Comprehensive nephrectomy services

If you’ve been diagnosed with kidney cancer, getting a nephrectomy may be your care team’s top recommendation for treatment. By definition, nephrectomy is a surgery that removes all or part of your kidney. Sometimes nephrectomy is called renal surgery. You can expect a urologist, who specializes in treating urologic conditions related to the kidneys and urinary tract, to be part of your care team.

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What are the types of nephrectomy surgery?

Nephrectomy surgery can be considered partial or radical. During partial nephrectomy, only some kidney tissue is removed, while the entire kidney is removed as part of radical nephrectomy.

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

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

Imaging tests can help your care team better understand the answers to some of these questions. You may undergo imaging such as CT, intravenous pyelogram (IVP) or ultrasound.

Partial nephrectomy

Partial nephrectomy is appropriate when the malignant (cancerous) tissue in your kidney can be removed while leaving healthy tissue intact. This procedure is also called a kidney-sparing or nephron-sparing surgery.

Radical nephrectomy

Radical nephrectomy, or the complete removal of a kidney, is performed when the cancer has spread or your kidney is badly damaged. Other components of the kidney will also be removed, including the adrenal gland on top of the kidney, the fatty tissue around the kidney and a portion of the ureter (the tube connecting the kidney and bladder).

How is the nephrectomy procedure performed?

Once your care team determines whether you’ll have a partial or radical nephrectomy, your surgeon will make a recommendation on how the surgery is performed. These options include open, laparoscopic or robotic surgery.

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 Advocate, 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.

What are the risks of nephrectomy?

Many surgeries, including nephrectomy, carry risks such as infection, blood clots and the risk of undergoing anesthesia. Long term, you may experience complications from having had nephrectomy surgery, such as:

• High blood pressure, also called hypertension
• High protein levels in your urine, a potential sign of kidney damage
• Chronic kidney disease, which gradually damages the kidneys and lessens their ability to remove waste from your blood

What to expect when getting a nephrectomy

It may come as a surprise that one healthy kidney can be as effective as two kidneys. In fact, you might not notice a difference in your quality of life at all, as most people with one kidney function well. Ask your care team if you have specific questions or concerns in preparation for nephrectomy.

Before your nephrectomy

As with many surgeries, you’ll undergo general anesthesia so you’ll be in a sleep-like state where you don’t feel pain. You’ll also have a catheter placed in your urethra to drain urine. Your nephrectomy will take about three or more hours.

After your nephrectomy

You can expect 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 be removed within a few days as well. Your blood pressure, electrolytes and fluid levels will be monitored closely, as they relate to how well your remaining kidney or kidneys function.

Nephrectomy recovery

You’ll be advised to rest and recover for six weeks or more after nephrectomy. Don’t lift heavy objects or do strenuous activity. When your care team gives you the OK, you can return to your normal routines – and you most likely won’t notice a change in your quality of life.

After nephrectomy, you may have to make some modifications to your lifestyle:

• Avoid contact sports so you don’t damage your remaining kidney. Wear extra protective gear if you do decide to play sports such as hockey, football or soccer, or engage in martial arts.
• Eat well and try to avoid excess salt in your diet. Make sure you’re drinking enough water, too.
• Maintain a healthy weight by eating a balanced diet and exercising regularly.

You’ll also meet with your care team at regular checkups so they can monitor your kidney function. You can expect checks of your blood pressure and testing to measure levels of protein in your urine and how well your kidney is filtering waste from your blood.

If your original diagnosis warrants additional therapies to prevent your cancer from spreading or recurring, your care team may suggest including chemotherapy, radiation or hormone therapy as part of your treatment plan.