Radical nephrectomy

A radical nephrectomy is a surgery where the whole kidney, along with some of the surrounding tissue, is removed. The goal is to remove all the cancer to stop it from spreading. It’s usually done for kidney cancers that haven’t spread but have grown into nearby tissue. It’s also used for stage 1 kidney cancer when a partial nephrectomy isn’t possible. Most people can live with just one healthy kidney without serious problems. 

How it’s done

There are two ways to do a radical nephrectomy.

• One option is open surgery, where the doctor makes a cut in the abdomen to directly reach the kidney and tumour.
• The other option is laparoscopic surgery, where small cuts are made, and the doctor uses thin tube-like instruments to see inside the body and remove the tumour. 

Sometimes, a surgical robot is used to assist with laparoscopic surgery.

Both methods work well. Laparoscopic surgery usually helps you recover faster, but it's more complicated and needs a doctor who is experienced with it.

• Open surgery
  • You’ll be given general anaesthesia, so you’ll be asleep and pain-free during the surgery.
  • The doctor makes a cut in your side or abdomen.
  • The kidney is carefully removed along with surrounding tissue, and sometimes the adrenal gland and nearby lymph nodes.
• Laparoscopic surgery
  • You’ll be given general anaesthesia, so you’ll be asleep and pain-free during the surgery.
  • The doctor makes a larger cut in your side or abdomen.
  • The doctor uses a small camera and special tools to help remove the kidney.
  • The kidney is taken out through one of the small openings.
  • This way of doing surgery usually helps you heal faster and feel less pain.

What happens after the surgery?

• You’ll stay in the hospital for a few days so doctors can make sure you’re healing well. Keep in mind that the length of hospital stay can vary in different countries.
• You’ll need to rest, but light movement like walking will help you heal.
• Most people return to normal activities within 4–8 weeks.
• If you had one kidney removed, the other kidney will take over its job.
• Your doctor will plan regular follow-up visits to check how you are doing. How often you’ll need to come in depends on the results of the tumour that was removed. These follow-up visits usually last for at least 5 years. Common tests during these visits include scans of your abdomen (like CT or ultrasound), chest X-rays, and urine and blood tests.

What are the side effects?

• You might feel some pain or soreness in the treated area, but pain medicine can help.
• It’s normal to feel weak or have low energy while your body heals.
• Your body may take time to adjust, but most people pee normally with one kidney.

You need to go to your doctor or to the hospital right away if you:

• Have a fever (above 38°C or 100.4°F). This could be a sign of infection.
• Have heavy blood loss or pain that doesn’t improve with medication or suddenly gets much worse.

The information provided here is general and may vary based on where you live. You may want to ask your doctor for advice that's specific to your situation. 

Here are some questions you can ask your doctor:

About the surgery

• Why is radical nephrectomy recommended to me?
• How is radical nephrectomy different from partial nephrectomy?
• Will I have open surgery or laparoscopic/robot-assisted surgery? Why?
• How long will the surgery take?
• What are the risks of the surgery and what problems could come up?

After the surgery

• How long will I stay in the hospital? 
• What is the healing process going to be like for me? 
• What should I expect during my healing process at home?
• How will my pain be treated after surgery?
• When can I return to my normal activities, such as work or exercise?
• How soon can I return to work?
• How will my remaining kidney be checked up on?
• Are there lifestyle changes I should make to protect the kidney that I have left?

Follow-up and long-term outlook

• How often will I need follow-up appointments?
• What tests will be done to keep an eye on my kidney health and check if the cancer comes back?
• What are the chances of the cancer coming back after this surgery?
• What happens if the cancer comes back? 
• Will I need any more treatments after surgery?

These questions can help you understand your treatment and feel more prepared.

This chapter contains general information about radical nephrectomy for kidney cancer. If you have any specific questions about your own medical situation you should consult your doctor or other professional healthcare provider. No website or leaflet can replace a personal conversation with your doctor.

Last updated: February 2025