Nephrectomy procedure

When you’ve been diagnosed with kidney cancer, your care team may recommend a nephrectomy. Nephrectomy is a procedure to remove all or part of your kidney. Nephrectomy may also be referred to as renal surgery. Your care team will include a urologist, a specialist who treats urologic conditions related to the kidneys, urinary tract, prostate gland and more.

What are the types of nephrectomy surgery?

There are two types of nephrectomy: partial and radical. Partial nephrectomy removes only some kidney tissue, while radical nephrectomy removes the entire kidney.

When you have kidney cancer, factors that determine whether you’ll have a partial or radical nephrectomy may include:

• If the tumor remains within the kidney or has spread beyond it
• If there are multiple tumors
• How damaged your kidney is
• If surrounding tissue is affected by your cancer
• How well your other kidney functions
• If you have other conditions that affect kidney function

Imaging performed prior to surgery can help answer some of these questions. These tests may include CT, MRI, intravenous pyelogram (IVP) or ultrasound.

Open nephrectomy

During open surgery, surgeons use scalpels to make incisions in the body to perform repairs or remove tissue. During a nephrectomy, your surgeon will make an incision in your abdomen. Then, either some or all of your kidney will be removed. Though most nephrectomy procedures don’t require an open approach, it may be used when less invasive procedures aren’t the best option.

Laparoscopic nephrectomy

Laparoscopic surgery uses tiny surgical instruments that are inserted through small incisions. A thin tube containing a video camera with a light is inserted in one of the incisions so your surgeon can see inside your abdomen. When used for nephrectomy, the advantages of minimally invasive laparoscopic surgery are less blood loss and pain, shorter hospital stays and faster recovery times.

Robotic nephrectomy

Robotic-assisted surgery uses the laparoscopic technique with the help of robotic arms controlled by the surgeon. This allows for more precise movements and maneuverability and also results in less blood loss and pain, shorter hospital stays and faster recovery times. At Aurora, our surgeons use the state-of-the-art da Vinci® Surgical System.

To help shorten the length of your surgery and contribute to a more successful recovery process, many surgeons prefer conducting kidney removal surgery laparoscopically or robotically.

Nephrectomy risks

Having a partial or radical nephrectomy carries some risks that are common for many surgeries such as infection, blood clots and the risk of undergoing anesthesia. Over time, having had a nephrectomy procedure can result in complications such as:

• High blood pressure, also known as hypertension
• Excess protein in your urine, which may be a sign of kidney damage
• Chronic kidney disease, which damages the kidneys over time and impairs them from filtering waste from the blood

What should I expect when getting a nephrectomy?

You might be wondering whether it’s possible to have the same quality of life after having a kidney removed. In fact, one healthy kidney can work just as well as two kidneys. Most people who only have one kidney don’t have issues. You and your care team will discuss everything you need to know about preparation for nephrectomy.

Before your nephrectomy

First, you’ll be placed under general anesthesia so you’re asleep and don’t feel pain. A catheter will be placed in your urethra to remove urine. You can expect your nephrectomy to take three or more hours.

After your nephrectomy

The catheter will remain in place for a few days. If you had a drain inserted to help remove extra fluid near the surgical site, this will also be removed within a few days. Your care team will monitor levels related to kidney function, such as blood pressure, fluid and electrolytes. Most people stay in the hospital for one to seven days.

Nephrectomy recovery

It’s a good idea to take it easy for six weeks or more after nephrectomy. This means no heavy lifting or strenuous exercise. Once you’re cleared by your care team, you can return to your normal routines – and most likely won’t notice a change in your quality of life.

Long term, there may be some modifications to your lifestyle after nephrectomy:

• Avoid contact sports to lessen the risk of damage to your remaining kidney. If you do engage in activities such as hockey, football, soccer or martial arts, wear extra protective gear.
• Eat a balanced diet and try to limit your sodium intake. Make sure you’re drinking enough water, too.
• Maintain a healthy weight by eating well and getting regular exercise.

After your nephrectomy, your care team will monitor your condition with regular checkups to ensure your kidney is functioning well. They’ll check your blood pressure, levels of protein in your urine and how well your kidney is filtering waste from your blood.

Depending on your original diagnosis, your care team may also recommend additional therapies to prevent your cancer from recurring or spreading further. These options could include chemotherapy, radiation or hormone therapy.