Kidney removal: the past, presence, and perspectives: a historical review

Abstract

More than 140 years have passed since the first documented planned nephrectomy. Throughout all these years, people gained significant knowledge on the renal functions and diseases, and what is more, the surgical workshop underwent considerable improvement. Initially, the kidney removal operations were performed due to ureterovaginal fistulas and renal lithiasis. Later, they were executed mainly in patients with renal tumors, whereas today, the number of these surgeries tend to decrease to the benefit of nephron sparing procedures. Current nephrectomies are more and more often performed in case of organ donation, what will probably remain the most significant indication for the kidney removal in close future. While the first surgeries were executed with classical surgical methods, nowadays, after years of studies concerning nephron sparing and minimally invasive operations, we can see surgeries carried out through natural body orifices with robotic assistance. In relation to simple surgical operation based on ligation of 3 tubular anatomic structures, we can perceive the true scope of the progress that occurred in surgery. The aim of this article is to present the evolution of indications and operating techniques utilized to remove the kidney in chronological aspect.