Radical nephrectomy is a surgical procedure to remove an entire kidney. In some cases, nearby structures such as the adrenal gland, surrounding fat, lymph nodes, or part of the ureter (the tube connecting the kidney to the bladder) may also need to be removed.
There are three main surgical techniques that may be used:
- Open surgery
- Laparoscopic (keyhole) surgery
- Robotic-assisted laparoscopic surgery
Dr Jimmy Lam is an expert in kidney surgery and cancer management. With his advanced training and modern techniques, he offers the least invasive approach suitable for your condition, while providing highly personalised care.
Who is suitable for a radical nephrectomy?
A radical nephrectomy may be recommended for:
- Kidney cancer
- Benign (non-cancerous) kidney tumours
- Severely damaged or non-functioning kidneys
Most radical nephrectomies are now performed using laparoscopic or robotic-assisted laparoscopic techniques. An open procedure may be required if:
- The tumour is very large (typically >10cm)
- The tumour invades surrounding veins or structures
- The patient has had multiple prior abdominal surgeries
Your surgeon will assess your individual case and recommend the most appropriate surgical approach.
Benefits of laparoscopic and robotic-assisted nephrectomy
Minimally invasive (laparoscopic and robotic) surgery offers several patient benefits:
- Smaller incisions
- Less bleeding
- Shorter hospital stay
- Quicker recovery
Robotic-assisted surgery (using the da Vinci system) further enhances the surgeon’s capabilities, providing:
- Magnified 3D high-definition vision
- Precision tools with a greater range of motion than the human hand
- Superior dexterity and control for meticulous dissection and removal
When is open radical nephrectomy used?
Open surgery may be required when:
- The tumour is very large or complex
- The cancer extends into nearby veins or organs
- Prior surgeries have caused scarring that makes minimally invasive techniques unsafe
Though more invasive, open surgery may be the safest and most effective method in these situations.
How is the procedure performed?
You will be under general anaesthetic for the duration of the surgery, which typically lasts 1–4 hours depending on complexity.
- Several small incisions are made in the abdomen.
- A camera and surgical tools (or robotic arms) are inserted.
- The kidney is freed from surrounding tissue.
- A slightly larger (around 10cm) incision is made at the end to remove the kidney.
- This incision is usually lower on the abdomen to reduce pain and improve cosmetic appearance.
- The instruments are removed and incisions carefully closed.
- A larger incision (15–20cm) is made, typically along the flank.
- The kidney, and sometimes the ureter, adrenal gland, or lymph nodes, are removed.
- The incision is closed with sutures or staples.
What to expect after surgery
- Hospital stay: 3–7 days (shorter for laparoscopic/robotic surgery)
- Mobility: You will be encouraged to walk early to help prevent pneumonia and blood clots
- Urinary catheter: A tube will drain urine from your bladder temporarily (removed after a day or two)
- Pain: Discomfort is normal and will be managed with medications
- Activity: Light activity as tolerated from early on and avoid heavy lifting or strenuous activity for 4–6 weeks
If you have concerns at any stage, our team is available to support your recovery and ensure your questions are answered promptly.
