Nephrectomy is the medical term for surgery to remove a kidney. It’s a common treatment for kidney cancer — and may even cure it if cancer is limited to the kidney. Studies show that people have a very high chance of surviving for at least five years when kidney cancer is found early and treated with surgery.

In this article, we’ll explain when nephrectomy is needed and what to expect before, during, and after the procedure. We’ll also cover the different types of nephrectomy and surgical techniques your doctor might use.

When Is Nephrectomy Recommended?

If your kidney cancer is only in one kidney and hasn’t spread to other parts of the body, your doctor might recommend nephrectomy. This includes most people with stage 1, stage 2, or stage 3 renal cell carcinoma. In these stages, surgery offers the best chance to remove the cancer completely and possibly cure it.

Doctors also look at the tumor’s size and location and whether it’s growing into nearby areas like veins, fat, or lymph nodes. If the tumor is small, you might be able to have a partial nephrectomy, which removes only the cancer, keeping the rest of the kidney. This is also called a nephron-sparing surgery. If the tumor is large or in a tricky spot, you may need a radical nephrectomy, where the entire kidney is removed.

In some people with stage 4 kidney cancer, surgery may still be recommended if removing the tumor will help control symptoms or improve how other treatments work. This is called cytoreductive or palliative surgery.

You can live a normal life with just one healthy kidney. However, if you already have kidney disease or you have cancer in both kidneys, your doctor may try to save as much kidney tissue as possible. If both kidneys need to be removed, surgery may not be recommended, because that would require dialysis. Dialysis is a treatment that uses a machine to filter your blood when your kidneys can no longer do it.

Doctors look at your overall health, kidney function, and tumor size and location when deciding if surgery is the right choice. They might use imaging tests such as MRI or CT scans when making treatment decisions.

Types of Nephrectomy Surgery

There are two main types of nephrectomy for treating kidney cancer: partial nephrectomy and radical nephrectomy. Both surgeries can be done through a large incision (open surgery) or using a minimally invasive surgical technique through small incisions using special tools (laparoscopic or robotic nephrectomy). Your healthcare team will recommend which type of surgery you should have based on the size and location of the tumor, as well as your overall health.

Partial Nephrectomy

A partial nephrectomy removes only the tumor and a small amount of healthy tissue around it. The rest of the kidney is left in place. This surgery is used when the tumor is small and in a location that makes it safe to remove. It’s often chosen for people with kidney disease, a single kidney, or tumors in both kidneys. This helps preserve as much kidney function as possible. Compared to a radical nephrectomy, a partial nephrectomy may lower the risk of kidney complications in the future.

Before surgery, you’ll have imaging tests like a CT scan or MRI. This helps the surgeon see exactly where the tumor is and how close it is to blood vessels or other important structures, like the ureter (tube connecting the kidney to the bladder). You’ll also likely get blood tests to check your kidney function and overall health.

The surgery is done while you’re asleep under general anesthesia. After surgery, you’ll have a catheter (a flexible tube) placed in your bladder to drain urine and other fluids. Most people stay in the hospital for a few days for recovery and monitoring. Your urologist or a member of your healthcare team will send you home with post-operative instructions. You’ll likely need to rest, manage pain with some medications, care for your wounds, and avoid intense or strenuous activity. Full recovery times can vary but may take up to six to 12 weeks. Most people don’t need dialysis after a partial nephrectomy.

Radical Nephrectomy

A radical nephrectomy is surgery to remove the entire kidney. In most cases, the surgeon also removes nearby fatty tissue, the ureter, and sometimes, the adrenal gland or nearby lymph nodes. This surgery is often recommended when the tumor is large or growing deep into the kidney. It may also be used if the tumor is close to important blood vessels or if the lymph nodes are involved. It may also be used if a partial nephrectomy isn’t safe or possible.

Before surgery, you’ll have imaging tests, blood work, and possibly an electrocardiogram (test for heart function.) These tests help your doctor look at the tumor and assess your kidney function and overall health. The surgery is done under general anesthesia, so you’ll be asleep the whole time.

Recovery from a radical nephrectomy is similar to that of a partial nephrectomy. You’ll probably stay in the hospital for two to seven days. You may have some pain or discomfort at the surgery site, which can be managed with medications.

After surgery, you may have a catheter in your bladder or other drains in place for some time. You’ll need to stay home, rest, and avoid heavy lifting and driving for several weeks. If your remaining kidney is healthy, it should take over and keep your body working normally.

Depending on how far your cancer has spread, you may need additional cancer treatments. This can include radiation therapy, immunotherapy, or chemotherapy. Be sure to attend all follow-up appointments so your healthcare team can monitor your recovery and determine future steps, if necessary.

Surgical Techniques for Nephrectomy

Some surgeries are done through one large cut — this is called open surgery. Others are done using small incisions with special tools. These are called laparoscopic or robotic-assisted surgeries. Laparoscopic surgeries are less invasive than open surgery and may allow you to heal faster and with less discomfort.

Laparoscopic Surgery

Laparoscopic surgery is a type of minimally invasive surgery. It can be used for a partial or radical nephrectomy. Instead of one large cut, the surgeon makes a few small incisions in your belly. A thin tube with a camera — called a laparoscope — is inserted to help the surgeon see inside your body. Other long, thin tools are used to remove the kidney or tumor.

Laparoscopic surgery usually involves less pain, a lower risk of complications, and a shorter hospital stay. You’ll still be asleep under general anesthesia. Unfortunately, not all kidney cancers can be treated this way, especially if the tumor is very large or in a hard-to-reach spot.

Robot-Assisted Surgery

Robot-assisted surgery is considered an advanced type of laparoscopic surgery. It uses a special machine with robotic arms. The surgeon controls the robot from a nearby console. The robot gives the surgeon a 3D view and very fine control of the surgical instruments. This allows for precise movements, especially in tight spaces or near important blood vessels.

This type of surgery can also be used for a partial or radical nephrectomy. Since it uses smaller incisions, you may have less pain, smaller scars, and a quicker recovery. Like the other procedures, it’s done under general anesthesia, and full recovery may still take several weeks. Your healthcare team will schedule checkups after the procedure to monitor you for any complications and track your recovery.

Risks and Side Effects of Kidney Removal Surgery

As with any major surgery, nephrectomy has some risks. Most people recover well, but problems can happen. The most common side effects include:

• Bleeding or blood loss during or after the surgery
• Infection at the incision site
• Blood clots in the legs or lungs
• Pain, discomfort, or soreness during recovery
• Injury to nearby organs or blood vessels (in rare cases)

If you have a partial nephrectomy, there’s a small chance of urine leaking from the kidney where it was repaired. In rare cases, people may have long-term kidney problems after surgery. This can happen if the remaining kidney doesn’t work well. If both kidneys are damaged or removed, dialysis may be needed to filter your blood.

Your healthcare team will do everything they can to lower the risk of complications. If you notice any of the symptoms listed above, reach out right away. They can help you figure out whether your symptoms are a normal part of recovery or something more serious.

Talk With Others Who Understand

On MyKidneyCancerTeam, people with kidney disease and their loved ones come together to ask questions, give advice, and share their stories with others who understand life with kidney disease.

Have you undergone a partial or radical nephrectomy? What advice would you share with those who will undergo the same surgery? Share your story in the comments below, or start a conversation by posting on your Activities page.