Nephrectomy ProcedureDescription, Latest Information and Doctors
Learn About Nephrectomy
Kidney removal, or nephrectomy, is surgery to remove all or part of a kidney. It may involve:
- Part of one kidney removed (partial nephrectomy).
- All of one kidney removed (simple nephrectomy).
- Removal of one entire kidney, surrounding fat, and the adrenal gland (radical nephrectomy). In these cases, neighboring lymph nodes are sometimes removed.
Nephrectomy; Simple nephrectomy; Radical nephrectomy; Open nephrectomy; Laparoscopic nephrectomy; Partial nephrectomy
This surgery is done in the hospital while you are asleep and pain-free (general anesthesia). The procedure can take 3 or more hours.
Simple nephrectomy or open kidney removal:
- You will be lying on your side. Your surgeon will make an incision (cut) up to 12 inches or 30 centimeters (cm) long. This cut will be on your side, just below the ribs or right over the lowest ribs.
- Muscle, fat, and tissue are cut and moved. Your surgeon may need to remove a rib to do the procedure.
- The tube that carries urine from the kidney to the bladder (ureter) and blood vessels are cut away from the kidney. The kidney is then removed.
- Sometimes, just a part of the kidney may be removed (partial nephrectomy).
- The cut is then closed with stitches or staples.
Radical nephrectomy or open kidney removal:
- Your surgeon will make a cut about 8 to 12 inches (20 to 30 cm) long. This cut will be on the front of your belly, just below your ribs. It may also be done through your side.
- Muscle, fat, and tissue are cut and moved. The tube that carries urine from the kidney to the bladder (ureter) and blood vessels are cut away from the kidney. The kidney is then removed.
- Your surgeon will also take out the surrounding fat, and sometimes the adrenal gland and some lymph nodes.
- The cut is then closed with stitches or staples.
Laparoscopic kidney removal:
- Your surgeon will make 3 or 4 small cuts, most often no more than 1 inch (2.5 cm) each, in your belly and side. The surgeon will use tiny probes and a camera to do the surgery.
- Towards the end of the procedure, your surgeon will make one of the cuts larger (about 4 inches or 10 cm) to take out the kidney.
- The surgeon will cut the ureter, place a bag around the kidney, and pull it through the larger cut.
- This surgery may take longer than an open kidney removal. However, most people recover faster and feel less pain after this type of surgery when compared to the pain and recovery period following open surgery.
Sometimes, your surgeon may make a cut in a different place than described above.
Some hospitals and medical centers are doing this surgery using robotic tools.
Kidney removal may be recommended for:
- Someone donating a kidney
- Birth defects
- Kidney cancer or suspected kidney cancer
- A kidney damaged by infection, kidney stones, or other problems
- To help control high blood pressure in someone who has problems with the blood supply to their kidney
- Very bad injury (trauma) to the kidney that cannot be repaired
Risks of any surgery are:
- Blood clots in the legs that may travel to the lungs
- Breathing problems
- Infection, including in the surgical wound, lungs (pneumonia), bladder, or kidney
- Blood loss
- Heart attack or stroke during surgery
- Reactions to medicines
Risks of this procedure are:
- Injury to other organs or structures
- Kidney failure in the remaining kidney
- After one kidney is removed, your other kidney may not work as well for awhile
- Hernia of your surgical wound
Tell your surgeon or nurse if:
- You are or could be pregnant
- You are taking any medicines, including medicines, drugs, supplements, or herbs you bought without a prescription
- You have been drinking a lot of alcohol, more than 1 or 2 drinks a day
Planning for your surgery:
- If you have diabetes, heart disease, or other medical conditions, your surgeon may ask you to see the provider who treats you for these conditions.
- If you smoke, it's important to cut back or quit. Smoking can slow healing and increase the risk for blood clots. Ask your provider for help quitting smoking.
- If needed, prepare your home to make it easier to recover after surgery.
- Ask your surgeon if you need to arrange to have someone drive you home after your surgery.
During the week before your surgery:
- You may be asked to temporarily stop taking medicines that keep your blood from clotting. These medicines are called blood thinners. This includes over-the-counter medicines and supplements such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and vitamin E. Many prescription medicines are also blood thinners.
- Ask your surgeon which medicines you should still take on the day of surgery.
- Let your surgeon know about any illness you may have before your surgery. This includes COVID-19, a cold, flu, fever, herpes breakout, or other illness. If you do get sick, your surgery may need to be postponed.
On the day of the surgery:
- You will most often be asked not to drink or eat anything after midnight the night before the surgery.
