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PROCEDURE AT A GLANCE
PERIOP BRIEFING
Nephrectomy
INDICATIONS FOR PROCEDURE
The removal of a kidney may be necessary to treat renal o congenital obstructions,o tumors,o severe trauma that cannot be corrected with reconstructive surgery,
o infections that cannot be cleared with medication, o abscesses, ando hypertension.1
Two major types of nephrectomy include partial and radical nephrectomy; the indication for the procedure determines which is appropriate.
o In partial nephrectomy, the surgeon removes only the diseased portion of the kidney.
o In radical nephrectomy, the surgeon removes the entire kidney, a section of the ureter, the adrenal gland, perirenal fat, Gerotas capsule (fascia), and lymph nodes.1,2
PATIENT POSITIONING
Patients are placed in a modied lateral decubitus (jackknife) position with the upper arm on an overhead support and exed slightly. The lower leg should be exed at the knee and the upper leg should be extended, with a pillow or support between the legs. To increase surgical access to the kidney, the kidney rest under the iliac crest should be raised to achieve the desired lateral exion. A headrest or pillow can support neutral alignment of the spine and head. An axillary roll...