Partial nephrectomy

Partial nephrectomy is used to treat kidney cancer that has not spread to other tissue. It is recommended whenever possible. The aim is to remove the part of the kidney with abnormally growing cells (tumour) but to leave as much as possible of the healthy kidney.

How is partial nephrectomy performed?

First, the exact location of the tumour is determined. A renal artery clamp is used to stop the blood supply to the kidney during the surgery to minimise blood loss. This allows for the removal of the entire tumour. Crushed ice is sometimes used to lower the temperature of the kidney during the surgery and prevent damage from lack of blood flow.

After the tumour is removed the surgeon will suture the wound and apply sealing agents to stop further bleeding if necessary (Fig. 1).

If the tumour has invaded the collecting system of the kidney, the surgeon may need to place a JJ-stent to make sure urine can flow through the urinary system. The stent will be removed when your wounds have healed and your urine flow is back to normal. This can take anywhere between several days and a few weeks (Fig. 2).

Fig. 1: In partial nephrectomy the tumour is removed, leaving as much as possible of the healthy kidney tissue.
Fig. 1: In partial nephrectomy the tumour is removed, leaving as much as possible of the healthy kidney tissue.
Fig 2. A Double-J stent is inserted to make sure urine can flow through the urinary tract.
Fig 2. A Double-J stent is inserted to make sure urine can flow through the urinary tract.

Partial nephrectomy can be performed as open or laparoscopic surgery.

Open surgery is the standard of care for partial nephrectomy. The surgeon cuts the abdominal wall to access the kidney and the tumour directly.

Laparoscopic partial nephrectomy is a minimally invasive surgery. For this kind of procedure, the doctor inserts small plastic tubes into your abdomen. Through these tubes the surgeon can insert the instruments needed to remove the tumour. One of the small tubes is used to insert a camera which allows the surgeon to see a high-quality image of your kidney on a video monitor (Fig. 3). Laparoscopic surgery can also be done assisted by a surgical robot system.

Fig. 3: For laparoscopic surgery the surgeon inserts the surgical instruments through small incisions in the abdomen.
Fig. 3: For laparoscopic surgery the surgeon inserts the surgical instruments through small incisions in the abdomen.