This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science.
This page was updated on May 20, 2022.
Surgery is the main treatment for most kidney cancers. The surgical procedure, known as a nephrectomy, may involve removing all or just part of your kidney. Some patients may require removal of nearby tissues and lymph nodes as well.
The types of surgery used for kidney cancer are:
Which type is right for you depends on where the tumor is located, how big it is, how many tumors you have, and whether the cancer has spread to nearby lymph nodes or distant organs.
Simple nephrectomy: This surgery is to remove all of one kidney.
Radical nephrectomy: As with a simple nephrectomy, this one involves removing an entire kidney. However, a radical nephrectomy also involves removal of the adrenal gland (which sits atop the kidney) and a section of the ureter (the tube that leads to the bladder). Fatty tissue surrounding the kidney also may be excised.
Your doctor is likely to recommend a radical nephrectomy if your tumor is large or is located in the middle of your kidney, or if you have multiple tumors in one kidney. Also, a radical nephrectomy may be recommended if the cancer has spread to your lymph nodes or other organs.
Some kidney tumors grow directly in the renal vein and enter the vena cava, the largest vein in the body, on its way to the heart. In this case, you need a cardiovascular surgeon to assist with the removal of your kidney.
Partial nephrectomy: During a partial nephrectomy, the surgeon removes only the diseased section of your kidney. This is the preferred treatment for those whose cancer is in the early stages.
If you have a single tumor that’s smaller than 4 cm, your surgeon is likely to recommend a partial nephrectomy. However, a partial nephrectomy may be performed on tumors as large as 7 cm.
An advantage to a partial nephrectomy is that you still have a working kidney. Also, the surgeon makes a smaller incision with a partial nephrectomy than with a radical nephrectomy, which likely means fewer side effects and a faster recovery.
There are different approaches to kidney surgery as well.
Laparoscopic and robotic surgery may take longer than traditional open surgery, but they may allow for a quicker recovery than open surgery. Your scars may fade with time.
Neither minimally invasive approach may be possible if your tumor measures more than 7 cm, or if it’s grown into the renal vein or spread to nearby lymph nodes.
Laparoscopic and robotic nephrectomies require special expertise. You should look for a surgeon who has this expertise if this is your appropriate option.
These types of kidney surgery are performed in the hospital, require general anesthesia and typically take about three or more hours.
During a simple nephrectomy, open kidney surgery and radical nephrectomy: Your surgeon cuts an incision—up to 12 inches—below your ribs or over your lowest rib. Your surgeon may have to remove a rib to move muscle, fat and tissue and reach your kidney. After the necessary removals, your incision is closed with stitches or staples.
Specifically, during a radical nephrectomy:
During laparoscopic nephrectomy:
After surgery, movement is important to prevent deep vein thrombosis (blood clots), also known as DVT. If you’re at high risk for DVT, you may be given a preventive dose of blood thinners and asked to wear compression stockings.
You may be discharged from the hospital in one to seven days, depending on the type of surgery and how fast you recover.
A nephrectomy is surgery, which means there may be some risks involved. Your doctor may be able to give you medication that provides pain relief or provide other treatments. Possible risks include:
It may take three to six weeks to recover from kidney surgery. You should be able to resume normal activities in four to six weeks.
You may experience pain in your belly or on your side where your kidney was removed. You also may have:
To speed your recovery and stay safe, consider these tips:
In most cases, you may eat a normal healthy diet. Be sure to drink four to eight glasses of water or liquid a day. Ask your doctor whether you need special dietary instructions or restrictions.
Some pain medications may cause constipation. Moving may help, and so can foods that are high in fiber. Ask your doctor about laxatives or stool softeners if necessary.
Call your doctor if:
Any of these may be signs of an infection.
You have two kidneys and can live with one healthy kidney. Your doctor will order tests to be sure your healthy kidney remains so. These tests include:
If you have one kidney, you should avoid sports or any activities where you may be injured by a collision or heavy contact.
The success of surgery depends largely on the cancer stage at diagnosis.