- Take the medicines as you have been told, with a small sip of water.
- You will be told when to arrive at the hospital.
You will stay in the hospital for 1 to 7 days, depending on the type of surgery you have. During a hospital stay, you may:
- Be asked to sit on the side of the bed and walk on the same day of your surgery
- Have a tube or catheter that comes from your bladder
- Have a drain that comes out through your surgical cut
- Not be able to eat the first 1 to 3 days, and then you will begin with liquids
- Be encouraged to do breathing exercises
- Wear special stockings, compression boots, or both to prevent blood clots
- Receive shots under your skin to prevent blood clots
- Receive pain medicine into your veins or pills
Recovering from open surgery may be painful because of where the surgical cut is located. Recovery after a laparoscopic procedure is most often quicker with less pain.
The outcome is most often good when a single kidney is removed. If both kidneys are removed, or the remaining kidney does not work well enough, you will need dialysis or a kidney transplant.
Cleveland Clinic Main Campus
Jihad Kaouk is a Urologist practicing medicine in Cleveland, Ohio. He has been practicing medicine for over 37 years. Dr. Kaouk is rated as an Elite provider by MediFind in Nephrectomy. He is also highly rated in 31 other conditions, according to our data. His clinical expertise encompasses Renal Cell Carcinoma (RCC), Prostate Cancer, Horseshoe Kidney, Nephrectomy, and Prostatectomy. Dr. Kaouk is board certified in American Board Of Urology, 2013.
Johns Hopkins Health Care & Surgery Center - Green Spring Station, Lutherville
Dr. Mohamad Allaf is Professor of Urology and Oncology, as well as Director of the Department of Urology and the Brady Urological Institute and Urologist-in-Chief of the Johns Hopkins Hospital. Dr. Allaf is a world renowned surgeon-scientist having performed more than 2,000 robotic procedures and published over 250 peer reviewed research papers in the field's best journals. As one of the busiest robotic radical prostatectomy surgeons in the world, he aims to achieve the best outcomes for his patients. Having trained with Dr. Patrick Walsh, Dr. Allaf has used Dr. Walsh's method of radical prostatectomy as the basis for his own anatomic method to this complex operation. Dr. Allaf is also amongst the leaders in kidney cancer surgery, having served on the American Urological Association Guideline Committee for Kidney Cancer. He led a team who performed the rigorous analysis to help inform the most recent guidelines that was funded by the Agency for Healthcare Research and Quality (AHRQ). He is best known for his ability to save the kidney and remove the tumor in patients with kidney tumors. Dr. Allaf runs a research endeavor aiming to decrease the morbidity associated with the treatment of cancer, and he has mentored numerous leaders in academic urology. He is actively involved in fund raising for research and education, and believes in expanding our base of support in order to advance our important mission. Dr. Allaf is rated as an Elite provider by MediFind in Nephrectomy. He is also highly rated in 16 other conditions, according to our data. His clinical expertise encompasses Renal Cell Carcinoma (RCC), Renal Oncocytoma, Prostate Cancer, Nephrectomy, and Prostatectomy. Dr. Allaf is board certified in American Board Of Urology.
Johns Hopkins Health Care & Surgery Center - Green Spring Station, Lutherville
Nirmish Singla is an Oncologist practicing medicine in Lutherville, Maryland. Dr. Singla is rated as an Elite provider by MediFind in Nephrectomy. He is also highly rated in 26 other conditions, according to our data. His clinical expertise encompasses Upper Tract Urothelial Carcinoma (UTUC), Renal Cell Carcinoma (RCC), Urothelial Cancer, Nephrectomy, and Orchiectomy. Dr. Singla is board certified in American Board Of Urology.
Summary: The goal of this clinical trial is to use the validated PROMIS Emotional Distress - Anxiety - Short Form 8a and PROMIS Emotional Distress-Depression-Short Form pre-and post-intervention to establish a superior correlation between the auriculotherapy treatment and the reduction of perioperative anxiety. Subject population will include those having a partial or total nephrectomy for cancer. Drawing ...
Summary: The purpose of this study is to compare to assess the incidence of post-operative complications related to nephrectomy, which occur up to 1 month after the operation.
Published Date: January 01, 2025
Published By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Moreira DM, Kavoussi LR. Laparoscopic and robotic surgery of the kidney. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 102.
Olumi AF, Blute ML. Open surgery of the kidney. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 101.
Weiss RH, Jaimes EA, Hu SL. Kidney cancer. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 41.