Radical Nephrectomy

Learn more about radical nephrectomy surgery at King Edward VII’s Hospital

Why would I need a radical nephrectomy?

A radical nephrectomy is when the whole kidney, including the surrounding fatty tissue, lymph nodes, and sometimes the adrenal gland and top end of the ureter are removed.

Usually this procedure is undertaken to remove a tumour when the cancer has not spread to other organs.

What symptoms does a radical nephrectomy address?

A radical nephrectomy is used to mainly treat kidney cancer.

Although there are no obvious symptoms of kidney cancer, a radical nephrectomy will help with the below symptoms and assist in avoiding the spread of cancer to other organs:

• Blood in urine
• Persistent pain in lower back or side, below the ribs
• Loss of appetite and weight loss
• High temperature
• Hypertension (high blood pressure)
• Swollen glands
• Night sweats

When should you speak to your specialist about a radical nephrectomy?

If you have any of the above symptoms or are concerned about any unusual symptoms or pain, please see one of our specialists in renal cancer treatment.

How is a robotic assisted laparoscopic radical nephrectomy performed?

You will be placed under general anaesthetic (you will be unconscious) for the procedure.

During the procedure, approximately three-five very small (keyhole) incisions will be made in your abdomen. Your surgeon will place a telescope (called robotic laparoscope) in one incision, and use robotic tools in the others. The robotic laparoscope allows your surgeon to see a magnified image of your abdomen for the operation.

Your abdomen is filled with carbon dioxide to create more space, and your surgeon will then cut and divert the blood supply from the kidney so they can carefully remove it. Once the kidney and tumour has been removed, it is placed in a bag and removed through one of your incisions.

The incisions are then closed with sutures, and the carbon dioxide removed.

What is the recovery like for a radical nephrectomy?

Your recovery will depend on multiple factors, including your age, fitness level and the nature of your procedure. Your specialist and nursing team will give you information about your recovery.

Your hospital stay will usually be between one-two days. You will likely feel some pain, discomfort and nausea in the first one-two days, and you may experience some transient pain in your shoulder from the carbon dioxide.

Your intestinal function may be a little slow after surgery, so a small liquid diet is recommended until you pass gas and your appetite returns. This usually only lasts a day.

It is recommended to avoid heavy lifting or exertion for up to 4 weeks following surgery, although gentle exercise such as walking is encouraged. Most people can return to full activity, including work, after three-four weeks.

Your remaining kidney will take over the function of your removed kidney.

Are there any risks/complications associated with a radical nephrectomy?

As with any major medical procedure, it’s possible for risks or complications to arise. Please speak to your specialist for more information.

Here are some risks and complications associated with the procedure:

• Abdominal bloating (common)
• Bleeding (that needs further transfusions)
• Infection of the incisions
• Damage to lung capacity
• Conversion to an open operation
• Injury to other organs
• Poor function of the remaining kidney, leading to the need for dialysis

How can I prepare for a radical nephrectomy?

Prior to surgery, your surgeon will discuss with you how best to prepare, as each patient is different with differing needs.

Common preparations for surgery include:

• Routine blood tests, x rays or scans as requested by your surgeon
• Taking steps to stop smoking if you smoke
• Losing weight if you’re overweight
• Remaining active and doing regular exercise

Are there alternatives for a radical nephrectomy?

There are some alternatives to a radical nephrectomy. Your specialist will discuss these and your best course of treatment with you.

These might include:

• Observation
• Embolisation (cutting off blood supply to tumour)
• Partial nephrectomy (part of the kidney is removed)