Nephrectomy

[8] Nephrectomy for renal cell carcinoma is rapidly being modified to allow partial removal of the kidney.

For the open procedure, the surgeon makes an incision in the side of the abdomen to reach the kidney.

The laparoscopic approach utilizes three or four small (5–10 mm) cuts in the abdominal and flank area.

Such alternatives include renal embolization[11] for those who are poor candidates for surgery, or partial nephrectomy if possible.

[citation needed] Occasionally renal cell cancers can involve adjacent organs, including the inferior vena cava (IVC), the colon, the pancreas or the liver.

If the cancer has not spread to distant sites, it may be safely and completely removed surgically via open or laparoscopic techniques.

This is the first time a healthy kidney has been removed via this method, though it has been done in the past for nephrectomies carried out due to pathology.

Removing organs through orifices prevents some of the pain of an incision and the need for a cosmetically unappealing larger scar.

Any advance which leads to a decrease in pain and scarring has the potential to boost donor numbers.

[14] Living donation has a mortality risk of 0.03% during the procedure and seems to result in similar health outcomes to controls.

[21] However, due to limited x-ray and imaging capabilities to find small kidney tumors and significant complications associated with early operations it was largely abandoned.

Partial nephrectomy is also the standard of care for nearly all patients with small renal masses (<4 cm in size).

The patient is typically placed on the operating room bed lying on the side opposite the kidney tumor.

[citation needed] Patients who undergo partial nephrectomy experience complications around 15-25% of the time.

Laparoscopic nephrectomy