Radical Nephrectomy: A Guide to Kidney Removal Surgery

What Is a Radical Nephrectomy?

A radical nephrectomy is a type of kidney surgery where the entire kidney is removed. In many cases, the procedure also involves the removal of:

  • The adrenal gland (located on top of the kidney)

  • The fatty tissue surrounding the kidney

  • Nearby lymph nodes (depending on the situation)

This surgery is typically done to treat kidney cancer, especially if the tumor is large or has spread to surrounding tissues.


When Is Radical Nephrectomy Recommended?

Doctors may recommend a radical nephrectomy for several conditions, including:

  • Kidney cancer (renal cell carcinoma)
    This is the most common reason, especially if the tumor cannot be removed with a partial nephrectomy.

  • Large or complex kidney tumors
    When tumors are centrally located or involve critical structures, removing the entire kidney may be safer.

  • Severe trauma or damage
    If a kidney is badly injured and beyond repair.

  • Non-cancerous but dangerous conditions
    Like persistent bleeding, infection, or chronic pain when other treatments fail.


Types of Radical Nephrectomy

Radical nephrectomy can be performed using different surgical approaches:

1. Open Nephrectomy
  • Involves a larger incision on the side or abdomen

  • Allows direct access to the kidney and nearby structures

  • Often used for very large tumors or complex cases

2. Laparoscopic Nephrectomy
  • Minimally invasive

  • Uses small incisions and a camera to guide the surgeon

  • Faster recovery and less pain post-surgery

Frequently asked questions

Before Surgery

You’ll undergo several evaluations including:

  • Blood and urine tests

  • Imaging scans (CT, MRI)

  • Heart and lung function assessments

Your healthcare team will give you detailed instructions on fasting, medications, and what to bring on the day of surgery.

During Surgery
  • You’ll receive general anesthesia

  • The procedure typically takes 2–4 hours

  • The surgical team will carefully remove the kidney and associated tissues

After Surgery
    • Hospital stay: Usually 2–4 days, depending on the surgical method

    • Pain management: Through IV or oral medications

    • Walking and movement: Encouraged early to prevent complications

    • Return to normal activity: Typically within 4–6 weeks

As with any major surgery, radical nephrectomy comes with potential risks:

  • Infection or bleeding

  • Blood clots

  • Injury to nearby organs (e.g., bowel, spleen)

  • Hernia at the incision site

  • Reduced kidney function (especially if the remaining kidney isn’t healthy)

Your surgeon will discuss these risks with you in detail based on your specific case.

The human body can function well with just one kidney. After recovery, most people:

  • Lead normal, active lives

  • Need regular follow-ups to monitor kidney function

  • Should avoid overuse of certain medications (like NSAIDs)

  • Should adopt a kidney-friendly lifestyle (hydration, blood pressure control, healthy diet)

If you had cancer, your care team will also continue to monitor for any signs of recurrence or metastasis.

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