Depending on the method of carrying out, nephrectomy is divided into several types:
- open nephrectomy;
- laparoscopic surgery;
- nephrectomy with robotic da Vinci system.
Open (cavitary) nephrectomy
Abdominal removal of the kidney is performed through an oblique incision in the lumbar region, the patient lies on a healthy side. By dissecting the tissues in layers, the surgeon reaches the kidney and separates it from the fatty capsule. Next, the organ is brought to the surface, the doctor bandages the ureter with adjacent vessels and excised them together with the renal pedicle. Having freed the organ from fixation, the surgeon removes it, sutures the surgical field in layers and applies a sterile bandage.
The duration of an open nephrectomy is 2-3 hours.
Laparoscopic kidney removal
The surgeon makes 3-4 punctures on the anterior and lateral surfaces of the abdominal wall (each 1 cm in diameter). Through them, a special instrument is inserted - a laparoscope with a camera for visualization and control of the operation. The doctor removes the kidney with the renal pedicle, ureter and blood vessels.
Laparoscopic nephrectomy is technically much more complicated than open surgery, but it has a number of advantages :
- short rehabilitation period;
- reduced postoperative pain syndrome;
- absence of a large suture/scar in the patient.
Robotic surgery with Da Vinci
Specialists of foreign clinics are increasingly performing nephrectomy using the Da Vinci robotic unit . First of all, with its help, it is possible to carry out the most organ-preserving operation - to remove only a part of the affected kidney.
Today, the Da Vinci robot is the “gold standard” for nephrectomy. In the course of its implementation, the doctor controls the "hands" of the robot and makes punctures no larger than 1 cm. The duration of the robotic operation is about 2 hours, and the subsequent stay in the hospital is a maximum of 3 days.
Benefits of robotic nephrectomy with Da Vinci :
- minimal blood loss and trauma during surgery;
- low likelihood of complications;
- short rehabilitation period (3-4 days), reduced pain syndrome;
- absence of scars on the body after surgery.