hospitals. It has the following advantages: 

  • Minimal trauma: kidney removal is carried out without using only very small incisions.
  • No cutting through skin and muscle.
  • No blood loss.
  • No peritoneal adhesions.
  • No scarring or hernias.
  • Recovery takes only a few days
Laparoscopy is the modern-day gold standard for kidney removal.
EAU Guidelines

Laparoscopic kidney removal

Laparoscopic kidney removal in leading clinics of Europe and USA is the gold standard due to obvious advantages of this method: 
The patient’s abdomen is not wide open to germs and there is no pain or ugly scarring after the operation and no risk of peritonitis. The patient is up and about on the day following the surgery and can be discharged home after 2 or 3 days and carry on with their life.

Advantages of laparoscopic removal of the kidney - video

Preparing for kidney removal surgery

- Dr Dilanyan, is it not at all possible to save the kidney? You perform kidney tumour resections all the time…. I am only 48 years old…
I take off my glasses and rub my eyes. Every single time the decision to remove the kidney does not come easy to me. But it is the only way to save the patient. One cannot play games with cancer. 
- No Andrey, it is not possible. The tumour is nearly 8 cm in size and it is no longer the first stage. Let’s try and avoid unnecessary risks. 
- Ok, I understand. After all we have already discussed it three times. But you also asked for lots of pre-operative tests. What for?
-It’s standard procedure Andrey. We have to be sure that the operation is going to be safe for you. In order to be sure we need to have the information about your kidney and liver function and see if there is any inflammation present and also need to test coagulation. It is also important to make sure that the anaesthetic is safe for you and in order to do this we need to check your heart and lungs. 
- But it will take really long, nearly two weeks of tests.  
- One day, no longer.  
- Will you remove the kidney laparoscopically? 
-Yes we will. As you never had abdominal surgery before you have no contraindications to laparoscopic surgery. 
- Ok, great…

After kidney removal surgery

There are two important time periods after kidney removal surgery: early post-operative period and recovery. During the post-operative period which lasts no longer than 3 to 4 days following laparoscopic surgery the patient remains in hospital under the doctors’ supervision, receives antibacterial treatment and undergoes daily monitoring of certain bodily functions. We always get the patient up on the day following kidney removal operation in order to normalise bowel function. Recovery period incorporates a specific diet and some limitations which allow the remaining kidney to assume the function of the removed kidney and compensate for it. All the recommendations are individually tailored for each patient and made with careful consideration of many factors.

Prognosis after kidney removal

Doing doctors rounds after surgery is a very important part of our job. We do not treat it as just a routine as every single patient wants to and needs to know how the surgery went and how soon they are likely to recover. 
- Good afternoon, Andrey, - I smile, - how are you feeling? I know you have had a good night and didn’t even ask for any pain relief. But I am also aware that you did not really sleep until you got some sleeping medication. What’s the matter? What is bothering you? 
- Look, doctor, I am not stupid. Tell me, Do I have at least a year left to live? I need to… - Andrey suddenly goes quiet and shy. 
- Everything will be fine, Andrey, - I say. The operation went very well and the affected kidney has been completely removed, as we call it, within the healthy tissue boundary. 
- And what if there are metastases?  
- First of all, there were none present before the operation. Secondly, you will be followed up and under observation for the next five years. So, plan your life like you did before, ok? 
- You are not lying to me are you? 
- Andrey, I could show you medical publication where it is stated that prognosis after kidney removal in your case pretty much means you are cured from cancer. But let’s just say that you need to believe me when I say this: You will have a very long life, ok? 
- Ok, Dr Dilanyan.

Complications of kidney removal

Removing any organ and especially a vital organ like the kidney has effect on the body. The body tries to adapt to the new conditions of the organ being absent and the remaining kidney has to work harder in order to filter the blood. 
We can minimise the complications of kidney removal by following a few simple recommendations: 

  • Monitoring certain tests.
  • Special doctor approved diet.
  • Getting rid of excess body weight.
  • Giving up smoking.
  • Kidney ultrasound every six months

All our patients are followed up for around 5 years and come for their check up every six months. This ensures that they are protected from any relapses and their kidney function is monitored to prevent renal insufficiency. Follow up is essential as it helps avoid common complications of kidney removal.

Our guarantees

- We guarantee your safety by using modern and highest quality anaesthesia manufactured in Austria or France. 
- We DO NOT USE low quality equivalents of any drug which significantly lowers the risk of any complications.
- Over 12 years of experience ensures precise diagnosis and correct treatment. 
- We DO NOT REFER our patients to unknown clinics for follow up and further treatment and provide outpatient follow up as well as inpatient treatment.

Every patient is provided with a discharge summary with detailed recommendations and an official sick leave certificate
Our Advantages

Professional Approach: Up to date treatment of cancers in accordance with the European Association of Urology recommendations.

Our team: Specialised science-based oncology urology team.

Board of doctors: Every patient’s case is assessed by a board of doctors consisting of an oncologist, radiologist and chemotherapy specialist to ensure appropriate treatment. 

Specialised equipment: equipment by Karl Storz, Covidien and Philips Medical for precise diagnostics and effective treatment.

Comfort: no queueing or waiting for a consultation and premium inpatient facility with professional care.

Safety: we only use methods recommended by professional associations such as EAU and AAU 

Result: precise diagnosis and effective treatment of cancerous conditions. 

We are also GCP certified, which confirms we provide the highest standards of diagnosis and treatment. 

Certificates
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Information for foreign patients:

If you require a kidney removal operation in Moscow please contact us. We will arrange your admission to hospital on the day you arrive and carry out all necessary tests and get together the board of doctors. We will also perform the surgery. You can receive your follow up consultations remotely after returning home.

Your city - Ashburn. Learn how we can organize your visit to Moscow for treatment.
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