Nephrectomy may involve eradicating a small portion of the kidney or removing the entire organ as well as surrounding tissues. In a Partial Nephrectomy, only the diseased or infected portion of the kidney is extracted. A radical nephrectomy involves the removal of the entire kidney, a section of the tube leading to the bladder (ureter), the adrenal gland and the fatty tissue surrounding the kidney. A simple nephrectomy requires the removal of the kidney and a section of the attached ureter.

Hand-Assisted Laparoscopic Nephrectomy
A technique using minimally invasive surgical procedures, Hand-assisted laparoscopic nephrectomy has recently enhanced kidney removal procedures. Removing a kidney because of infection, obstruction or cancer historically meant making a 10- to 12-inch incision in the patient's side and sometimes removing a rib. Today the innovative hand-access procedure allows surgeons to view, cut and remove the kidney or infected area—through a significantly smaller incision.

The physician makes four small ¼- to ½- inch incisions in the abdomen. A flexible videoscope is inserted in one of the incisions providing the surgeon with a magnified view of the kidney and surrounding tissue. Other surgical instruments on long, narrow rods are placed through the other incisions. A fifth incision of about 3 inches provides access for the surgeon's hand. Once the kidney is freed, it is secured in a bag and channeled out of the body through this same incision.

This procedure takes about the same amount of time as a conventional nephrectomy, it results in enormous postoperative benefits to the patient. The decreased size of incision results in less pain, shorter hospital stays, fewer infections and faster recovery. With hand-assisted nephrectomy, patients generally stay in the hospital for two days and return to their normal activities within one to three weeks. Traditional surgery usually requires patients to stay in the hospital for five days and return to normal activities at four to six weeks. Another benefit of the minimally invasive technique is an improved cosmetic result—the three inch incision is often hidden in one's belt line.

Advances in Treating Kidney Stones
In the past, patients with kidney stones too large to pass faced a major surgery to remove the stones. Even when stones were smaller, passing kidney stones was painful and not always possible.

Urologists at GW use several minimally invasive techniques when stones are large or the patient cannot pass them easily.

Extracorporeal shockwave lithotripsy (ESWL) uses high-frequency ultrasound delivered from outside the body to smash the stones into a passable dust-like material. ESWL is a major advance in the ability to deal with kidney stones.

Even if smashed, larger stones create too much debris to pass through the ureter. In this case, urologic surgeons at GW Hospital use a procedure called percutaneous nephrostolithotomy to access the kidneys with endoscopic instruments inserted through the patient’s back. The stones are then broken up with a laser or other tools and removed.

Open surgery for kidney stones is almost obsolete. Now, there are a lot of different ways to deal with stones.