Kidney Cancer Surgery – Partial & Radical Nephrectomy

A nephrectomy is an operation to remove part or all of a kidney. It is commonly used to treat kidney cancer or certain other kidney conditions.

Partial nephrectomy removes the tumour and preserves the remaining kidney tissue. Radical nephrectomy removes the entire affected kidney. The choice depends on tumour features, kidney function and surgical safety.

Partial nephrectomy is generally recommended for localised T1 kidney tumours when technically feasible. It preserves more kidney tissue and can provide effective cancer treatment in suitable cases.

There is no single size that automatically requires radical nephrectomy. Tumour location, involvement of surrounding structures, kidney function and surgical complexity are also important. Larger tumours are more likely to require complete kidney removal.

No. Some kidney tumours are benign. CT, MRI and, in selected cases, biopsy help assess cancer risk. Sometimes the final diagnosis is only established after surgery.

Not necessarily. A biopsy is useful when the result could change management. However, it may not be necessary when imaging is strongly suspicious and surgery is recommended regardless of biopsy results.

Robotic partial nephrectomy is a keyhole operation where the surgeon controls robotic instruments to remove the tumour and repair the kidney while preserving healthy tissue.

No. Robotic instruments are controlled by a trained surgeon. The robot does not independently decide or carry out the procedure.

No. Surgery may be performed robotically, laparoscopically or using an open approach. The most appropriate method depends on tumour anatomy, medical factors and available expertise.

Keyhole surgery involves several smaller incisions, with one sometimes enlarged to remove the kidney or tumour. Open surgery requires a larger incision. Scar appearance varies.

Not routinely. The adrenal gland is usually preserved unless there is clinical concern about tumour involvement or another specific reason to remove it.

Not routinely for every localised kidney cancer. Lymph node removal may be considered when there are suspicious or enlarged nodes or other clinical indications.

Operating time varies considerably. Some procedures take a few hours, while complex partial nephrectomy or advanced cancer surgery may take longer. Your surgeon can provide a more specific estimate for your operation.

Yes. Nephrectomy is usually performed under general anaesthesia. Your anaesthetist will review the planned approach, medications and relevant risks.

A temporary urinary catheter is commonly used during and shortly after surgery to monitor urine output. It is removed when clinically appropriate.

Not always. Drains may be used in selected circumstances, particularly following complex partial nephrectomy. Your surgeon will explain whether one is needed.

Hospital stay depends on the type of surgery and recovery. Keyhole procedures may allow discharge after a shorter admission, while open or complex surgery may require several days or longer.

Many patients gradually return to routine activities over several weeks. Full recovery can take approximately six to twelve weeks, particularly after major open surgery. Individual recovery varies.

Return to work depends on your recovery, operation and job requirements. Desk-based work may be possible earlier than work involving heavy lifting. Follow your surgeon's instructions.

Resume driving only when your treating team permits it, you are no longer impaired by sedating medication, and you can safely control the vehicle, including an emergency stop.

Gentle walking is commonly encouraged during recovery. Heavy lifting and strenuous exercise are often restricted for around four to six weeks or longer, depending on the operation and healing.

Many people live healthy lives with one functioning kidney. However, monitoring kidney function, blood pressure and other health factors is important.

Usually not when the remaining kidney functions well. Dialysis may be required if remaining kidney function is inadequate, particularly in patients with existing kidney disease.

Partial nephrectomy aims to preserve healthy kidney tissue and can reduce the amount of kidney function lost compared with complete kidney removal. The result depends on the remaining functioning tissue and surgical factors.

During partial nephrectomy the kidney's urine-collecting system may be opened. Occasionally urine leaks from the repaired area after surgery. Some leaks settle with drainage, while others require a ureteric stent or additional treatment.

Occasionally, yes. Unexpected tumour anatomy, significant bleeding or difficulty safely preserving the remaining kidney can make complete removal necessary. This possibility should be discussed during surgical consent.

Yes. Conversion may be required if bleeding, difficult anatomy or another complication makes keyhole surgery unsafe. The priority is safe surgery and appropriate cancer treatment.

No. The adrenal gland is not routinely removed when there is no evidence that it is affected by the tumour.

Yes. Some kidney cancers extend into the renal vein or larger vena cava. These cases can require more complex surgery and specialist multidisciplinary planning.

Traditional chemotherapy is not routinely used for most renal cell cancers. Selected patients may require immunotherapy or other oncology treatments depending on the tumour and stage. Many patients need surveillance only.

Yes. Cancer can recur locally or elsewhere, even after apparently complete removal. Follow-up is tailored to the tumour stage, grade and other risk factors.

Many patients require follow-up imaging after kidney cancer surgery. The type, frequency and duration of imaging depend on the cancer's recurrence risk and kidney function.

Some renal masses prove to be benign on final pathology. Your surgeon will explain the diagnosis, whether any further treatment is required, and the appropriate follow-up.

Selected small kidney masses may be suitable for active surveillance with repeat imaging. This depends on tumour features, overall health and whether delayed treatment would remain appropriate.

Ablation uses freezing or heating techniques to destroy selected kidney tumours without conventional surgical removal. It may be appropriate in some smaller tumours, especially when surgery carries higher risk.

Surgery requires particularly careful planning if you have a solitary functioning kidney. Preserving kidney tissue may be especially important. Your urologist may involve a nephrologist in your care.

No. Nephrectomy removes part or all of a kidney. Nephroureterectomy removes the kidney and ureter, usually including a cuff of bladder, and is commonly performed for selected cancers arising from the upper urinary tract lining.

Bring your GP referral, CT or MRI reports and images if available, medication list, kidney function test results, previous biopsy or operation reports and relevant medical records.