Nephrectomy (Kidney removal)

Today we will talk about Surgery.
There are some words used in surgery like ECTOMY or OSTOMY.... people usually confuse this words, but it is very simple.
When the suffix ECTOMY is used it basically means removal of that part like PROSTECTOMY (removal of Prostate Gland), APPENDISECTOMY (removal of Appendix) etc....
When the suffix OSTOMY is used don't mistake it for ECTOMY, because it can give a whole new meaning to it..
OSTOMY means making a incision or just making a hole like THORACOTOMY (means making a incision in your chest (thorax)).

NEPHRECTOMY

     It is removal of kidney along with part of ureter, perinephric pad of fat and enlarged lymph nodes near the hilum.

Types:
Partial nephrectomy
Total Nephrectomy
Radical Nephrectomy

What are the indications:
Stone with gross infected kidney (polynephrosis)
Stone with hydronephrosis with non functional kidney
Multiple stones scattered in the kidney substances and in different calyces.
Renal Tuberculosis
Carcinoma of kidney - WILMS Tumor.
Pyogenic infections
Haemorrhage
Raised Blood Pressure due to renal causes
Hydronephrosis.

Now the Procedure:
Before doing this, must remember that the central arteral kidney must be proved healthy before considering the operation.
Next ask the patient to sleep on the later side.
That way operated kidney is kept on superior side.
Next, arms of the operated side should be supported well.
The legs are extended and fixed.
Antibiotics are given to lower the infection
General anesthesia is given to the patient.

5 Muscles are incised.
Latissmus dorsi
Serratus Anterior
3 oblique muscles of abdomen
Posterior lumbar fascia
and extra peritoneal fat.

Oblique incision on the skin is put to form the angle of 12th rib to spine.
Ligate the renal artery and cut the artery
similarly after ligate the renal vein and cut it.
Than cut the ureter.
Slowly remove the kidney and suture and close back layer by layer with antiseptic solution.

Thus, in the process of total nephrectomy  alnog with kidney, part of ureters surrounding soft tissues, lymph nodes, veins and arteries are also removed.

Complications
Hemorrhage
Infections.