Definition
Nephrotomy is a surgical procedure involving an incision into the kidney. It is typically performed to remove kidney stones, tumors, or other obstructions within the renal tissue when less invasive methods are not suitable. The goal is to preserve as much kidney function as possible while resolving the underlying problem.
Indications
Nephrotomy is indicated in cases where other treatments such as extracorporeal shock wave lithotripsy (ESWL) or ureteroscopy are ineffective. It is also used for accessing large or complex renal calculi, treating renal abscesses, and managing certain congenital anomalies or tumors that require direct access to the renal parenchyma.
Types
There are two main types of nephrotomy: simple nephrotomy and radial nephrotomy.
A simple nephrotomy involves a direct incision into the kidney without removing tissue, whereas a radial nephrotomy follows the lines of blood supply to minimize damage during access.
Procedure
The procedure is usually done under general anesthesia. After gaining access to the kidney through a flank or abdominal incision, the surgeon carefully makes an incision into the renal capsule and parenchyma. Once the pathology is addressed, the kidney is sutured and hemostasis is achieved.
Complications and Recovery
Potential complications include bleeding, infection, urine leakage, and temporary or permanent loss of renal function. Postoperative care involves monitoring kidney function and ensuring proper healing. Most patients recover within a few weeks with appropriate follow-up.
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