Complete (radical) nephrectomy is surgery to remove all of a kidney. Kidney-sparing surgery (partial nephrectomy) removes part of a kidney.
Nephrectomy (nuh-FREK-tuh-me) is a surgical procedure to remove all or part of a kidney:
Most often a nephrectomy is performed to treat kidney cancer or to remove a noncancerous (benign) tumor. In some cases, a nephrectomy is performed to deal with a diseased or seriously damaged kidney. In the case of a donor nephrectomy, the urologic surgeon removes a healthy kidney from a donor for transplant into a person who needs a functioning kidney.
The urologic surgeon may perform a nephrectomy through a single incision in the abdomen or side (open nephrectomy) or through a series of small incisions in the abdomen using a camera and small instruments (laparoscopic nephrectomy).
In some cases, these laparoscopic procedures are performed using a robotic system. In robotic surgery, the surgeon sits at a computer console near the operating table. He or she controls the camera arm and mechanical arms, which have surgical instruments attached to them that are working inside the patient's body.
During a partial nephrectomy, only the cancerous tumor or diseased tissue is removed (center), leaving in place as much healthy kidney tissue as possible. Partial nephrectomy is also called kidney-sparing surgery.
The most common reason a urologic surgeon performs a nephrectomy is to remove a tumor from the kidney. These tumors are usually cancerous, but they can be noncancerous (benign). Sometimes a nephrectomy is needed because of other kidney diseases.
Most people have two kidneys — fist-sized organs located near the back of the upper abdomen. Your kidneys:
Often a urologic surgeon performs nephrectomy to remove a cancerous tumor or abnormal tissue growth in a kidney. The most common kidney cancer in adults, renal cell carcinoma, begins in the cells that line the small tubes within your kidneys.
Kidney tumors in children are rare. But when they occur, children are more likely to develop a type of kidney cancer called Wilms' tumor, probably caused by the poor development of kidney cells.
The decision about how much kidney tissue to remove depends on:
The urologic surgeon makes a decision based on the results of imaging tests, which may include:
A partial or radical nephrectomy may be needed to remove severely damaged, scarred or nonfunctioning kidney tissue due to traumatic injury or other diseases.
Nephrectomy is generally a safe procedure. But as with any surgery, nephrectomy carries a potential risk of complications, such as:
Long-term complications from a nephrectomy relate to potential problems of living with less than two complete, fully functioning kidneys. Although overall kidney function decreases after a nephrectomy, the remaining kidney tissue usually works well enough for a healthy life.
Problems that may occur with long-term reduced kidney function include:
Potential risks and complications depend on the type of surgery, reasons for surgery, patient's overall health and many other issues, including surgical expertise and experience. For example, at Mayo Clinic these procedures are performed by urologists with advanced training and extensive experience to minimize the chances of problems related to surgery and assure the best possible outcomes.
For a better understanding of potential risks it's important that you discuss these issues with your urologic surgeon.
Before surgery, you'll talk with your urologic surgeon about what options are available for you. Questions you might ask include:
You may need to stay in the hospital from one night to a week or more, depending on the type of procedure. Ask your surgeon and health care team about your probable recovery time.
You'll receive instructions about what to do the day before and the day of your surgery. Make note of any questions you might have, such as:
A nephrectomy procedure is performed during general anesthesia. You'll receive a medication (anesthetic) before surgery so that you won't be awake or feel pain during surgery. You'll also have a urinary catheter — a small tube that drains urine from your bladder — placed before surgery. During the procedure, the urologic surgeon and anesthesia team work together to minimize pain after surgery.
The nephrectomy procedure varies, depending on how the surgery is performed and how much of the kidney is removed. Variations include:
Your urologic surgeon will discuss the advantages and disadvantages of robotic or other types of minimally invasive surgery versus open surgery, including issues such as scarring and the time it takes to return to normal activities.
Recovery time after the procedure and the length of your hospital stay depend on your overall health and the type of nephrectomy performed. The urinary catheter remains in place for a short time during your recovery.
Expect to receive instructions before leaving the hospital about restrictions to your diet and activities. You may be encouraged to begin light, everyday activities as soon as you feel able, but you'll need to avoid strenuous activity or heavy lifting for several weeks.
For most patients, these procedures don't affect quality of life — once you're completely recovered, you can expect to resume your normal routine and activities.
Questions that you may want to discuss with your urologic surgeon or other members of your health care team after your nephrectomy include:
Most people can function well with only one kidney or with one whole kidney and part of the second. You'll likely have checkups to monitor the following factors related to kidney function.
After a nephrectomy or partial nephrectomy, you may have overall normal kidney function. To preserve normal kidney function, your doctor may recommend that you eat a healthy diet, engage in daily physical activity and attend regular checkups to monitor your kidney health.
If you develop chronic kidney disease (reduced kidney function) after complete or partial nephrectomy, your doctor may recommend additional lifestyle changes, including possible dietary changes and being careful about prescription and over-the-counter medications.