Radical Nephrectomy

Keyhole or robotic removal of the whole kidney for larger, more complex, or centrally placed kidney tumours - performed through small incisions whenever possible.

What is a radical nephrectomy?

A radical nephrectomy is the removal of the whole kidney, together with its surrounding fatty envelope, usually for kidney cancer that is not suitable for kidney-preserving surgery. In most cases Dr Kooner performs this operation laparoscopically or with robotic assistance, through several small keyhole incisions rather than one large open wound. Alternatively, one single small incision is made (single port robot).

The remaining (healthy) kidney takes over urine production. Most patients with a normal second kidney go on to have normal long-term kidney function.

Who is it for?

A radical nephrectomy is typically considered when:

  • The tumour is large or centrally placed such that partial nephrectomy is not safely feasible.
  • The tumour involves major renal blood vessels, the collecting system, or is locally advanced.
  • There are multiple tumours in the kidney, or the kidney is already not functioning.
  • Pre-operative imaging raises concern about more aggressive histology where wider clearance is needed.

Where partial nephrectomy is feasible it is preferred - but for the right indications, radical surgery remains the most reliable way to clear locally confined disease.

Key points

  • Performed laparoscopically or robotically in the majority of cases - small incisions, shorter hospital stay than open surgery.
  • Open surgery is reserved for very large tumours or those involving the major veins.
  • The adrenal gland on the same side is usually left in place unless imaging suggests it is involved.
  • Nearby lymph nodes may be sampled depending on imaging findings.

How Dr Kooner performs it

Under general anaesthetic, four or five small incisions are made in the abdomen or flank (multi port robot). Alternatively, a single small incision is made (single port robot). The kidney is freed from its surrounding tissues, the main renal artery and vein are carefully identified and divided with secure clips or staples, and the kidney is removed inside a sealed specimen bag via a slightly enlarged incision. The small wounds are then closed with dissolvable sutures or surgical glue.

Your journey - what to expect

  1. Before surgery

    Planning & imaging review

    A CT (and sometimes MRI) is reviewed to confirm staging and plan the approach. Baseline blood tests including kidney function are checked, along with anaesthetic fitness.

  2. Day of surgery

    Operation

    Admission on the day of surgery. The keyhole procedure typically takes 2–3 hours.

  3. 2–5 days

    Hospital stay

    Most patients are up and walking the following day and home within 2–5 days, depending on recovery and pain control.

  4. 3–6 weeks

    Return to normal activity

    Light walking and desk work within 1–2 weeks; driving usually from around 2 weeks; strenuous exercise and heavy lifting withheld for 4–6 weeks.

  5. Follow-up

    Pathology review

    A tailored follow-up schedule is agreed based on the final pathology and stage - typically involving periodic imaging and blood tests.

Risks & considerations

  • Bleeding during or after surgery, occasionally requiring transfusion.
  • Injury to nearby structures (bowel, spleen, pancreas or pleura) - uncommon but possible.
  • Infection or wound complications.
  • Development of chronic kidney disease over time - more likely if the remaining kidney was already not working well.
  • Conversion to open surgery - uncommon, but considered in advance where tumours are large or involve vessels.
  • General risks of anaesthesia, DVT/PE, and abdominal surgery.

Frequently asked questions

Can I live a normal life with one kidney?

Yes. The remaining kidney typically increases its workload and most people go on to have essentially normal kidney function. Regular blood pressure and kidney function checks are sensible long-term.

Will I need chemotherapy or radiotherapy?

Traditional kidney cancer does not respond to standard chemotherapy. Surgery alone is curative for most localised disease. If the pathology shows aggressive features, modern immunotherapy and targeted therapies may be recommended and are coordinated with a medical oncologist.

How long will I be in hospital?

For a keyhole radical nephrectomy, typically 2–4 days depending on recovery, pain control, and how far you are travelling from home.

Do I really need the whole kidney out - could it be done as a partial?

Always a fair question. If another surgeon has recommended a full nephrectomy and you are not sure whether partial surgery is possible, Dr Kooner is happy to review the imaging and give a second opinion.

Related services

Good to know: even when a full nephrectomy has been recommended, a brief review of the imaging is sometimes worthwhile to confirm kidney-preserving surgery is not possible.

Speak with Dr Kooner's rooms

Arrange a consultation or request a second opinion on kidney cancer, stones, or reconstructive kidney surgery.