Rigi10™ Malleable Penile Prosthesis
Also Known As
Complete nephrectomy, Total nephrectomy, Radical kidney removal, RN (abbreviation)
Definition
Radical nephrectomy is a surgical procedure involving the complete removal of a kidney, surrounding perinephric fat, and sometimes adjacent structures such as the adrenal gland and regional lymph nodes.1 This procedure is primarily performed to treat kidney cancer, particularly renal cell carcinoma (RCC), when the tumor is large or located in a position that makes partial removal challenging.2 The term “radical” refers to the comprehensive nature of the removal, as opposed to partial nephrectomy which preserves a portion of the kidney.3
The procedure can be performed through different surgical approaches, including open surgery (via a large incision in the abdomen or flank), laparoscopic surgery (using several small incisions and specialized instruments), or robot-assisted surgery (using robotic arms controlled by a surgeon).4 Radical nephrectomy is considered a major surgical procedure that requires general anesthesia and typically involves a hospital stay of several days.5
Clinical Context
Radical nephrectomy is primarily indicated for the treatment of localized renal cell carcinoma (RCC), particularly when tumors are large (typically >7 cm, classified as T2), located centrally near the hilum, or involve adjacent structures.1 It is also the standard approach for advanced kidney cancer that has extended beyond the kidney capsule or into major veins (T3-T4 tumors).2
Patient selection criteria include consideration of tumor characteristics (size, location, and stage), overall kidney function, and patient comorbidities.3 For patients with normal contralateral kidney function, radical nephrectomy is generally well-tolerated, as a single healthy kidney can maintain adequate renal function.4 However, for patients with pre-existing chronic kidney disease or risk factors for future renal impairment, nephron-sparing approaches may be preferred when technically feasible.5
The surgical procedure typically takes 2-3 hours and involves several key steps: patient positioning, incision (depending on approach), isolation of the kidney and its blood vessels, ligation of the renal artery and vein, removal of the kidney with surrounding fat (and sometimes adrenal gland and lymph nodes), and closure of the surgical site.6
Recovery following radical nephrectomy varies by surgical approach. Open surgery typically requires 6-8 weeks for full recovery, while laparoscopic or robotic approaches may allow return to normal activities within 3-4 weeks.7 Potential complications include bleeding, infection, damage to surrounding organs, and reduced kidney function.8 Long-term outcomes for localized RCC treated with radical nephrectomy are generally favorable, with 5-year survival rates exceeding 90% for stage I disease.9